On becoming a cardiac surgeon in Russia: survey among cardiovascular surgical residency graduates

Despite the fact that Russia has a long history of cardiac surgery, little is known about how cardiac surgeons are actually trained here. Our aim was to reveal current challenges in cardiac surgical training in Russia by surveying recent residency (ordinatura) graduates.

An online survey using Google Forms was conducted among cardiovascular surgical residency graduates who completed their training in 2017–2021. The survey contained 34 questions on demography, workload, technical and non-technical skills, research, mentor–mentee relationship, etc. In addition, room for comments was provided.

From February 19, 2022, to March 12, 2022, 69 entries were received. Sixty entries were available for analysis, 14 (23%) were from female surgeons and 35 (58%) were from those who chose cardiac surgery as a primary subspecialty. The median age of residency graduates was 25 (IQR 25.0–26.3). The median number of residents per hospital was 7 (IQR 4.0–14.0). The majority of respondents (60%) were trained in hospitals performing 350–3500 cardiac surgical procedures annually. Forty-five (75%) respondents entered cardiovascular surgical residency immediately after medical school. Fifty-two (87%) responders worked for at least 60 h per week during residency and 31 (52%) responders participated in more than five surgical procedures per week. Data on cardiac surgical technical skills were collected only for the 35 respondents who chose cardiac surgery as a primary subspecialty. Only 3 respondents reported performing cardiac surgical procedure as a first operator during the training. As for the simulation training, it was a mandatory part of the program only for 8% of respondents. While 55% of the respondents stated that their mentors had no allocated time for communication with residents, only 32% pointed out that they were not able to freely share their problems, doubts, and get help from the mentor. At the same time, only 8% of respondents said they had discussed papers with mentors, and research was a mandatory part of training for 17% of respondents. Unstructured comments by respondents indicated dissatisfaction with mentorship and training.

Our study showed that during a residency in cardiovascular surgery trainees were unable to master the surgical skills necessary to perform cardiac surgery. Among possible reasons, there were a very short duration of training and a lack of mentorship. These factors may contribute to trainees’ overall dissatisfaction with their training. Further study is warranted to assess the effectiveness of current cardiac surgical training in Russia.