J R Sadaba & J KluinJ R Sadaba & J Kluin

The Challenge of Training The Challenge of Training Cardio-thoracic Surgeons in the Cardio-thoracic Surgeons in the

XXI CenturyXXI Century

Towards an “IntegratedTowards an “IntegratedEuropean Training European Training

Programme“Programme“

Junior Committee EACTSJunior Committee EACTS

At the doors of the XXI century, Cardio-thoracic Surgery is confronting new challenges. The way the specialty has been traditionally taught might not be the adequate one to prepare surgeons to face these challenges…

Increasing Importance of Training Increasing Importance of Training Cardio-thoracic Surgeons in EuropeCardio-thoracic Surgeons in Europe

4 reasons4 reasons 5 initiatives5 initiatives

Reason 1: Increased Public Reason 1: Increased Public ExpectationsExpectations

Improvement in surgical outcome Improvement in surgical outcome Results readily available to publicResults readily available to public ““Risk paradox” (sicker patients, better Risk paradox” (sicker patients, better

results)results) Sensationalism in health related newsSensationalism in health related news Patients see themselves as consumersPatients see themselves as consumers

Reason 2: Increased AccountabilityReason 2: Increased Accountability

Hospital and individual surgeon’s Hospital and individual surgeon’s results are widely availableresults are widely available

Patients are more knowledgeable Patients are more knowledgeable about their conditionabout their condition

Reason 3: New Technologies – Higher Reason 3: New Technologies – Higher Demand on TrainingDemand on Training

Surgical techniquesSurgical techniques Basic scienceBasic science

Reason 4: Restriction on Training Reason 4: Restriction on Training Time (Absolute and Relative)Time (Absolute and Relative)

European Working Time DirectiveEuropean Working Time Directive < 48h/week< 48h/week >11h rest/24h>11h rest/24h > 20 min rest/6h> 20 min rest/6h > 6h continuous rest/24h> 6h continuous rest/24h > 4 weeks leave/year> 4 weeks leave/year

The imbalance between the demands imposed on future Cardio-thoracic Surgeons and the facilities available for training is obvious. Never before has there been such a need to create properly structured training programmes in Cardio-thoracic Surgery…

Initiative 1: European School of Initiative 1: European School of Cardio-thoracic Surgery in BergamoCardio-thoracic Surgery in Bergamo

3 annual Cardiac courses 3 annual Cardiac courses 3 annual Thoracic courses3 annual Thoracic courses

http://www.eacts.org/doc/6898

http://mmcts.ctsnetjournals.org/

Initiative 2: Multimedia Manual of Initiative 2: Multimedia Manual of Cardio-thoracic SurgeryCardio-thoracic Surgery

Premier online manual of cardiovascular Premier online manual of cardiovascular and thoracic surgical proceduresand thoracic surgical procedures

Initiative 3: International Symposium Initiative 3: International Symposium on Training in Cardio-thoracic Surgeryon Training in Cardio-thoracic Surgery

Sharing new teaching strategies Sharing new teaching strategies Exploring new learning resourcesExploring new learning resources

Initiative 4: Development of an Initiative 4: Development of an Integrated European Training Integrated European Training ProgrammeProgramme

Constructed from establised national Constructed from establised national programmesprogrammes

Guidelines and targets of competencyGuidelines and targets of competency Externally assessedExternally assessed

Initiative 5: Accreditation of Training Initiative 5: Accreditation of Training Centres Centres

European Cardiovascular and ThoracicEuropean Cardiovascular and Thoracic

Surgery Institute of AccreditationSurgery Institute of Accreditation

With the implementation of these and other initiatives we may be able to develop a new teaching culture which hopefully will be sufficient to train Cardio-thoracic surgeons capable of facing the challenges of the XXI century.