Education Presented at the Academic Surgical Congress 2020| Volume 169, ISSUE 5, P1221-1227, May 2021

Impact of advanced clinical fellowship training on future research productivity and career advancement in adult cardiac surgery



      Advanced clinical fellowships are important for training surgeons with a niche expertise. Whether this additional training impacts future academic achievement, however, remains unknown. Here, we investigated the impact of advanced fellowship training on research productivity and career advancement among active, academic cardiac surgeons. We hypothesized that advanced fellowships do not significantly boost future academic achievement.


      Using online sources (eg, department webpages, CTSNet, Scopus, Grantome), we studied adult cardiac surgeons who are current faculty at accredited United States cardiothoracic surgery training programs, and who have practiced only at United States academic centers since 1986 (n = 227). Publicly available data regarding career advancement, research productivity, and grant funding were collected. Data are expressed as counts or medians.


      In our study, 78 (34.4%) surgeons completed an advanced clinical fellowship, and 149 (65.6%) did not. Surgeons who pursued an advanced fellowship spent more time focused on surgical training (P < .0001), and those who did not were more likely to have completed a dedicated research fellowship (P = .0482). Both groups exhibited similar cumulative total publications (P = .6862), H-index (P = .6232), frequency of National Institutes of Health grant funding (P = .8708), and time to achieve full professor rank (P = .7099). After stratification by current academic rank, or by whether surgeons pursued a dedicated research fellowship, completion of an advanced clinical fellowship was not associated with increased research productivity or accelerated career advancement.


      Academic adult cardiac surgeons who pursue advanced clinical fellowships exhibit similar research productivity and similar career advancement as those who do not pursue additional clinical training.
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        • Valk W.L.
        Requirements for specialization after basic experiences.
        Ann Surg. 1968; 168: 584-586
        • Rifkin W.J.
        • Cammarata M.J.
        • Kantar R.S.
        • et al.
        From “coordinated” to “integrated” residency training: evaluating changes and the current state of plastic surgery programs.
        Plast Reconstr Surg. 2019; 143: 644e-654e
        • Batista P.
        • Abai B.
        • Salvatore D.
        • DiMuzio P.
        The first assessment of operative logs for traditional vascular fellowship track versus integrated vascular training programs.
        J Vasc Surg. 2015; 62: 1076-1082
        • Zhu Y.
        • Goldstone A.B.
        • Woo Y.J.
        Integrated thoracic surgery residency: current status and future evolution.
        Semin Thorac Cardiovasc Surg. 2019; 31: 345-349
        • Wood D.E.
        Cardiothoracic surgery: a specialty divided or as one.
        J Thorac Cardiovasc Surg. 2009; 137: 1-9
        • Shemin R.J.
        • Ikonomidis J.S.
        Thoracic Surgery Workforce: report of STS/AATS Thoracic Surgery Practice and Access Task Force—Snapshot 2010.
        Ann Thorac Surg. 2012; 93: 348-355
        • Chikwe J.
        • Cavallaro P.
        • Itagaki S.
        • Seigerman M.
        • Diluozzo G.
        • Adams D.H.
        National outcomes in acute aortic dissection: influence of surgeon and institutional volume on operative mortality.
        Ann Thorac Surg. 2013; 95: 1563-1569
        • Chikwe J.
        • Toyoda N.
        • Anyanwu A.C.
        • et al.
        Relation of mitral valve surgery volume to repair rate, durability, and survival.
        J Am Coll Cardiol. 2017; : S0735-S1097
        • Watkins A.C.
        • Ghoreishi M.
        • Maassel N.L.
        • et al.
        Programmatic and surgeon specialization improves mortality in isolated coronary bypass grafting.
        Ann Thorac Surg. 2018; 106: 1150-1158
        • Vemulapalli S.
        • Carroll J.D.
        • Mack M.J.
        • et al.
        Procedural volume and outcomes for transcatheter aortic-valve replacement.
        N Engl J Med. 2019; 380: 2541-2550
        • Shudo Y.
        • Wang H.
        • Lingala B.
        • et al.
        Evaluation of risk factors for heart-lung transplant recipient outcome: an analysis of the United Network for Organ Sharing database.
        Circulation. 2019; 140: 1261-1272
        • Pelletier M.P.
        • Kaneko T.
        • Peterson M.D.
        • Thourani V.H.
        From sutures to wires: the evolving necessities of cardiac surgery training.
        J Thorac Cardiovasc Surg. 2017; 154: 990-993
        • Borger M.A.
        The future of cardiac surgery training: a survival guide.
        J Thorac Cardiovasc Surg. 2017; 154: 994-995
        • Hirsch J.E.
        An index to quantify an individual’s scientific research output.
        Proc Natl Acad Sci USA. 2005; 102: 16569-16572
        • Bruns S.D.
        • Davis B.R.
        • Demirjian A.N.
        • et al.
        The subspecialization of surgery: a paradigm shift.
        J Gastrointest Surg. 2014; 18: 1523-1531
        • Bucholz E.M.
        • Sue G.R.
        • Yeo H.
        • Roman S.A.
        • Bell R.H.
        • Sosa J.A.
        Our trainees’ confidence: results from a national survey of 4136 US general surgery residents.
        Arch Surg. 2011; 146: 907-914
        • Eloy J.A.
        • Svider P.F.
        • Mauro K.M.
        • Setzen M.
        • Baredes S.
        Impact of fellowship training on research productivity in academic otolaryngology.
        Laryngoscope. 2012; 122: 2690-2694
        • Kasabwala K.
        • Morton C.M.
        • Svider P.F.
        • Nahass T.A.
        • Eloy J.A.
        • Jackson-Rosario I.
        Factors influencing scholarly impact: does urology fellowship training affect research output?.
        J Surg Educ. 2014; 71: 345-352
        • Agarwal N.
        • Clark S.
        • Svider P.F.
        • Couldwell W.T.
        • Eloy J.A.
        • Liu J.K.
        Impact of fellowship training on research productivity in academic neurological surgery.
        World Neurosurg. 2013; 80: 738-744
        • Huang G.
        • Fang C.H.
        • Lopez S.A.
        • Bhagat N.
        • Langer P.D.
        • Eloy J.A.
        Impact of fellowship training on research productivity in academic ophthalmology.
        J Surg Educ. 2015; 72: 410-417
        • Sood A.
        • Therattil P.J.
        • Chung S.
        • Lee E.S.
        Impact of subspecialty fellowship training on research productivity among academic plastic surgery faculty in the United States.
        Eplasty. 2015; 15: e50
        • Valsangkar N.P.
        • Liang T.W.
        • Martin P.J.
        • et al.
        Impact of clinical fellowships on academic productivity in departments of surgery.
        Surgery. 2016; 160: 1440-1446
        • Verrier E.D.
        Getting started in academic cardiothoracic surgery.
        J Thorac Cardiovasc Surg. 2000; 119: S1-S10
        • Rosati C.M.
        • Valsangkar N.P.
        • Gaudino M.
        • et al.
        Training patterns and lifetime career achievements of US academic cardiothoracic surgeons.
        World J Surg. 2017; 41: 748-757