A Decade of Change: Training and Career Paths of Cardiothoracic Surgery Residents 2003 to 2014 Elizabeth H. Stephens, MD, PhD, David Odell, MD, William.

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A Decade of Change: Training and Career Paths of Cardiothoracic Surgery Residents 2003 to 2014 Elizabeth H. Stephens, MD, PhD, David Odell, MD, William Stein, MD, Damien J. LaPar, MD, MS, Walter F. DeNino, MD, Muhammad Aftab, MD, Kathleen Berfield, MD, Amanda L. Eilers, DO, Shawn Groth, MD, John F. Lazar, MD, Michael P. Robich, MD, MPH, Asad A. Shah, MD, Danielle A. Smith, MD, Cameron Stock, MD, Vakhtang Tchantchaleishvili, MD, Carlos M. Mery, MD, MPH, Joseph W. Turek, MD, PhD, Jorge Salazar, MD, Tom C. Nguyen, MD The Annals of Thoracic Surgery Volume 100, Issue 4, Pages 1305-1314 (October 2015) DOI: 10.1016/j.athoracsur.2015.04.026 Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Percentage of residents in integrated programs. The Annals of Thoracic Surgery 2015 100, 1305-1314DOI: (10.1016/j.athoracsur.2015.04.026) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Specialty interest and intention to pursue additional training. For a given variable, data points with different letters were statistically significantly different on post hoc testing, whereas data points with the same letter or no letters were not statistically significantly different. Residents were queried regarding specialty interest (blue line = mixed cardiac; red line = adult cardiac; green line = general thoracic; purple line = congenital) and additional training (black dashed line) in separate questions, but their responses are plotted on the same graph for consolidation. The Annals of Thoracic Surgery 2015 100, 1305-1314DOI: (10.1016/j.athoracsur.2015.04.026) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Adequacy of training with oral board pass rates (green line) superimposed. Note: the board pass rate would reflect residents who graduated 1 to 2 years prior. (Blue line, adequately trained; red line, prepared for boards.) The p value is the overall p value comparing all years. The Annals of Thoracic Surgery 2015 100, 1305-1314DOI: (10.1016/j.athoracsur.2015.04.026) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Percentage of job seekers with none (blue line), 1 or 2 (red line), or more than 2 (green line) firm job offers. The p value represents the overall p value comparing all years. The Annals of Thoracic Surgery 2015 100, 1305-1314DOI: (10.1016/j.athoracsur.2015.04.026) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Graduating residents with debt greater than $200,000. However in 2008 the cutoff was >$150,000 (not >$200,000). Data do not take into account inflation. The Annals of Thoracic Surgery 2015 100, 1305-1314DOI: (10.1016/j.athoracsur.2015.04.026) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 Percentage of residents who would recommend cardiothoracic surgery (CTS) to trainees. The p value represents the overall p value comparing all years. For a given variable, data points with different letters were statistically significantly different on post hoc testing, whereas data points with the same letter or no letters were not statistically significantly different. (Blue line, agree; red line, neutral; green line, disagree.) The Annals of Thoracic Surgery 2015 100, 1305-1314DOI: (10.1016/j.athoracsur.2015.04.026) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 7 Study aids for the in training exam. (Blue line, Thoracic Surgery Residents’ Association (TSRA) Review; red line, Thoracic Surgery Directors’ Association (TSDA) curriculum; green line, Self Education Self Assessment in Thoracic Surgery (SESATS); turquoise line, textbooks; blue line, TSRA clinical scenarios.) The Annals of Thoracic Surgery 2015 100, 1305-1314DOI: (10.1016/j.athoracsur.2015.04.026) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 8 Percentage of residents who frequently (blue line), occasionally (red line), or rarely (green line) use simulation. The p value represents the overall p value comparing all years. For a given variable, data points with different letters were statistically significantly different on post hoc testing, whereas data points with the same letter or no letters were not statistically significantly different. The Annals of Thoracic Surgery 2015 100, 1305-1314DOI: (10.1016/j.athoracsur.2015.04.026) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions