The Society of Thoracic Surgeons hosted an early career webinar, How to Maximize Your First Six Months of Training, facilitated by Sandeep Bharadwaj, MD, Northwestern University, and featuring insights from faculty, fellows, and recent graduates, including Sara Pereira, MD, Indiana University School of Medicine; Irbaz Hameed, MD, Yale University School of Medicine; Allison Davila, MD, Lurie Children’s Hospital of Chicago; Kathleen Banfield, MD, University of Washington; and Rachel Schenkel, MD, University of Minnesota. The session focused on how residents and fellows can set themselves up for success during the critical early months of cardiothoracic surgery training.

Here are the five key takeaways:

1. Preparation and Attention to Detail Build Trust

Panelists emphasized that preparation begins with knowing the patient thoroughly through indications, imaging, labs, and prior operative notes. Because each attending has different preferences, keeping a running document of techniques and nuances is invaluable. Remembering even small details, such as how a surgeon places retraction stitches, signals meticulousness and builds early trust.

Tip: Take notes or create personalized preference cards after each case. Reviewing them before scrubbing in demonstrates initiative and reliability.

Panelists also talked about the importance of using medical journals and resources strategically. For example, the Annals of Thoracic Surgery was highlighted as the most commonly read journal, with additional helpful content sometimes found in cardiology-focused publications such as Circulation or JACC. Apps like the older CSAT versions can also be valuable if still available.

2. Maximize Rotations Beyond the Operating Room

Early in training, residents should take advantage of rotations in anesthesia, perfusion, and imaging. These experiences provide foundational knowledge about cardiopulmonary bypass, echocardiography, and perioperative care that will make OR time more meaningful later.

Advice from faculty: “You’ll have plenty of opportunities for cardiac and thoracic cases. Early on, prioritize learning the physiology, imaging, and team dynamics that support those operations.”

3. Presence Matters More Than Case Volume

Technical milestones in the first six months vary widely and depend largely on faculty trust. Rather than focusing on how many sternotomies or cannulations you log, concentrate on showing up prepared and present. Double-scrubbing, even when you’re not the primary, provides an opportunity to observe technique, communication, and decision-making without the pressure of leading the case. 

Key reminder: “It isn’t always about doing, it’s about being present and understanding the flow of the operation.”

4. Clarify Communications, Manage Expectations, and Avoid Comparisons

Many trainees struggle with self-doubt when their technical skills don’t advance as quickly as their peers’ skills. Faculty urged residents not to compare themselves to others or to what’s portrayed on social media. Everyone progresses at a different pace, and impostor syndrome is common. Define communications protocols. Different institutions use pagers, texts, WhatsApp, Epic chat, or Teams messages. Trainees should learn the preferred hierarchy of communication (e.g., page - call vs. text - call) and align with their team’s expectations. Junior residents are also encouraged to err on the side of overcommunication with seniors and attendings. If you’re unsure whether to call, the safe rule is that you should.

Practical step: Check in regularly with program directors or attendings. Structured feedback often reveals that you’re performing at or above expectations, even if you feel behind.

5. Develop a Study System That Works for You

Learning outside the OR is just as important as time inside it. Some panelists recommended structured reading plans, such as committing to one textbook in the first year, while others suggested journaling surgical techniques or building photo libraries of operative steps. The method matters less than consistency.
Advice from the panel: Identify a study routine early and stick to it, whether through textbooks, operative atlases, or case-based reviews. Over time, selective reading and case preparation will sharpen your clinical judgment.

The first six months of cardiothoracic surgery training are about more than technical skills. They are about building trust, cultivating presence, and laying the foundation for a lifelong career. By preparing thoroughly, engaging fully in every rotation, and giving themselves grace, residents can maximize this critical period.

 

Sep 22, 2025
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The next generation of cardiothoracic surgeons took a major step forward in their training during the 2025 STS Boot Camp, held August 21–24 in Chicago. Over four days, 60 junior residents from across the country received intensive, hands-on guidance from leading CT surgeons. Attendees engaged in high-fidelity simulations of real-world and emergency scenarios, gaining valuable experience in a structured instructional framework.

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STS Boot Camp
Participants practiced core critical thinking skills in a focused setting.

“This year’s Boot Camp offered first-year residents a unique chance to practice fundamental cardiothoracic skills in a low stress setting,” said program co-chair Jonathan Nesbitt, MD, of Vanderbilt University. “Personalized instruction from experienced faculty, combined with realistic scenarios, helped participants build both competence and confidence in a focused environment.”

The curriculum included training in cardiopulmonary bypass techniques, vessel anastomosis, diagnostic and therapeutic endoscopies, open and robotic lobectomy, TAVR/TEVAR, and wire skills. Participants also received instruction on mitral and aortic valve surgery, echocardiography, communication in the operating room, and the role of surgical ablation.

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STS Boot Camp
First-year CT surgery residents simulated real-world and emergency scenarios.

For many participants, the Boot Camp also sparked inspiration and enthusiasm about their path ahead. "I'm truly excited about building a foundation at the beginning of my fellowship and what the future holds for me," said Boot Camp participant Weston Andrews, MD, a cardiothoracic fellow at the Medical College of Wisconsin. 

“We designed this program to strengthen technical skills while also fostering reflection, discussion, and connection,” said Dr. Nesbitt. “From complex procedures to feedback in the OR, this experience supports a smooth, engaged transition into surgical training—with mentorship every step of the way.”

 

Aug 26, 2025
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Don’t miss the latest Thinking Thoracic episode as host Erin Gillaspie, MD, is joined by Stephanie Worrell, MD, associate professor, University of Arizona, and thoracic surgeon, Banner Health, for a lively and insightful post-ASCO discussion. Together, they unpack the significance of the CheckMate 577 and Matterhorn trials, and explore what these groundbreaking studies mean for the future of esophageal and gastroesophageal junction cancer care.

Tune in to hear their take on:

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