In the United States and Canada, a cardiac surgery residency typically comprises anywhere from six to nine years (or longer) of training to become a fully qualified surgeon. Cardiac surgery training may be combined with thoracic surgery and / or vascular surgery and called cardiovascular (CV) / cardiothoracic (CT) / cardiovascularthoracic (CVT) surgery. Cardiac surgeons may enter a cardiac surgery residency directly from medical school, or first complete a general surgery residency followed by a fellowship. Cardiac surgeons may further sub-specialise cardiac surgery by doing a fellowship in a variety of topics including: pediatric cardiac surgery, cardiac transplantation, adult acquired heart disease, etc.
Historically, cardiac surgeons in Canada completed general surgery followed by a fellowship in CV / CT / CVT. During the 1990's, the Canadian cardiac surgery training programs changed to six-year "direct-entry" programs following medical school. The direct-entry format provides residents with experience related to cardiac surgery they would not receive in a general surgery program (e.g. echocardiography, coronary care unit, cardiac pathology, etc).
Contemporary Canadian candidates completing general surgery and wishing to pursue cardiac surgery often complete a cardiothoracic surgery fellowship in the United States. However, the University of Toronto offers a three-year cardiac surgery fellowship for qualified general surgeons.
Cardiac surgery training in the United States is combined with thoracic surgery and called cardiothoracic surgery. Cardiothoracic surgeons in the U.S. first complete a general surgery residency (typically five to seven years), followed by a cardiothoracic surgery fellowship. The Cardiothoracic fellowship typically spans two or three years, but certification is based on the number of surgeries performed as the operating surgeon, not the time spent in the program. Recently, however, options for a six-year cardiothoracic residency (in place of the general surgery residency plus fellowship) have been established at a few select institutions.
The American Board of Thoracic Surgery offers a special pathway certificate in congenital heart surgery which typically requires an additional year of fellowship. This formal certificate is unique because pediatric cardiac surgeons in other countries do not have formal evaluation and recognition of pediatric training by a licensing body.
- Overview of the University of Toronto cardiac surgery program, a Canadian direct-entry training program.