The Western Thoracic Surgical Association

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Young Cardiothoracic Surgeons' First Job: From Searching To Securing And The Gaps In-between
Helene M Sterbling1, Daniela Molena2, Sowmya Rao1, Sharon L Stein3, Virginia R Litle1
1Boston University School of Medicine, Boston, MA;2Memorial Sloan Kettering Cancer Center, New York, New York, NY;3University Cleveland Medical Center, Cleveland, OH

Objective: Recent industry studies have projected a deficit in cardiothoracic (CT) surgeons by 2030. With a shrinking workforce and increasing demand, finding CT surgery jobs should be easy. Little is known about the difficulties of the job search process after CT training. The purpose of this study is to explore the current practices of first job hunt and contract negotiation for young CT surgeons, and to identify the gaps in resources available to applicants.
Methods: In October 2017, a 56-question, web-based survey was sent to recent (2012-2017) board-certified CT surgeons in the United States (US) inquiring about their experience securing their first CT job. The survey was approved by the Institutional Review Board and administered via RedCap. The responses were accepted over a period of three months. Participation was voluntary and personal identifiers were not collected.
Results: A total of 475 survey requests were emailed, with a response rate of 17.5% (83/475). All 56 questions were answered by 61/475 (12.8%) respondents. The majority of respondents were male (50/61; 82.0%) and were US medical graduates (86.9%). Mean age at the completion of CT surgery training (traditional general surgery pathway followed by fellowship, 4+3 program, or I-6 program) was 35.7 years, and 63.9% of respondents reported not having pursued advanced training beyond their CT board certification. The majority of CT program graduates (86.9%) interviewed for jobs between October and March of their final CT training year and attended a median number of 4 interviews (range = 3-6), with 54.1% of participants attending 2 separate-visit interviews for the position accepted. Contracts for first employment were signed prior to completing CT training in 79.7% of cases, and 63.9% of respondents negotiated their first contract, with 47.5% of contracts reviewed by lawyers. The most common contract duration was 3 years (45.9%) and 60.7% of respondents were initially employed in an academic setting. Only 54.5% of women and 52.0% of men reported having explicit parental leave provisions in their benefits. The two most influential factors in job selection were partner mentorship (49.2%) and geographical location (24.3%). Average starting pre-tax salary for respondents was $377,818 ( $109,320) and salaries were most commonly guaranteed for 2-3 years (77.0%). Over half of respondents reported needing more resources and support for the identification (59.0%) and comparison (54.1%) of job opportunities, contract negotiation (70.5%), and salary guidelines navigation (77.0%). Open text advice from survey respondents focused on the realities of job availability, the need to start interviewing early and as much as possible, the importance of network with peers and advisors alike, as well as the primordial importance of mentorship, contract and salary negotiation.
Conclusion: Despite lengthy and rigorous technical training, very little guidance exists to support the search and securing of young CT surgeons' first employment. Resources, whether institutional or organizational, are sparse and difficult to tailor to individual needs. Given the potential ramification of early career decisions, focused support is needed to remediate the lack of preparation and human resources available to the newest generations of CT surgeons.


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