title: Predictors of Career Choice Among Cardiothoracic Surgery Trainees.
abstract: BACKGROUND
  The impact of factors influencing career choice by cardiothoracic surgery (CTS) trainees remains poorly defined in the modern era. We sought to examine the associations between CTS trainee characteristics and future career aspirations.
  
  
  METHODS
  The 2012 Thoracic Surgery In-Training Examination survey results were used to categorize responders according to career interest: congenital, adult cardiac, mixed cardiac/thoracic, and general thoracic surgery. Univariate and multivariable analyses were used to identify and analyze characteristics associated with career interest categories.
  
  
  RESULTS
  With a 100% response rate, 300 responses from trainees in programs accredited by the Accreditation Council for Graduate Medical Education were included in the analysis. Multinomial logistic regression identified three factors associated with career choice in CTS: level of training (p < 0.001), type of training pathway (p < 0.001), and primary motivating factor to pursue CTS (p = 0.002). Trainees interested in general thoracic surgery were more likely to commit to CTS during their senior years of general surgery training and were more likely to enroll in 2-year or 3-year traditional fellowships, whereas individuals pursuing adult or congenital cardiac surgery were more likely to commit earlier during training and were more commonly interested in 6-year integrated or joint training pathways. Moreover, trainees interested in general thoracic surgery were predominantly influenced by early mentorship (p = 0.025 vs adult cardiac), and trainees interested in adult cardiac surgery were more likely to be influenced by types of operations (p = 0.047 vs general thoracic).
  
  
  CONCLUSIONS
  Career choice in CTS appears strongly associated with level of training, exposure to mentors, and training paradigm. These results demonstrate the importance of maintaining all four currently approved training pathways to retain balance and diversity in future CTS practices.
authors.affiliation: University of Rochester Medical Center, Rochester, New York.
authors.forename: Vakhtang
authors.initials: V
authors.lastname: Tchantchaleishvili
authors.affiliation: University of Virginia, Charlottesville, Virginia.
authors.forename: Damien J
authors.initials: DJ
authors.lastname: LaPar
authors.affiliation: University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: David D
authors.initials: DD
authors.lastname: Odell
authors.affiliation: Emory University, Atlanta, Georgia.
authors.forename: William
authors.initials: W
authors.lastname: Stein
authors.affiliation: Cleveland Clinic Foundation, Cleveland, Ohio.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Aftab
authors.affiliation: University of Washington, Seattle, Washington.
authors.forename: Kathleen S
authors.initials: KS
authors.lastname: Berfield
authors.affiliation: University of Texas Health Science Center at San Antonio, San Antonio, Texas.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Eilers
authors.affiliation: Baylor College of Medicine, Houston, Texas.
authors.forename: Shawn S
authors.initials: SS
authors.lastname: Groth
authors.affiliation: Pinnacle Health CardioVascular Institute, Harrisbsurg, Pennsylvania.
authors.forename: John F
authors.initials: JF
authors.lastname: Lazar
authors.affiliation: Cleveland Clinic Foundation, Cleveland, Ohio.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Robich
authors.affiliation: Duke University Medical Center, Durham, North Carolina.
authors.forename: Asad A
authors.initials: AA
authors.lastname: Shah
authors.affiliation: Northwestern University, Chicago, Illinois.
authors.forename: Danielle A
authors.initials: DA
authors.lastname: Smith
authors.affiliation: Columbia University, New York, New York.
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Stephens
authors.affiliation: Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Cameron T
authors.initials: CT
authors.lastname: Stock
authors.affiliation: Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Walter F
authors.initials: WF
authors.lastname: DeNino
authors.affiliation: Memorial Hermann Hospital-Heart and Vascular Institute, University of Texas Medical School at Houston, Houston, Texas. Electronic address: tom.c.nguyen@gmail.com.
authors.forename: Tom C
authors.initials: TC
authors.lastname: Nguyen
mesh_terms: D002321:Career Choice; D005544:Forecasting; D011795:Surveys and Questionnaires; D013903:Thoracic Surgery / Q000193:education