Unmatched Integrated Cardiothoracic Surgery Program Applicants: Where Do They End Up?

Background: With the recent introduction of Integrated Cardiothoracic Surgery Residency Programs (IPs), limited data exist on unmatched applicants. We aimed to determine the dropout rate in individuals who applied for IP but did not match. Methods: An online Institutional Review Board–approved survey was sent to current residents (n = 409), provided by the Thoracic Surgery Directors Association, to evaluate preferences and pathway to cardiothoracic surgery (CTS). Descriptive analysis was performed on quantitative data. Main Residency Match Data from 2008 to 2017 were collected. Results: Of 250 respondents, 89 (36%) were in IPs. In the cohort, 110 (44%) applied for at least one IP, whereas only 10 of the remaining 140 CTS residents had contemplated applying. From written comments of those 140 residents, the most common reasons against applying for IP programs were (1) uncertainty of IP training/belief that general surgery offered more well-rounded training and (2) uncommitted to CTS as a medical student. Interestingly, 96% of IP residents were set on a cardiac career, whereas a larger proportion of 4/3 and traditional residents were interested in general thoracic (36%). According to the National Resident Matching Program, 147 individuals applied to IP programs from 2008 to 2011 and were unmatched. Only 20 of those individuals (14%), from our results, ended up in a CTS residency program. Conclusions: Only a small percentage of applicants that did not match to an IP from 2008 to 2011 have ended up in CTS. As IPs continue to develop and improve, the concerns brought about by current CTS residents must be addressed to attract the next generation of exceptional surgeons.