aboo-ali-sina said:
although the ABTS (american board of thoracic surgery) and the ABS (american board of surgery) are working on a 3 + 3 or a 4 + 2 integrated cirriculum for cardiothoracic (much like in plastics) where you start in gen surg and you end in CT but you are only board certified in CT.
it would be to his advantage to go somewhere where they are more likely to have one of these programs in the initial years (this will likely be places like Hopkins and Duke that had such programs before they were truly allowed)
Two points:
1. The 4+2 model described would still leave you board eligible in General Surgery as well. This is also the proposal for Pediatric Surgery, Trauma/CC, and Transplant. The pilot programs for CTVS are expected to start people into the fellowship tract this summer according the ACS Bulletin I read yesterday. The 3/3 model for CTVS is more contraversial & much less close to becoming reality. Vascular Surgery is in limbo as the Amer. Board of Surgery & the Vascular Surgery societies are fighting over whether Vascular Surgery should become its own board in the American Board of Medical Specialties or remain a specialty board of the ABS (they've petitioned previously & been denied but have appealed that.....stay tuned). The ABS would include Vascular with the 4/2 models while the Vascular Board would prefer to do an integrated 3/3 model
2. The Duke/Hopkins "integrated" CTVS programs really weren't the same animal as what we're talking about. They were essentially non-binding promises that you'd eventually become a fellow. There was no special or abbreviated clinical curriculum as I understand, but they all included various stents in the lab for several years. Routinely those people were a resident for up to a decade with the lab time.
I cut and pasted the relavent info. from the ACS bulletin below.
http://www.facs.org/fellows_info/bulletin/2004/tenspecialty0404.pdf
VOLUME 89, NUMBER 4, BULLETIN OF THE AMERICAN COLLEGE OF SURGEONS
52
Initiation of early specialization program
After 12 months of preparation and comment,
the ABS, in January 2003, adopted the early specialization
program for vascular and pediatric surgery.
The program will allow residents in an institution
with residencies in either of these specialties
plus general surgery to have an integrated program
in which they will enter specialty training
after the PGY-4 year. The chief year of general surgery
will be completed in the PGY-4 year, and the
PGY-5 year, which will be the first year of specialty
training, will also count as a fifth year of general
surgery. The program will allow residents to complete
training in six years and be eligible for both
the general surgery and specialty certificates.
Initially the program will only be implemented
in a single institution although, as experience is
gained, it is envisioned that residents will be able
to move between institutions for general surgery
and specialty training. The program will be operating
on a pilot basis initially, with outcome measures
being maintenance of the number and diversity
of total cases, as well as those in the defined
categories of the residency review committee
for surgery (RRC-S). Impact on those individuals
entering the program, as well as other residents
in the program, will be assessed and the
ability of participants to maintain first-time pass
rates on the qualifying and certifying examinations
will also be monitored.
The program was reviewed by the RRC-S in February
2003 and approved. An oversight committee
of representatives from the ABS and the RRCS
has been appointed under the chairmanship of
J. David Richardson, MD, FACS, and is currently
in the process of developing specific guidelines and
implementing the program. It is envisioned that
applications will be received by the RRC-S this fall,
based examinations for recertification, beginning
in October 2003, with the specialty areas
of vascular surgery, pediatric surgery, and surgical
critical care.
The American Board of Vascular Surgery
(ABVS) applied for independent board status
with the ABMS last year, and the application was
heard by the Liaison Committee for Specialty
Boards (LCSB) in December 2002. The LCSB
denied the application, and the ABVS has decided
to appeal the decision. A new committee
will re-review the application and render a new
judgment, but the timetable for that process has
not yet been set.The ABS continues to oppose the designationof the ABVS as an independent board, and believes the VSB-ABS has done an outstanding job
of representing vascular surgery. It is the belief
of the board that vascular surgery represents an
essential content area of general surgery and
that the teaching of vascular surgery to general
surgery residents remains crucial to their training,
whether they choose to enter vascular surgery
as a specialty area or not. Virtually all areas
of general surgery and its specialties require
a basic knowledge of vascular surgery, and the
separation of this discipline from general surgery
training would be a crucial error.
New pathways/requirements certification
On October 20, 2001, the ABTS approved the following
resolutions regarding thoracic surgery certification.
The exact timing of implementation for
some of the resolutions has yet to be determined.
1. Certification by the American Board of Surgery
(ABS) is optional rather than mandatory for
residents who begin their thoracic surgery training
in July 2003 and after.
2. One pathway to ABTS certification will consist
of successful completion of a full general surgery
residency approved by the Accreditation
Council on Graduate Medical Education (five
years) or the Royal College of Physicians and Surgeons
of Canada, with or without ABS certification,
followed by successful completion of a twoor
three-year ACGME-approved thoracic surgery
residency. Individuals entering thoracic surgery
residencies in July 2003 or after will be eligible
under this pathway.
3. A second pathway to ABTS certification will
be a categorical-integrated six-year thoracic surgery
residency, to be developed by the Thoracic
Surgery Directors Association (TSDA). Residents in these programs will be under the direction of
the thoracic surgery program directors. Before
this pathway is implemented, the residency review
committee for thoracic surgery (RRC-TS)
must first approve the standards and requirements
for such programs. Individuals will match
for such programs directly from medical school
or at some later time. It is estimated that the
first such programs would begin to accept residents
in 2004 at the earliest.
4. A third pathway to ABTS certification will
be through successful completion of an ACGMEapproved
three-year thoracic surgery residency
after a minimum of three years in an ACGMEapproved
general surgery residency, so long as
certain prerequisite criteria are met during the
general surgery training. These prerequisites include:
General surgery: 12 months
(including six months abdominal
surgery and six months pediatric,
oncology, and head and neck surgery)
Critical care: 2 months
Transplantation and immunology: 2 months
Trauma: 2 months
Cardiothoracic surgery: 3 months
Vascular surgery: 3 months
Total: 24 months
It is estimated that such programs would begin
to accept residents in 2005 at the earliest.
5. Any individual currently in the ABTS certification
process (that is, in a thoracic surgery
residency or has already finished a thoracic
surgery residency) will be guided by the requirements
in force at the time of his or her residency.
6. The ABTS supports the following recommendations
of the Joint Council for Thoracic
Surgery Education (JCTSE):
a. The JCTSE strongly encourages the RRCTS
as part of the special requirements for thoracic
surgery residencies to require documentation
of faculty participation in medical school
curriculum.
b. The JCTSE strongly encourages the ABS
and Association of Program Directors in Surgery
(APDS) to develop a shorter curriculum in ?surgery?
?to include ABS certification that, if and
when approved, would permit an alternate pathway
to ABTS certification.
c. The JCTSE strongly encourages the ABS
and APDS to participate in the development of
a surgical preparatory core curriculum as a standard
entry to ACGME boarded surgical specialties.
Interested parties should take particular note
that the categorical-integrated program and the
3/3 program mentioned above have yet to be fully
developed and will require approval action by
the RRC-TS before they become available. The
ABTS is committed to working closely with the
ABS and other organizations in general surgery
toward the development of combined 4/3 programs
leading to the possibility of certification
by both the ABS and the ABTS.
.
