The Journey of Becoming a Congenital Heart Surgeon: Too Long, Too Expensive, Too Unpredictable
Presented During:
Sunday, May 7, 2023: 7:00AM - 7:15AM
Los Angeles Convention Center
Posted Room Name:
403B
Abstract No:
106
Submission Type:
Abstract Submission
Authors:
Matthew Mikulski (1), Charles Fraser (1), Neil Venardos (1), Carlos Mery, MD, MPH (1), Andrew Well (1)
Institutions:
(1) Dell Medical School, The University of Texas at Austin, Austin, TX
Submitting Author:
Matthew Mikulski
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Dell Medical School, The University of Texas at Austin
Dell Medical School, The University of Texas at Austin
Co-Author(s):
*Charles Fraser
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Dell Medical School, The University of Texas at Austin
Dell Medical School, The University of Texas at Austin
Neil Venardos
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Dell Medical School, The University of Texas at Austin
Dell Medical School, The University of Texas at Austin
*Carlos Mery
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Dell Medical School, The University of Texas at Austin
Dell Medical School, The University of Texas at Austin
Andrew Well
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Dell Medical School, The University of Texas at Austin
Dell Medical School, The University of Texas at Austin
Presenting Author:
*Charles Fraser
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Dell Children's Medical Center
Dell Children's Medical Center
Abstract:
Objective: The pathway to become a congenital heart surgeon(CHS) is challenging and unpredictable. Previous voluntary manpower surveys have shed partial light on this problem but have not included all trainees. We believe this arduous journey merits more attention.
Methods: To examine the real-life challenges of recent participants in American Council of Graduate Medical Education accredited CHS training programs, we conducted phone interviews with graduates of all 11 approved programs from 2020-2022. This IRB approved survey focused on issues including preparation, length of training, debt burden and employment. Results are presented in n(%) and median(range).
Results: All 22(100%) graduates during the study period were interviewed and were predominantly male(77%), white(64%), married(86%) and have children(77%). (Table) Age at fellowship completion was 37(range: 33-45) years. Individuals were highly accomplished in college and medical school with the majority honors graduates and 33% having additional advanced degrees. Number of peer reviewed manuscripts at completion of training was 20 (range: 5-100). Pathways to fellowship included traditional general surgery with adult cardiac(43%), abbreviated general surgery("4+3", 19%) and integrated-6(38%). For CHS fellowship preparation, 1(5%) underwent visual acuity testing and 0 participated in formal leadership training. Time spent on any pediatric related rotation prior to CHS fellowship was 3(range: 1-7) months. Three(14%) participated in formal pediatric echocardiography or catheterization rotations. Nine(43%) participated in a formal cardiac morphology course. Neonatal cases actually performed as primary surgeon during fellowship was 8(range: 2-25). Debt burden at completion was $179,000(range $0-$550,000). Maximal financial compensation during training before and during CHS fellowship were $65,000(range: $50,000-$100,000) and $80,000(range: $65,000-$165,000) respectively. All are employed - 5(22.7%) as instructors, 13(59.1%) as assistant or associate professors, and 2(9.1%) private practice. Median salary in first job is $450,000(range: $80,000-$700,000). Nine(40.9%) had any financial savings at fellowship completion.
Conclusion: While graduates of CHS fellowships find jobs, individuals are old and compensation is highly variable. Aptitude screening and pediatric focused preparation are minimal. Debt burden is onerous. Further attention to refining training paradigms and compensation are justified.
Methods: To examine the real-life challenges of recent participants in American Council of Graduate Medical Education accredited CHS training programs, we conducted phone interviews with graduates of all 11 approved programs from 2020-2022. This IRB approved survey focused on issues including preparation, length of training, debt burden and employment. Results are presented in n(%) and median(range).
Results: All 22(100%) graduates during the study period were interviewed and were predominantly male(77%), white(64%), married(86%) and have children(77%). (Table) Age at fellowship completion was 37(range: 33-45) years. Individuals were highly accomplished in college and medical school with the majority honors graduates and 33% having additional advanced degrees. Number of peer reviewed manuscripts at completion of training was 20 (range: 5-100). Pathways to fellowship included traditional general surgery with adult cardiac(43%), abbreviated general surgery("4+3", 19%) and integrated-6(38%). For CHS fellowship preparation, 1(5%) underwent visual acuity testing and 0 participated in formal leadership training. Time spent on any pediatric related rotation prior to CHS fellowship was 3(range: 1-7) months. Three(14%) participated in formal pediatric echocardiography or catheterization rotations. Nine(43%) participated in a formal cardiac morphology course. Neonatal cases actually performed as primary surgeon during fellowship was 8(range: 2-25). Debt burden at completion was $179,000(range $0-$550,000). Maximal financial compensation during training before and during CHS fellowship were $65,000(range: $50,000-$100,000) and $80,000(range: $65,000-$165,000) respectively. All are employed - 5(22.7%) as instructors, 13(59.1%) as assistant or associate professors, and 2(9.1%) private practice. Median salary in first job is $450,000(range: $80,000-$700,000). Nine(40.9%) had any financial savings at fellowship completion.
Conclusion: While graduates of CHS fellowships find jobs, individuals are old and compensation is highly variable. Aptitude screening and pediatric focused preparation are minimal. Debt burden is onerous. Further attention to refining training paradigms and compensation are justified.
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