title: Cardiothoracic surgery residency training: past, present, and future.
abstract: BACKGROUND
  A dramatic transformation of cardiothoracic surgical education has evolved over the past few decades.
  
  
  METHODS
  We begin by presenting recognized catalysts of this change, organized by whom they primarily affect: the trainees, the trainers, and the profession as a whole. Our trainees' prior training is different, and their current demographics and priorities have changed. There is less incentive to teach, with time-honored traditions of education inadequate to meet the needs of trainees. Concurrently, our profession has to adjust to new regulations, increasing financial constraints, and an expanding body of knowledge and technology. To address these issues requires developing new models of education and assessment that can thrive in today's environment. We discuss efforts in the United States and abroad, including new training paradigms ranging from restructuring existing models to novel approaches (eg, competency-based training). Training tools are being developed, such as online instruction, simulation-based learning, and regular student-centered assessments. Finally, models that recognize and reward teaching as a scholarly activity are being implemented.
  
  
  CONCLUSIONS
  Like the radical advances we have witnessed in surgical therapy, surgical education requires creative and perhaps disruptive changes if we are to continue to produce well-trained additions to our professional ranks.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, University of Texas M.D. Anderson Cancer Center, Houston, Tex. Electronic address: avaporci@mdanderson.org.
authors.forename: Ara Asadur
authors.initials: AA
authors.lastname: Vaporciyan
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Yang
authors.forename: Craig J
authors.initials: CJ
authors.lastname: Baker
authors.forename: James I
authors.initials: JI
authors.lastname: Fann
authors.forename: Edward D
authors.initials: ED
authors.lastname: Verrier
mesh_terms: D001291:Attitude of Health Personnel; D006348:Cardiac Surgical Procedures / Q000193:education* / Q000266:history / Q000639:trends; D003479:Curriculum; D004059:Diffusion of Innovation; D004503:Education, Medical, Graduate / Q000266:history / Q000379:methods* / Q000639:trends; D005180:Faculty, Medical; D005544:Forecasting; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007396:Internship and Residency / Q000266:history / Q000639:trends; D017145:Models, Educational; D009042:Motivation; D013663:Teaching / Q000379:methods; D019616:Thoracic Surgical Procedures / Q000193:education* / Q000266:history / Q000639:trends
keywords: 2; 4.2; ACGME; Accreditation Council for Graduate Medical Education; CT; JCTSE; Joint Council on Thoracic Surgery Education; cardiothoracic