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90th Annual Meeting Abstracts

Impact of Job Availability on Applications for Cardiothoracic Surgery Residency Training
*Juan A Sanchez, MD1, *Grayson H. Wheatley, MD2, Richard J. Shemin, MD3
1Saint Mary's Hospital, Waterbury, CT;2Arizona Heart Institute, Phoenix, AZ;3UCLA, Los Angeles, CA

Objectives: We examined the temporal and quantitative relationship between sharp decreases in job availability for fully-trained cardiothoracic (CT) surgeons and notable drops in applications to CT training programs for the ten-year time period, 1997-2006. We also compared these reductions against actual changes in surgical volumes for key CT surgical procedures and for Medicare reimbursement rates.
Design: This was exclusively an observational study of labor market variables. Job listings were obtained from each issue of Annals of Thoracic Surgery from Jan 1997-Dec 2006. Non-clinical, additional training and assistant surgeon positions were excluded. Applicant data for the study period was obtained from the American Board of Thoracic Surgery . Index cases were obtained from the National Inpatient Sample and included coronary revascularization, heart valve procedures, and anatomic pulmonary resections for CY1997-2006. Medicare historical conversion factors (CF) were obtained from the Centers for Medicare and Medicaid Services.
Results: The number of available jobs decreased by 80% followed by a 50% reduction in applications by 24 months. In contrast, key case volumes and CF experienced modest reductions.
Conclusions: This study suggests that applications for CT surgery training were temporally but not proportionally affected by a consistent decrease in jobs with a lag of 24 months. Furthermore, the acute drop in available jobs beginning in 2001, presumably related to anticipated reductions in the number of key procedures and reimbursement rates, substantially overshot actual reductions. Close monitoring of economic conditions, including job availability, is necessary in order to anticipate future workforce needs in CT surgery.


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