EDITORIALS
Graduate Education in Thoracic Surgery Benson R. Wilcox, MD Department of Cardiothoracic Surgery, The University of North Carolina, Chapel Hill, North Carolina
F
or thoracic surgeons, education has always been an important subject; it appears now to have become a “hot” topic. It is rare in a gathering of thoracic surgeons that the conversation does not, at some point, turn to the topic of residency training and the perceived need to “do something about it.” Sensing this ferment, an ad hoc committee has been formed in the hope of providing some shape to this rather amorphous movement. Although the Council of The Society of Thoracic Surgeons has agreed to support this undertaking, the committee must not be thought of as representing any particular group or point of view. A brief examination of the membership shows it to be inclusive and diverse in its makeup. All are members of The Society of Thoracic Surgeons and the American Association for Thoracic Surgery, including the treasurers of both organizations, and most are members of either the Western or Southern Thoracic Surgical Associations. There are present and former members of the American Board of Surgery, the American Board of Thoracic Surgery, the Residency Review Committee for Thoracic Surgery, and the Thoracic Surgery Directors Association. Practice profiles reveal the members to be general thoracic and cardiac surgeons from metropolitan areas and small towns, large private clinics and solo practice, as well as academic institutions and the private arena-truly a representative spectrum of thoracic surgeons. The first meeting of this group was held in conjunction with that of the American Association for Thoracic Surgery in May 1991. At that time, an effort was made to define our tasks and to determine our limits. First of all, we see ourselves as a fact-finding body that will gather essential information that is fundamental to any subsequent deliberations. Second, having gathered those data, we would act as a facilitator in bringing together those who are responsible for what we call thoracic surgery training. We see our task as a three-step process. Detailed, in-depth information will be collected on what is the present state of thoracic surgical residency education. Because approximately 70% of the time currently spent in training to be a thoracic surgeon is in conjunction with our general surgical colleagues, we will require special help from them as well as from our own program directors. Address reprint requests to Dr Wilcox, Division of Cardiothoracic Surgery, The School of Medicine, The University of North Carolina, CB 7065, 108 Burnett-Womack Bldg, Chapel Hill, NC 27599. Dr Wilcox is Chairman of the Ad Hoc Committee for Graduate Education in Thoracic Surgery; the members are Richard P. Anderson, William A. Gay, Jr, George C. Kaiser, Mark B. Orringer, W. Gerald Rainer, and Robert L. Replogle.
0 1991 by The Society of Thoracic Surgeons
Second, but not necessarily sequentially, we will make an effort to discover what people believe ought to be done for thoracic residents in training. For this, we plan to use the Delphi method of sampling a broad spectrum of practicing thoracic surgeons as well as those individuals who play a more direct role in the educational process. It is absolutely essential that all who are contacted make a special effort to respond thoughtfully to this vital phase of our task. In the third phase, having made some determinations as to what the present situation is, and having gathered thoughtful opinions as to what it ought to be, an effort will be made to reconcile the two. It is hoped that the ad hoc committee can then act as a catalyst in assuring that the reactions produced by mixing these elements proceed to a fruitful end. Preliminary plans call for a consensus conference (or more than one conference) that involves those bodies (particularly, but not exclusively, the directors, the boards, and residency review committees) who have the ultimate responsibility for overseeing and regulating the education of our residents. Finally, it must be noted that the committee begins this undertaking with three basic preconceptions that will necessarily have some effect on how we go about our task. First, we all believe that thoracic surgery is a broad discipline encompassing both general thoracic and cardiovascular skills, and that no attempt should be made to artificially separate these areas of interest. This is not to deny the place for refining the focus of one’s skills and practice to fill special needs or deliver particular services; however, we believe in the value of a traditional definition of thoracic surgery as a broad and unified discipline. Also, because our specialty is broad in scope, we believe our residents should have the benefit of a broad educational experience. Too fine a focus too soon may lead to an end product that is too narrowly constructed to meet the challenges and changes that are inevitable in the 21st century. This point of view does not constrict our options; it simply intensifies the need to be innovative and comprehensive in our thinking. The third presupposition recognizes that we are an ad hoc committee with a limited life expectancy. Thus, it is important that we move on with our task, for the longer it takes, the less likely it is that our effort will prove fruitful. We ask that all those who are interested in the future of our discipline invest some time now in thinking about the best ways to educate our successors. Please help with this important task.
