Wood Douglas E, Farjah Farhood
Section of General Thoracic Surgery, Division of Cardiothoracic Surgery, University of Washington, Seattle, Washington 98195-6310, USA.
Ann Thorac Surg. 2009 Aug;88(2):515-21; discussion 521-2. doi: 10.1016/j.athoracsur.2009.04.010.
Training and certification for general thoracic surgeons varies enormously between countries. There is little knowledge about training and certification for general thoracic surgeons, and the relationship between thoracic surgery and cardiac surgery around the world.
A 38-item survey was designed to assess training, practice, demographics, and relationships of general thoracic and cardiac surgeons. Eighteen cardiothoracic societies representing surgeons on six continents were contacted, and 15 submitted the survey to their membership. The survey was advertised through CTSnet, and 928 surgeons from 105 countries were contacted directly in regions not covered by the professional societies.
In all, 1,520 survey respondents were tabulated, representing 95 separate countries. Non-US respondents were younger, more commonly had practices exclusively in cardiac or thoracic surgery, less commonly obtained general surgery certification, less commonly performed esophageal surgery, and had shorter overall surgical training but longer specialized training in cardiothoracic surgery, although US respondents received greater length of cardiac surgery specific training (all p < 0.05). The US respondents thought that cardiac surgery training was more important for the practice of general thoracic surgery than did non-US respondents, and that it was important for thoracic surgeons and cardiac surgeons to be aligned in public policy and specialty advocacy.
Marked differences in training and certification across the world result in discrepancies in clinical practice, levels of collaboration between cardiac and thoracic surgeons, and culture and attitude differences that are relevant to the feasibility of alliances relating to public policy. These findings also provide important data to inform any decisions about changes in US cardiothoracic training. Greater international cooperation may diminish these differences in order to propagate improvements in cardiothoracic education, and improve patient access and outcomes through shared specialty advocacy.
各国普通胸外科医生的培训和认证差异极大。对于普通胸外科医生的培训和认证，以及世界各地胸外科与心脏外科之间的关系，人们了解甚少。
设计了一项包含38个项目的调查，以评估普通胸外科和心脏外科医生的培训、实践、人口统计学特征及二者之间的关系。联系了代表六大洲外科医生的18个心胸外科学会，其中15个将会调查发给了其成员。该调查通过心胸外科医师协会网络（CTSnet）进行宣传，并在专业学会未覆盖的地区直接联系了来自105个国家的928名外科医生。
总共统计了1520名调查受访者，他们来自95个不同的国家。非美国受访者更年轻，更常见的是专门从事心脏或胸外科手术，较少获得普通外科认证，较少进行食管手术，总体外科培训时间较短，但心胸外科专科培训时间较长，不过美国受访者接受的心脏外科专项培训时间更长（所有p<0.05）。美国受访者认为心脏外科培训对普通胸外科实践比非美国受访者更为重要，并且认为胸外科医生和心脏外科医生在公共政策和专业倡导方面保持一致很重要。
全球范围内培训和认证的显著差异导致临床实践、心脏外科和胸外科医生之间的合作水平以及与公共政策联盟可行性相关的文化和态度差异存在差异。这些发现也为美国心胸外科培训变革的任何决策提供了重要数据。加强国际合作可能会减少这些差异，从而促进心胸外科教育的改进，并通过共同的专业倡导改善患者就医机会和治疗效果。
