title: First nationwide survey of US integrated 6-year cardiothoracic surgical residency program directors.
abstract: OBJECTIVE
  The recently implemented integrated 6-year (I-6) format represents a significant change in cardiothoracic surgical residency training. We report the results of the first nationwide survey assessing I-6 program directors' impressions of this new format.
  
  
  METHODS
  A 28-question web-based survey was distributed to program directors of all 24 Accreditation Council for Graduate Medical Education-accredited I-6 training programs in November 2013. The response rate was a robust 67%.
  
  
  RESULTS
  Compared with graduates of traditional residencies, most I-6 program directors with enrolled residents believed that their graduates will be better trained (67%), be better prepared for new technological advances (67%), and have superior comprehension of cardiothoracic disease processes (83%). Just as with traditional program graduates, most respondents believed their I-6 graduates would be able to independently perform routine adult cardiac and general thoracic operations (75%) and were equivocal on whether additional specialty training (eg, minimally invasive, heart failure, aortic) was necessary. Most respondents did not believe that less general surgical training disadvantaged I-6 residents in terms of their career (83%); 67% of respondents would have chosen the I-6 format for themselves if given the choice. The greater challenges in training less mature and experienced trainees and vulnerability to attrition were noted as disadvantages of the I-6 format. Most respondents believed that I-6 programs represent a natural evolution toward improved residency training rather than a response to declining interest among medical school graduates.
  
  
  CONCLUSIONS
  High satisfaction rates with the I-6 format were prevalent among I-6 program directors. However, concerns with respect to training relatively less experienced, mature trainees were evident.
authors.affiliation: Section of Cardiac Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Conn.
authors.forename: Amir H
authors.initials: AH
authors.lastname: Lebastchi
authors.affiliation: Section of Cardiac Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Conn.
authors.forename: John J
authors.initials: JJ
authors.lastname: Tackett
authors.affiliation: Section of Cardiac Surgery, New York Presbyterian-Columbia University Medical Center, New York, NY.
authors.forename: Michael
authors.initials: M
authors.lastname: Argenziano
authors.affiliation: Division of Thoracic Surgery, University of Texas Health Science Center, San Antonio, Tex.
authors.forename: John H
authors.initials: JH
authors.lastname: Calhoon
authors.affiliation: Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, Wis.
authors.forename: Mario G
authors.initials: MG
authors.lastname: Gasparri
authors.affiliation: Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, Ga.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Halkos
authors.affiliation: Division of Cardiothoracic Surgery, University of Rochester Medical Center, Rochester, NY.
authors.forename: George L
authors.initials: GL
authors.lastname: Hicks
authors.affiliation: Department of Cardiothoracic Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Iannettoni
authors.affiliation: Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, SC.
authors.forename: John S
authors.initials: JS
authors.lastname: Ikonomidis
authors.affiliation: Division of Cardiac Surgery, Northwestern University Feinberg School of Medicine, Chicago, Ill.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: McCarthy
authors.affiliation: Division of Thoracic Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio.
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Starnes
authors.affiliation: Division of Cardiovascular and Thoracic Surgery, Duke University School of Medicine, Durham, NC.
authors.forename: Betty C
authors.initials: BC
authors.lastname: Tong
authors.affiliation: Section of Cardiac Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Conn. Electronic address: david.yuh@yale.edu.
authors.forename: David D
authors.initials: DD
authors.lastname: Yuh
mesh_terms: D000068:Accreditation; D001291:Attitude of Health Personnel; D006348:Cardiac Surgical Procedures / Q000193:education*; D002983:Clinical Competence; D003479:Curriculum; D006801:Humans; D020407:Internet; D007396:Internship and Residency; D010549:Personal Satisfaction; D008486:Physician Executives; D011795:Surveys and Questionnaires; D013903:Thoracic Surgery / Q000193:education*; D013997:Time Factors; D014481:United States