title: Cardiothoracic surgery resident education: update on resident recruitment and job placement.
abstract: BACKGROUND
  Applications to cardiothoracic surgery training programs have steadily declined. The application cycle for 2004 marked the first time the number of applicants was lower than the positions offered. This survey reflects on this trend in applications and the perspectives of current and graduating residents.
  
  
  METHODS
  In June 2004, the Thoracic Surgery Residents Association, in conjunction with CTSNet, surveyed residents completing accredited cardiothoracic training or additional subspecialization. Participation was anonymous and voluntary.
  
  
  RESULTS
  Of the 140 graduates, 88 responded. Most were male (92%) and married (72%). Their average age was 35.7 years, and 56% had children. The mean educational debt was less than $50,000. Of the 88 respondents, 69 (78%) had plans to seek jobs whereas 15 (17%) sought additional training. Among job-seeking residents, 12% received no offers. Also, 59% of graduates initially sought a position in academics and 41% in private practice. Nearly one quarter (23%) reported that they would not choose a career in cardiothoracic surgery again, and more than half (52%) would not strongly recommend cardiothoracic surgery to potential trainees. Almost all (90%) of the graduates believed that the number of cardiothoracic training spots should be decreased, and 92% believed that a reduction in training positions should be achieved by closing marginal training programs. Additionally, 91% believed reimbursement for cardiothoracic surgery was inadequate, and 88% thought low reimbursement resulted in restricted patient access and decreased quality of care.
  
  
  CONCLUSIONS
  Cardiothoracic training programs are having difficulty in both applicant recruitment and in suitable job placement. This frustration in the job search coupled with reimbursement and lifestyle issues most likely contributes to the general dissatisfaction conveyed by the graduates. If these trends continue, the field will be faced with a crisis of unfilled residency programs and unemployed graduates.
authors.affiliation: University of Texas Health Science Center, San Antonio, San Antonio, Texas 78229, USA. salazarj2@uthscsa.edu
authors.forename: Jorge D
authors.initials: JD
authors.lastname: Salazar
authors.forename: Peter
authors.initials: P
authors.lastname: Ermis
authors.forename: Antonio
authors.initials: A
authors.lastname: Laudito
authors.forename: Richard
authors.initials: R
authors.lastname: Lee
authors.forename: Grayson H
authors.initials: GH
authors.lastname: Wheatley
authors.forename: Sean
authors.initials: S
authors.lastname: Paul
authors.forename: John
authors.initials: J
authors.lastname: Calhoon
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002321:Career Choice; D004503:Education, Medical, Graduate / Q000706:statistics & numerical data; D005260:Female; D005544:Forecasting; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D007586:Job Application; D007588:Job Satisfaction; D008297:Male; D008393:Marriage; D010560:Personnel Selection / Q000706:statistics & numerical data*; D010820:Physicians / Q000523:psychology / Q000600:supply & distribution; D010822:Physicians, Women / Q000523:psychology / Q000706:statistics & numerical data; D011364:Professional Practice / Q000706:statistics & numerical data; D012456:Salaries and Fringe Benefits; D013903:Thoracic Surgery / Q000193:education*; D014478:Unemployment; D014481:United States; D000078329:Workforce