Exploring the Influence of Gender on Surgical Clerkship Grades and Test Scores: A Single Institution, Multisite Comparison.

Objective: General surgery remains a male-dominated specialty. Women constitute 54% of medical students at the University of Washington, but only 3.4% of full professors within the Department of Surgery.

Safety and Costs of Endobronchial Ultrasound-Guided Nodal Aspiration and Mediastinoscopy.

Background: There remains debate over the best invasive diagnostic modality for mediastinal nodal evaluation. Prior studies have limited generalizability and insufficient power to detect differences in rare adverse events. We compared the risks and costs of endobronchial ultrasound (EBUS)-guided nodal aspiration and mediastinoscopy performed for any indication in a large national cohort.

How Does the Adult Surgeon Learn?

Both the breadth of knowledge and range of technical skills that residents are now expected to master prior to graduation have grown exponentially. A unique challenge that sets surgical education apart from medical education is that surgery as a specialty requires not only the mastery of complex physiology, anatomy, and disease processes but also the ability to interpret and apply that knowledge in the operating room. To be effective educators, it is imperative to understand the theoretic foundation of how adults learn.

Video-Assisted Thoracoscopic Lobectomy for Lung Cancer.

The use of video-assisted thoracoscopic surgery (VATS) lobectomy has become a mainstay of modern-day thoracic oncology practice and the technique of choice for resection of early-stage lung cancers at many institutions. The feasibility of VATS lobectomy has long been well established, and there is considerable belief that it leads to better patient outcomes. In the following review we seek to summarize the current experience with VATS lobectomy, identify the strengths and weaknesses of the available literature, and address future areas of research for our field.

Intraoperative Acute Multivessel Coronary Vasospasm in Cardiac Allograft: A Case Report.

We present a patient who developed acute intraoperative cardiac failure requiring open cardiac message immediately after uncomplicated heart transplantation. After successful resuscitation and establishment of extracorporeal membrane oxygenation, coronary angiography showed diffuse multivessel coronary vasospasm, which responded to intracoronary and IV administration of vasodilators. Cardiac function gradually improved and the patient was discharged home after a prolonged hospital course.

Sublobar resection for stage IA non-small cell lung cancer.

Advancements in the diagnosis, staging and management of lung cancer have all led to improvements in outcomes associated with sublobar resection. Lobectomy, for early stage lung cancers has been the treatment of choice for many years. However, there is mounting evidence that sublobar resection when applied to the appropriate patient population can provide not only excellent oncologic results but also equivalent survival to lobectomy.

Successful Repair of Acute Type A Aortic Dissection 15 Years Following Bilateral Lung Transplantation.

This report describes a patient treated for acute type A aortic dissection 15 years after undergoing bilateral lung transplantation by a clamshell thoracotomy.

Management of Postoperative Respiratory Failure.

Despite best efforts, postoperative complications such as postoperative respiratory failure may occur and prompt recognition of the process and management is required. Postoperative respiratory failure, such as postoperative pneumonia, postpneumonectomy pulmonary edema, acute respiratory distress-like syndromes, and pulmonary embolism, are associated with high morbidity and mortality. The causes of these complications are multifactorial and depend on preoperative, intraoperative, and postoperative factors, some of which are modifiable.

Understanding Why Residents May Inaccurately Log Their Role in Operations: A Look at the 2013 In-Training Examination Survey.

Background: With increased time and quality pressures, it may be more difficult for residents in cardiothoracic surgery residency programs to get independent operative experience. That may lead residents to inaccurately report their role as "surgeon" to meet American Board of Thoracic Surgery (ABTS) case requirements.

Methods: The 2013 In-Training Examination surveyed 312 cardiothoracic surgery residents and was used to contrast residents in traditional 2-year and 3-year cardiothoracic surgery residencies (traditional, n = 216) with those in 6-year integrated or 3+4-year programs (integrated, n = 96).

Endovascular Repair for Type A Aortic Dissection After Transcatheter Aortic Valve Replacement With a Medtronic CoreValve.

Transcatheter aortic valve replacement is being used with increasing frequency in patients with severe aortic stenosis who are otherwise deemed to be at high surgical risk. Aortic dissection is a rare complication of transcatheter aortic valve replacement and poses a unique management dilemma. We describe the treatment of an acute Stanford type A aortic dissection after transcatheter aortic valve replacement with a modified thoracic endovascular stent graft in a 95-year-old woman.

Resident Perception of Technical Skills Education and Preparation for Independent Practice.

Background: Surgical skills are traditionally taught and practiced in the operating room. However, changes in health care policy and outcome-based evaluation have decreased trainee operative autonomy. We examined cardiothoracic residents' perceptions of operative experience and the role of simulation.

A Decade of Change: Training and Career Paths of Cardiothoracic Surgery Residents 2003 to 2014.

Background: During the past decade, cardiothoracic surgery (CTS) education has undergone tremendous change with the advent of new technologies and the implementation of integrated programs, to name a few. The goal of this study was to assess how residents' career paths, training, and perceptions changed during this period.

Methods: The 2006 to 2014 surveys accompanying the Thoracic Surgery Residents Association/Thoracic Surgery Directors' Association in-training examination taken by CTS residents were analyzed, along with a 2003 survey of graduating CTS residents.

Predictors of Career Choice Among Cardiothoracic Surgery Trainees.

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.

Resident Perceptions of 2-Year Versus 3-Year Cardiothoracic Training Programs.

Background: Resident perceptions of 2-year (2Y) vs 3-year (3Y) programs have never been characterized. The objective was to use the mandatory Thoracic Surgery Residents Association and Thoracic Surgery Directors Association In-Training Examination survey to compare perceptions of residents graduating from 2Y vs 3Y cardiothoracic programs.

Methods: Each year Accreditation Council for Graduate Medical Education cardiothoracic residents are required to take a 30-question survey designed by the Thoracic Surgery Residents Association and the Thoracic Surgery Directors Association accompanying the In-Training Examination with a 100% response rate.

Current integrated cardiothoracic surgery residents: a Thoracic Surgery Residents Association survey.

Background: After approval by the Thoracic Surgery Residency Review Committee in 2007, 6-year integrated cardiothoracic surgery (I-6) residency programs have gained in popularity. We sought to assess and objectively quantify the level of satisfaction I-6 residents have with their training and to identify areas of improvement for future curriculum development.

Methods: A completely anonymous, electronic survey was created by the Thoracic Surgery Residents Association that asked the responders to provide demographic information, specialty interest, and lifestyle priorities, and to rate their experience and satisfaction with I-6 residency.