Crawford Fred A
Department of Surgery, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
Ann Thorac Surg. 2005 Jun;79(6):S2232-7. doi: 10.1016/j.athoracsur.2005.02.077.
Organized thoracic surgery education began with the establishment of the first thoracic residency program at the University of Michigan in 1928. Subsequent changes and progress in thoracic education have included the development of the American Board of Thoracic Surgery, the Thoracic Surgery Residency Review Committee, the Thoracic Surgery Directors' Association, the Matching Program, the In-Training Examination, and the Joint Council on Thoracic Surgery Education. Current challenges in thoracic surgery education include (1) the declining interest in medical school and especially in surgery and cardiothoracic surgery, (2) changing demographics of medical students and residents, (3) lifestyle of surgical residents and practicing surgeons, (4) changes in societal expectation, and (5) the need for better tools to assess the outcomes of surgical education and the continued competency of practicing surgeons. Despite the recent difficulty with job availability for finishing cardiothoracic residents, there is evidence that this is temporary and that there will be an increased need in the future. Recent changes by the American Board of Thoracic Surgery, including making optional American Board of Surgery certification, new pathways for entry into the cardiothoracic surgery educational process, and the recent development of a joint training proposal (4/3) by the American Board of Surgery and American Board of Thoracic Surgery, clearly signal the need for further changes in the cardiothoracic surgery educational process so that thoracic surgery remains relevant in the future care of patients with cardiovascular disease.
有组织的胸外科教育始于1928年密歇根大学设立首个胸外科住院医师培训项目。胸外科教育随后的变革与进展包括美国胸外科委员会、胸外科住院医师培训评审委员会、胸外科主任协会、配对项目、培训期间考试以及胸外科教育联合委员会的发展。胸外科教育当前面临的挑战包括：（1）医学院校尤其是外科及心胸外科的吸引力下降；（2）医学生和住院医师人口统计学特征的变化；（3）外科住院医师和执业外科医生的生活方式；（4）社会期望的改变；（5）需要更好的工具来评估外科教育的效果以及执业外科医生的持续胜任能力。尽管近期心胸外科住院医师完成培训后就业困难，但有证据表明这只是暂时的，未来需求将会增加。美国胸外科委员会最近的变革，包括将美国外科委员会认证设为可选项目、进入心胸外科教育过程的新途径，以及美国外科委员会和美国胸外科委员会最近制定的联合培训提议（4/3），明确表明心胸外科教育过程需要进一步变革，以便胸外科在未来心血管疾病患者的治疗中仍保持相关性。
