Content from the Journal of the American Neurological Surgeons.
While the number of operations performed by our specialty in the USA is diminishing, the number of residents being trained for our specialty remains fairly constant. The supply of cardiothoracic surgeons, in my view, needs to be brought into balance with the demand for our services. In brief, too many cardiothoracic residents are being trained…
In 1995 Hal Urschel, MD, past president of the Society of Thoracic Surgeons, served as the Schuster Visiting Professor at The Brigham and Women’s Hospital and Harvard Medical School. During that visit he delivered Surgical Grand Rounds, and his address was entitled “Let’s Bring the Magic Back”. His remarks were insightful and stimulating, and they…
These are trying times for the specialty of cardiothoracic surgery. The educational process for completion of training is criticized for being too lengthy. The work loads and work hours during the required general and cardiothoracic surgical residencies are excessive and stressful, leaving too little time for formal didactic teaching, individual study, family responsibilities, and recreation. …
Senza soldi is nati non fanno miracoli (without money the saints do not perform miracles) – Old Italian proverb It is our choices, Harry, that show what we truly are, far more than our abilities. – Albus Dumbledore, Headmaster at Hogwarts in Harry Potter and the Chamber of Secrets by JK Rowling. Abstract Access to…
A lot has been said recently on the decreasing quality and rising cost of education. So far it seems that the remedies offered have neither lowered the costs nor have they increased the level of quality. Probably it is time to review our existing system of post-graduate education and to examine some features that were…
We all know the monumental contribution of Alain Carpentier to the understanding of the pathology of the mitral valve, its function and therapeutic implications. There were also a number of surgeons who have expanded on the original idea (Duran, Cosgrove and others) and made contributions in this field. We know today unequivocally the superiority of…
Introduction Thoracic surgery has changed profoundly in the past thirty years, and although many of these changes have enabled us to serve patients better, others, particularly within our business environment, do not bode well for the future of our craft. Caseloads are level or declining, catheter-based technologies are improving, income is down, and public scrutiny…
The cardiac surgical outcomes literature is replete with studies documenting the improving risk/benefit ratio of increasing surgical volume for patients. Such studies have been used to justify minimum standards of operative cases for accreditation of cardiac surgical programs. Indeed, it is appropriate for those studies to focus the patients’ results – that is why we…
My interest in developing the case for a standardized global education, training and certification course of action results from my involvement in some of the organizational activities that relate to the educational, training and certification process in the United States and to my involvement with CTSNet. I have watched with admiration the efforts of CT…
Like most active clinical surgeons, I’ve been sued a few times for malpractice over the course of a long career in academia and private practice. In addition, I’ve served as an expert witness for the defense in about 20 malpractice actions that did not involve me or my group. For most physicians, malpractice actions are…
By Ulrich Hake, MD, PhD The cardiosurgical – to be more precise the coronary surgical – world is now confronted with the latest technological innovation – the proximal and the distal anastomotic device. The principal indication until now to use a proximal anastomotic device is beating heart surgery for those cases where venous grafts are…
Despite a half-century of experience in heart valve reconstruction, the tricuspid valve has been a “second class structure” for cardiac surgery. More than 20 years ago, the high incidence of tricuspid disease in our population, encouraged us to attempt to clarify the indications for repair, particularly in patients with functional tricuspid incompetence (1). Since functional…
By Anne Vinsel, MS Comments on “We Need an Attitude Adjustment” by Benson Wilcox, M.D. Dear Dr. Wilcox, I share office space with an area used by medical students to look through notebooks of physicians they can shadow and use as mentors, and I coach some medical students for their boards, so I hear (or…
Our society has changed vastly over the years in both positive and negative ways. Despite constant nonlinear changes, our medical community has evolved in a positive way toward better services for patients through improved hospital care, advancing technology, genomic discoveries, better training, improved medical records, outcomes-based therapy and closer self-scrutiny. No doubt society has demanded…
Women in the field of thoracic surgery were here to stay after Nina Braunwald, M.D., Ann McKiel and Nermin Tutunju became the first women certified by the American Board of Thoracic Surgery in 1961. Dr. Braunwald, in 1968, established a program in cardiovascular surgery at the University of CA in San Diego. By 1968, there…
In 1993 I finished my cardiothoracic residency and an additional year as the chief resident at the “number one cardiac surgery hospital in the country.” I felt like Leonardo Dicaprio in Titanic: ” I was on top of the world.” So how is it that nine years later I’ve been unemployed for 3 months and…
