Cardiac surgery: what the future holds?

Medical Student Perspectives on the Impact of Artificial Intelligence on the Practice of Medicine

INTRODUCTION

Concerns about radiologists being replaced by artificial intelligence (AI) from the lay media could have a negative impact on medical students' perceptions of radiology as a viable specialty. The purpose of this study was to evaluate United States of America medical students' perceptions about radiology and other medical specialties in relation to AI.

METHODS

An anonymous, web-based survey was sent to 32 radiology interest groups at United States medical schools. The survey was comprised of 6 questions assessing medical student perceptions of AI and its potential impact on radiology and other medical specialties. Responses were voluntary and collected over a 6-month period from November 2017 to April 2018.

RESULTS

A total of 156 students responded with representation from each year of medical school. Over 75% agreed that AI would have a significant role in the future of medicine. Most (66%) agreed that diagnostic radiology would be the specialty most greatly affected. Nearly half (44%) reported that AI made them less enthusiastic about radiology. The majority of students (57%) obtained their information about AI from online articles. Thematic analysis of free answer comments revealed mostly neutral comments towards AI, however, the negative responses were the strongest and most detailed.

CONCLUSIONS

US medical students believe that AI will play a significant role in medicine, particularly in radiology. However, nearly half are less enthusiastic about the field of radiology due to AI. As the majority receive information about AI from online articles, which may have negative sentiments towards AI's impact on radiology, formal AI education and medical student outreach may help combat misinformation and help prevent the dissuading of medical students who might otherwise consider the specialty.

Cardiothoracic surgery training grants provide protected research time vital to the development of academic surgeons

BACKGROUND

The Ruth L. Kirschstein Institutional National Research Service Award (T32) provides institutions with financial support to prepare trainees for careers in academic medicine. In 1990, the Cardiac Surgery Branch of the National Heart, Lung and Blood Institute (NHLBI) was replaced by T32 training grants, which became crucial sources of funding for cardiothoracic (CT) surgical research. We hypothesized that T32 grants would be valuable for CT surgery training and yield significant publications and subsequent funding.

METHODS

Data on all trainees (past and present) supported by CT T32 grants at two institutions were obtained (T32), along with information on trainees from two similarly sized programs without CT T32 funding (Non-T32). Data collected were publicly available and included publications, funding, degrees, fellowships, and academic rank. Non-surgery residents and residents who did not pursue CT surgery were excluded.

RESULTS

Out of 76 T32 trainees and 294 Non-T32 trainees, data on 62 current trainees or current CT surgeons (T32: 42 vs Control: 20) were included. Trainees who were supported by a CT T32 grant were more likely to pursue CT surgery after residency (T32: 40% [30/76] vs Non-T32: 7% [20/294], P < .0001), publish manuscripts during residency years (P < .0001), obtain subsequent NIH funding (T32: 33% [7/21] vs Non-T32: 5% [1/20], P = .02), and pursue advanced fellowships (T32: 41% [9/22] vs Non-T32: 10% [2/20], P = .02).

CONCLUSIONS

T32 training grants supporting CT surgery research are vital to develop academic surgeons. These results support continued funding by the NHLBI to effectively develop and train the next generation of academic CT surgeons.

Early Mentoring of Medical Students and Junior Doctors on a Path to Academic Cardiothoracic Surgery

BACKGROUND

In 2005 the Department of Cardiothoracic Surgery at The Royal Children's Hospital started an early academic mentoring program for medical students and junior doctors with the aim of fostering an interest in academic surgery.

METHODS

Between 2005 and 2015, 37 medical students and junior doctors participated in research in the Department of Cardiothoracic Surgery at The Royal Children's Hospital. Each was given an initial project on which to obtain ethics approval, perform a literature review, data collection, statistical analysis, and prepare a manuscript for publication. A search of the names of these former students and doctors was conducted on PubMed to identify publications.

RESULTS

A total of 113 journal articles were published in peer-reviewed journals with an average impact factor of 4.1 (range, 1.1 to 19.9). Thirty (30 of 37, 81%) published at least one article. A mean of 4.3 journal articles was published per student or junior doctor (range, 0 to 29). Eleven (11 of 37, 30%) received scholarships for their research. Nine (9 of 37, 24%) have completed or are enrolled in higher research degrees with a cardiothoracic surgery focus. Of these 9, 2 have completed doctoral degrees while in cardiothoracic surgery training. Five will complete their cardiothoracic surgery training with a doctoral degree and the other 2 are pursuing training in cardiology.

CONCLUSIONS

A successful early academic mentoring program in a busy cardiothoracic surgery unit is feasible. Mentoring of motivated individuals in academic surgery benefits not only their medical career, but also helps maintain high academic output of the unit.

Epidemiology of cardiovascular disease in the United States: implications for the perfusion profession. A 2017 update

INTRODUCTION

By analyzing epidemiological trends in cardiovascular disease (CVD), key stakeholders can make informed decisions on the future of disease burden and treatment. Accordingly, the cardiovascular perfusion community would benefit from data that would help predict future professional resource utilization.

METHODS

In 2003, the changes in the number of hospital discharges for CVD from 1990 to 2000 were published, based on data from the National Center for Health Statistics (NCHS). In this study, the NCHS database was reviewed, as well as other resources, to compile the procedure data.

RESULTS

Deaths due to heart disease and the number of hospital admissions for CVD have decreased over the last decade in contrast to the previous decade. Acute myocardial infarction (AMI), cardiac catheterization and angioplasty rates have also decreased. However, the percentage of the population older than 65 years of age is increasing at a much faster rate than the population growth in general. As a result, there has been a consistent increase in cardiac services utilization, such as transcatheter aortic valve replacement (TAVR), ventricular assist devices and extracorporeal life support (ECLS).

CONCLUSIONS

There are many different factors affecting the need for perfusionists in the future. An increasing and aging population with a higher prevalence of CVD, an increased number of hospitals offering cardiovascular services and increased access to care increases the need for perfusion services. It is important for the perfusion profession to follow these changing trends in CVD and treatment in order to plan for the future.