Komiya Tatsuhiko
Gen Thorac Cardiovasc Surg. 2013 Dec;61(12):694-8. doi: 10.1007/s11748-013-0325-2.
Reform of the Japanese postgraduate residency program has dramatically influenced the recruitment system. Because shortage of young cardiac surgeons is anticipated, an effective program for residents who want to become cardiac surgeons must be established at an earlier stage in surgical training.
A 3-year cardiac surgery residency curriculum was developed for senior residents. The surgical training program includes harvesting of the saphenous vein, radial artery and internal thoracic artery, and repair of abdominal aortic aneurysm and specifies the target number of surgical procedures for each training. Academic training is provided in addition to clinical skills training. Nine residents completed the 3-year program between 2004 and 2012. The number of surgical procedures performed, presentations made at scientific meetings, and scientific papers published were investigated and analyzed.
Each resident participated in 438 operations during 3-year program, 25.9 ± 8.3 (5.9 %) as main operator and 182.2 ± 15.8 (42 %) as first assistant. The average number of procedures per resident over the 3 years was 43.0 ± 6.7 for saphenous vein harvest, 14.4 ± 3.9 for radial artery harvest, 27.9 ± 13.0 for internal thoracic artery harvest, 7.1 ± 4.6 for abdominal aortic aneurysm. In addition, over the 3 years, the mean number of presentations at scientific meetings was 13.2 ± 3.2 and the mean number of publication of scientific papers was 1.9 ± 1.4.
The new cardiac surgery training curriculum for residents worked fairly well. A system for assessment of the program by an authoritative body should be established in the future.
日本研究生住院医师培训项目的改革对招聘系统产生了巨大影响。由于预计年轻心脏外科医生短缺,必须在外科培训的早期阶段为希望成为心脏外科医生的住院医师建立一个有效的项目。
为高年级住院医师制定了一个为期3年的心脏外科住院医师培训课程。外科培训项目包括大隐静脉、桡动脉和胸廓内动脉的采集,以及腹主动脉瘤的修复,并规定了每次培训的手术操作目标数量。除临床技能培训外,还提供学术培训。2004年至2012年期间,9名住院医师完成了该为期3年的项目。对所进行的手术操作数量、在科学会议上的发言以及发表的科学论文进行了调查和分析。
在为期3年的项目中,每位住院医师参与了438例手术,其中作为主刀医生参与了25.9±8.3例(5.9%),作为第一助手参与了182.2±15.8例(42%)。3年期间,每位住院医师大隐静脉采集的平均手术数量为43.0±6.7例,桡动脉采集为14.4±3.9例,胸廓内动脉采集为27.9±13.0例,腹主动脉瘤修复为7.1±4.6例。此外,在这3年中,在科学会议上发言的平均次数为13.2±3.2次,发表科学论文的平均数量为1.9±1.4篇。
新的住院医师心脏外科培训课程运行良好。未来应建立一个由权威机构对该项目进行评估的系统。