Insights Into Thoracic Surgery Training Program in Italy: A Nationwide Residents' Survey

AIM: To achieve continuous improvement of thoracic surgery residency program, it is of paramount importance to acknowledge and understand its features. Due to the lack of Italian evidence in literature, the residents' perspective was investigated through a nation-wide survey, focusing on the surgical exposure within Italian residency programs. METHODS: An online anonymous and voluntary survey of 74 items was generated with SurveyMonkey and sent to all thoracic surgery residents in Italy, between the 2nd and the 5th year of residency, selectively investigating surgical exposure and its potential influencing factors. RESULTS: Among 193 Italian thoracic surgery residents, 103 (53.4%) completed the survey and were included in the analysis. The mean cumulative and monthly number of surgical procedures carried out as first operator were 32.5 ± 44.0 (median 20.0) and 1.97 ± 1.95 (median 1.0), respectively. Independent factors associated to surgical exposure at the multivariable analysis were the administrative workload relative ratio (RR) 0.89, ([95% CI 0.84-0.99], p < 0.001), the perceived idea of free time RR 2.69 ([1.45-4.96], p = 0.003), the year of residency RR 0.34 ([0.17-0.68], p = 0.009), the gender RR 1.46 ([1.07-2.45], p = 0.045), and the number of residents per department RR 0.43 ([0.22-0.85], p = 0.043). CONCLUSIONS: According to the residents' perspective, Italian thoracic surgery residency program is a well-structured educational offer, where surgical exposure overlaps with that offered across Europe. Nonetheless, efforts should be done to address the main criticalities raised to continuously increase the quality of Italian residency programs, aiming at enhancing surgical exposure, as well as promoting fair education.