Training and mentoring of the congenital heart surgeon for India

Abstract

Congenital heart surgery is one of the most demanding subspecialities in surgery. To become a competent surgeon, a lot of investment of time, in-depth study, training under a committed mentor, acquisition of the necessary fine surgical skills, and development of a three-dimensional appreciation of corrections are needed to be cultivated. These make it not only a speciality of skills, but also a cerebral speciality. It is commonly felt amongst the residents training in cardiovascular and thoracic surgery that they perform far less operative work to make them even “somewhat” confident of doing procedures independently towards the end of their residency. If this young cardiac surgeon needs to subspecialize in congenital heart surgery, more exposure to newer concepts and a much higher level of skill-based training become mandatory for achieving competence. Taking all this into consideration, this article will dwell on some of the traits and abilities that are desired in the candidates choosing to train in congenital heart surgery (CHS), the requirements of the speciality, and some tips to the trainers/mentors to help in effective devolution of thoughts, principles, and skills. Salient points of the mentoring process have also been discussed. A modular plan for staged acquisition and transmission of surgical skills, as well as surgical management of common congenital cases, has been outlined. Finally, a note is added to sensitize the young congenital heart surgeon to learn to embrace the nuances of practicing this speciality in India. This could also apply to many other developing and low- and middle-income countries.