• Alexander P Nissen, Julian A Smith, Jan Dieter Schmitto, Silvia Mariani, AlmeidaRui M SRMSDivision of Cardiovascular Surgery, Western Parana State University, Cascavel, Brazil., Jonathan Afoke, Tohru Asai, Jessica G Y Luc, Oz M Shapira, Ari Mennander, Akiko Tanaka, Vasily I Kaleda, Song Wan, Alexander Wick, Hermann Reichenspurner, Benjamin M Cohn, and Tom C Nguyen.
• Department of Cardiothoracic and Vascular Surgery, The University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Tex; Department of Surgery, San Antonio Military Medical Center, Fort Sam Houston, Tex.
• J. Thorac. Cardiovasc. Surg. 2020 Jan 28.

ObjectiveVarious methods for cardiothoracic, cardiovascular, and cardiac surgical training exist across the globe, with the common goal of producing safe, independent surgeons. A comparative analysis of international training paradigms has not been undertaken, and our goal in doing so was to offer insights into how to best prepare future trainees and ensure the health of our specialty.MethodsWe performed a comparative analysis of available publications offering detailed descriptions of various cardiothoracic, cardiovascular, and cardiac surgical training paradigms. Corresponding authors from previous publications and other international collaborators were also reached directly for further data acquisition.ResultsWe report various approaches to common challenges surrounding (1) selection of trainees and plans for the future surgical workforce; (2) trainee assessments and certification of competency before independent practice; and (3) challenges related to a changing practice landscape.ConclusionsCardiothoracic surgery remains a dynamic and rewarding specialty. Current and future trainees face several challenges that transcend national borders. To foster collaboration and adoption of best practices, we highlight international strengths and weaknesses of various nations in terms of workforce selection, trainee operative experience and assessment, board certification, and preparation for future changes anticipated in cardiothoracic surgery.Copyright © 2020 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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