The bias against integrated thoracic surgery residency applicants during general surgery interviews

Background New paradigms for training cardiothoracic surgeons have been introduced, including the integrated thoracic surgery residency. Currently, a limited number of these programs exist, and all candidates apply to both integrated thoracic and general surgery residencies. We sought to investigate the applicants' experiences applying for both types of positions. Methods An online survey was distributed to applicants to three integrated thoracic surgery programs during a 2-year period. Results The response rate was 50% (90 of 180). Most respondents were fourth-year medical students (81%; 72 of 89) and were interested in adult cardiac surgery (81%; 73 of 90). Sixty-one percent (55 of 90) had an interest in cardiothoracic surgery before clinical clerkships, and 93% (84 of 90) tailored their clinical education to this interest. Fifty-seven percent (49 of 86) scored above 230 on the USMLE Step 1 examination. Ninety-two percent (80 of 87) performed research during medical school, and 78% (62 of 80), specifically within cardiothoracic surgery; 76% (61 of 80) published their work. The number of general surgery interviews varied widely, but 46% (36 of 79) interviewed at one to five integrated thoracic surgery programs, and 39% (31 of 79) interviewed at six to ten integrated thoracic surgery programs. During general surgery interviews, 36% (24 of 66) received negative comments regarding applying to integrated thoracic residencies. Fifty-two percent (38 of 73) thought that their application to integrated thoracic programs diminished their chances to match at a general surgery program. Conclusions The applicants to the integrated thoracic surgery residencies become interested in cardiothoracic surgery early and tailor their clinical education to this interest. Although they are academically successful, they report significant negativity regarding their applications to both general surgery and integrated thoracic residencies.