How We Solved the Shortage of Cardiothoracic Surgeons: Train More or Work Longer.

Background: In the early 2000s, a significant shortage of cardiothoracic surgeons was predicted. We sought to evaluate our specialty's progress and to update the predicted needs of cardiothoracic surgeons in the coming decades.

Methods: To assess the supply of cardiothoracic surgeons, the evolution of cardiothoracic surgery training was reviewed. The cardiothoracic surgery workforce and future supply and demand were obtained from the National Center for Health Workforce Analysis. Based on these data, predictions from the early 2000s were compared with the current status, and future supply of cardiothoracic surgeons was modeled.

Results: The number of cardiothoracic surgery trainees increased from 230 in 2008-2009 to 519 in 2022-2023. In 2022-2023, 174 trainees underwent the American Board of Thoracic Surgery Certification Exam, with 129 certificates awarded. From 2005 to 2021, the total number of practicing cardiothoracic surgeons in the United States increased from 4000 to 5200, which contradicts all projections from the early 2000s. The average attrition of 31 cardiothoracic surgeons per year was significantly less than predictive models from the early 2000s. Predictive models project a need of 7000 cardiothoracic surgeons by 2050, which can be met if we continue to fill our available training spots with 173 graduates per year.

Conclusions: The predicted shortage of cardiothoracic surgeons by midcentury has been overcome by training more cardiothoracic surgeons as well as by a reduction in cardiothoracic surgeon attrition. Future increasing demand can be met by filling our available training positions. Continual assessment of cardiothoracic surgeon supply and demand will help achieve the optimal number of cardiothoracic surgery training positions.