title: Factors affecting interest in cardiothoracic surgery: survey of North American general surgery residents.
abstract: BACKGROUND
  Applications to cardiothoracic surgery (CTS) training programs have declined precipitously. The viewpoints of potential applicants, general surgery residents, have not yet been assessed. Their perceptions are crucial to understanding the cause and formulating appropriate changes in our educational system.
  
  
  METHODS
  An initial survey instrument was content-validated, and the final instrument was distributed electronically between March 24 and May 2, 2008 through 251 general surgery program directors to all Accreditation Council for Graduate Medical Education-accredited general surgery residents (7,508).
  
  
  RESULTS
  The response rate was 29% (2153 residents; 89% programs). Respondent's demographics matched existing data; 6% were committed to CTS, and 26% reported prior or current interest in CTS. Interest waned after postgraduate year 3. Interest correlated with CTS rotation duration. Of the respondents committed to CTS, 76% had mentors (71% were cardiothoracic surgeons). CTS had the most shortcomings among 9 subspecialties. Job security and availability accounted for 46% of reported shortcomings (3 to 14 times higher than other subspecialties). Work schedule accounted for 25%. Length of training was not a very important factor, although it was identified as an option to increase interest in CTS. Residents who were undecided or uninterested in CTS were twice as likely to cite the ability to balance work and personal life as important than residents who chose CTS.
  
  
  CONCLUSIONS
  The dominant concern documented in the survey is job security and availability. The importance of mentorship and exposure to CTS faculty in promoting interest was also evident. Decision makers should consider these findings when planning changes in education and the specialty.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA. avaporci@mdanderson.org
authors.forename: Ara A
authors.initials: AA
authors.lastname: Vaporciyan
authors.forename: Carolyn E
authors.initials: CE
authors.lastname: Reed
authors.forename: Clese
authors.initials: C
authors.lastname: Erikson
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Dill
authors.forename: Andrea J
authors.initials: AJ
authors.lastname: Carpenter
authors.forename: Kristine J
authors.initials: KJ
authors.lastname: Guleserian
authors.forename: Walter
authors.initials: W
authors.lastname: Merrill
mesh_terms: D000068:Accreditation; D000328:Adult; D002170:Canada; D002648:Child; D003625:Data Collection; D005190:Family; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009656:North America; D010822:Physicians, Women / Q000706:statistics & numerical data; D013903:Thoracic Surgery / Q000706:statistics & numerical data*; D014481:United States