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Cardiothoracic Surgery Training: An Honest and Anonymous Assessment of the Trainee Experience
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  • Fatima Wilder G,
  • Jason Han,
  • William Cohen G,
  • Clauden Louis,
  • Hunter Mehaffey,
  • Alexander Brescia,
  • David Blitzer,
  • Jessica Luc,
  • Garrett Coyan,
  • Jordan Bloom,
  • Marissa Cevasco,
  • Ahmet Kilic
Fatima Wilder G
Johns Hopkins Medicine Department of Surgery

Corresponding Author:[email protected]

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Jason Han
University of Pennsylvania
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William Cohen G
University of Pennsylvania
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Clauden Louis
University of Rochester
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Hunter Mehaffey
University of Virginia
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Alexander Brescia
University of Michigan Department of Surgery
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David Blitzer
Columbia University Department of Surgery
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Jessica Luc
The University of British Columbia Library
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Garrett Coyan
University of Pittsburgh Department of Cardiothoracic Surgery
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Jordan Bloom
Massachusetts General Hospital Department of Orthopaedic Surgery
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Marissa Cevasco
University of Pennsylvania
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Ahmet Kilic
Johns Hopkins Medicine Department of Surgery
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Abstract

Objective(s): Trainee assessments aim to identify areas for improvement and address problems within training programs. However, effectiveness is limited by an inability to assess programs anonymously. We hypothesized concern for undesired repercussions may discourage honest responses. To test this, we conducted a comprehensive survey of trainees to assess their educational and work-related experiences anonymously.  Design: A 51-question survey was distributed electronically to the Thoracic Surgery Residents Association (TSRA) membership. Questions were multiple-choice. The Likert scale was utilized.  Setting: The survey was accessed electronically and was completed by participants nationwide. Participants: Trainees were incentivized to complete the survey with the opportunity to receive a $50 gift card or TSRA textbook. 109 of 551 cardiothoracic surgery trainees completed the survey. Results: 109 trainees (109/551, 19.8%) completed the survey. 57.8% of respondents reported complying with work hour restrictions, but 32.2% (n=35) did not feel comfortable reporting violations honestly. The majority of respondents agreed or strongly agreed that their program was preparing them to independently perform low risk cardiac (4.19 [1.22]) and thoracic (4.08 [1.13]) cases independently, 30.3% of chief residents reported planning to pursue additional training. 66% of respondents stated they would select the same program again. 33% reported having high morale, 47.7% moderate and 19.3% poor or declining morale. 84.4% of respondents did not feel their race or gender significantly impacted their training, 26.6% reported systemic bias in recruitment of new trainees or faculty, and 38.5% believed there was inadequate diversity among faculty and trainees. 30.3% reported experiencing verbal or physical harassment by an attending or fellow (14.7%).  Conclusions: Despite reporting an overall positive operative experience, a significant number of trainees plan to pursue additional training. The survey identifies important areas for attention including underreporting of issues related to diversity, as well as verbal and physical harassment by fellows and attendings.