Clinical Competence in Thoracic Surgery

Clinical competence in thoracic surgery requires factual knowledge and technical skills in the preoperative evaluation, operative management, and postoperative care of patients, including critical care, with pathologic conditions involving thoracic structures.  Precise definition of the scope of thoracic surgery as well as the current methods used to assess education, knowledge and experience  have been developed to ensure that an individual who is certified by the American Board of Thoracic Surgery has met certain standards and qualifications. 

The scope of thoracic surgery encompasses a knowledge of normal and pathologic conditions of both cardiovascular and general thoracic structures.  This includes congenital and acquired lesions (including infections, trauma, tumors, and metabolic disorders) of both the heart and blood vessels in the thorax, as well as diseases involving the lungs, pleura, chest wall, mediastinum, esophagus, and diaphragm.  In addition, the ability to establish a precise diagnosis, an essential step toward proper therapy, requires familiarity with diagnostic procedures such as cardiac catheterization, angiography, electrocardiography, echocardiography, imaging techniques, endoscopy, tissue biopsy, and biologic and biochemical tests appropriate to thoracic diseases.  It is essential that the thoracic surgeon be knowledgeable and experienced in evolving techniques, such as laser therapy, endovascular procedures, electrophysiologic procedures and devices, thoracoscopy and thoracoscopic surgery. Thoracic surgeons receive education and experience in the critical care of patients with cardiothoracic diseases, as an integral part of residency.

The factual knowledge and technical skills necessary to treat patients with thoracic conditions are obtainable in a thoracic surgery residency program that is approved by the RRC-TS and accredited by the ACGME.  The highest educational standards are best achieved in residency programs in which close supervision and instruction as well as progressive individual responsibility for operative and postoperative care are possible. 

The American Board of Thoracic Surgery realizes that an examination primarily tests the ability to reason and the factual knowledge acquired by the candidate.  The limitations of examinations alone to assess clinical competence are well recognized, and an important part of the responsibility for determining clinical competence rests upon the director of each thoracic surgery residency program.   It is for this reason that only applicants who complete an accredited thoracic surgery residency program will be considered for examination.  It is during the period of residency that the trainee's ethical and moral character, judgment, technical skills, and abilities to cope with a wide variety of clinical problems can be assessed most accurately.  Thus, the endorsement of the candidate by the Program Director and faculty are required to complete eligibility for certification by the American Board of Thoracic Surgery. 

Following the completion of residency in an accredited program, written and oral examinations are given to assess the trainee's capabilities.  These examinations are constructed and given annually by the American Board of Thoracic Surgery.  Consultation and assistance in developing the examinations and analyzing the results are obtained from psychometricians and other experts.  The validity and reliability of the examination process are scrutinized continually.  To enter the examination process, candidates must submit to the ABTS office an application form that includes the specifics of their thoracic surgical operative experience in residency and the signature of the Program Director indicating satisfactory completion of the residency program.  A passing score on the examination acknowledges that the candidate possesses a broad knowledge base that is necessary to be clinically competent in thoracic surgery.  

The current methods for establishing the candidate's qualifications are reviewed periodically and revised, when appropriate, in a continuing effort to assure the public that thoracic surgeons certified by the American Board of Thoracic Surgery have been adequately educated in and are competent to practice the specialty. 

American Board of Thoracic Surgery
633 North St. Clair Street, Suite 2320
Chicago, IL 60611
Tel: 312-202-5900
Fax: 312-202-5960

Copyright © 1998 - 2011 by The American Board of Thoracic Surgery.