Ann Thorac Surg 1991;52:177
0003-4975/91/$3.50
Graduate Education in Thoracic Surgery Benson R. Wilcox, MD Department of Cardiothoracic Surgery, The University of North Carolina, Chapel Hill, North Carolina
F
or thoracic surgeons, education has always been an important subject; it appears now to have become a “hot” topic. It is rare in a gathering of thoracic surgeons that the conversation does not, at some point, turn to the topic of residency training and the perceived need to “do something about it.” Sensing this ferment, an ad hoc committee has been formed in the hope of providing some shape to this rather amorphous movement. Although the Council of The Society of Thoracic Surgeons has agreed to support this undertaking, the committee must not be thought of as representing any particular group or point of view. A brief examination of the membership shows it to be inclusive and diverse in its makeup. All are members of The Society of Thoracic Surgeons and the American Association for Thoracic Surgery, including the treasurers of both organizations, and most are members of either the Western or Southern Thoracic Surgical Associations. There are present and former members of the American Board of Surgery, the American Board of Thoracic Surgery, the Residency Review Committee for Thoracic Surgery, and the Thoracic Surgery Directors Association. Practice profiles reveal the members to be general thoracic and cardiac surgeons from metropolitan areas and small towns, large private clinics and solo practice, as well as academic institutions and the private arena-truly a representative spectrum of thoracic surgeons. The first meeting of this group was held in conjunction with that of the American Association for Thoracic Surgery in May 1991. At that time, an effort was made to define our tasks and to determine our limits. First of all, we see ourselves as a fact-finding body that will gather essential information that is fundamental to any subsequent deliberations. Second, having gathered those data, we would act as a facilitator in bringing together those who are responsible for what we call thoracic surgery training. We see our task as a three-step process. Detailed, in-depth information will be collected on what is the present state of thoracic surgical residency education. Because approximately 70% of the time currently spent in training to be a thoracic surgeon is in conjunction with our general surgical colleagues, we will require special help from them as well as from our own program directors. Address reprint requests to Dr Wilcox, Division of Cardiothoracic Surgery, The School of Medicine, The University of North Carolina, CB 7065, 108 Burnett-Womack Bldg, Chapel Hill, NC 27599. Dr Wilcox is Chairman of the Ad Hoc Committee for Graduate Education in Thoracic Surgery; the members are Richard P. Anderson, William A. Gay, Jr, George C. Kaiser, Mark B. Orringer, W. Gerald Rainer, and Robert L. Replogle.
0 1991 by The Society of Thoracic Surgeons
Second, but not necessarily sequentially, we will make an effort to discover what people believe ought to be done for thoracic residents in training. For this, we plan to use the Delphi method of sampling a broad spectrum of practicing thoracic surgeons as well as those individuals who play a more direct role in the educational process. It is absolutely essential that all who are contacted make a special effort to respond thoughtfully to this vital phase of our task. In the third phase, having made some determinations as to what the present situation is, and having gathered thoughtful opinions as to what it ought to be, an effort will be made to reconcile the two. It is hoped that the ad hoc committee can then act as a catalyst in assuring that the reactions produced by mixing these elements proceed to a fruitful end. Preliminary plans call for a consensus conference (or more than one conference) that involves those bodies (particularly, but not exclusively, the directors, the boards, and residency review committees) who have the ultimate responsibility for overseeing and regulating the education of our residents. Finally, it must be noted that the committee begins this undertaking with three basic preconceptions that will necessarily have some effect on how we go about our task. First, we all believe that thoracic surgery is a broad discipline encompassing both general thoracic and cardiovascular skills, and that no attempt should be made to artificially separate these areas of interest. This is not to deny the place for refining the focus of one’s skills and practice to fill special needs or deliver particular services; however, we believe in the value of a traditional definition of thoracic surgery as a broad and unified discipline. Also, because our specialty is broad in scope, we believe our residents should have the benefit of a broad educational experience. Too fine a focus too soon may lead to an end product that is too narrowly constructed to meet the challenges and changes that are inevitable in the 21st century. This point of view does not constrict our options; it simply intensifies the need to be innovative and comprehensive in our thinking. The third presupposition recognizes that we are an ad hoc committee with a limited life expectancy. Thus, it is important that we move on with our task, for the longer it takes, the less likely it is that our effort will prove fruitful. We ask that all those who are interested in the future of our discipline invest some time now in thinking about the best ways to educate our successors. Please help with this important task.
Ann Thorac Surg 1991;52:177
0003-4975/91/$3.50
