J Chest Surg.
2023 Nov;56(6):420-430. 10.5090/jcs.23.093.
A 20-Year Update on the Practice of Thoracic Surgery in Canada: A Survey of the Canadian Association of Thoracic Surgeons
- Abdul SA
1,2,3 - Wright F4,5
- Finley C6,7,8
- Gilbert S1,2,3,8
- Seely AJE1,2,3,8
- Sundaresan S1,2,3,8
- Villeneuve PJ1,2,3,8
- Maziak DE1,2,3,5,8,
- Affiliations
-
- 1Division of Thoracic Surgery, The Ottawa Hospital General Campus, Ottawa, ON, Canada
- 2Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- 3Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- 4Department of Surgery, Faculty of Medicine, University of Toronto; 5 Ontario Health (Cancer Care Ontario), Toronto, ON, Canada
- 5Department of Surgery, Faculty of Medicine, McMaster University, Hamilton, ON, Canada
- 6Canadian Partnership Against Cancer (CPAC), Toronto, ON, Canada
- 7Canadian Association of Thoracic Surgeons (CATS), Ottawa, ON, Canada
- 8Telfer School of Management, University of Ottawa, Ottawa, ON, Canada
- KMID: 2547734
- DOI: http://doi.org/10.5090/jcs.23.093
Abstract
- Background
This study provides an update to a landmark 2004 report describing demographics, training, and trends in adherence to thoracic surgery practice standards in Canada.
Methods
An updated questionnaire was administered to all members of the Canadian Association of Thoracic Surgeons via email (n=142, compared to n=68 in 2004). Our report incorporates internal data from Ontario Health and the Canadian Partnership Against Cancer.
Results
Forty-eight surgeons completed the survey (male, 70.8%; mean±standard deviation age, 50.3±9.3 years). This represents a 33.8% response rate, compared to 64.7% in 2004. Most surgeons (69%) served a patient population of over 1 million per center; 32%–34% reported an on-call ratio of 1:4–1:5 days, and the average weekly hours worked was 56.4±11.9. Greater access to dedicated geographic units per center (73% in 2021 vs. 53% in 2004) has improved thoracic-associated services and house staff, notably endoscopy units (100% vs. 91%), with 73% of respondents having access to both endobronchial and endoscopic ultrasound. Access to thoracic radiology has also improved, particularly regarding positron emission tomography scanners per center (76.9% vs. 13%). Annual case volumes for lung (255 vs. 128), esophageal (41 vs. 19), and mediastinal resections (30 vs. 13), along with hiatal hernia repair (45 vs. 20), have increased substantially despite reports of operating room availability and radiology as rate-limiting steps.
Conclusion
This survey characterizes compliance with current practice standards, addressing the needs of thoracic surgeons across Canada. Over 85% of respondents were aware of the 2004 compliance paper, and 35% had applied for resources and equipment in response.
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