Training in General Thoracic Surgery in Europe

Dear Colleague,

As one of the European ESTS members, we would like to ask you to participate in this online survey to investigate the current training in General Thoracic Surgery across Europe and has two main objectives: to evaluate the current training situation and compare it to a previous evaluation performed in 2010.

All the questions in this survey relate exclusively to your opinions and practices. According to the system's estimation, this 45-question survey will take less than 25 minutes.

This survey is divided into demographic data (questions 1 to 23), state-of-the-art information (questions 24 to 38), future perspectives (questions 38 to 45), and final comments. The last question is a co-authorship data request. If you complete this questionnaire in all parts, you will allow the ESTS Society to understand the past and present, and together we can pave the way for the future of our specialty.

Your contribution is essential, and your effort in completing the survey in all parts requested can be part of OUR future projects.

Thank you,

Nuria Novoa
Director of Education on behalf of the ESTS Learning Affairs Committee

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* 1. Are you?

Female

Male

Other / Not to disclose

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* 2. How old are you?

<25

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-70

>70

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* 3. What year did you complete your basic medical school?

NOTE: if you don't recall the day and/or the month just write 01/06/and the precise year

Date

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* 4. What year did you graduate as a specialist?

NOTE: if you don't recall the day and/or the month just write 01/06/and the precise year

Date

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* 5. In which country of the European continent did you have the majority of your specialty training? IF YOU ARE NOT ON THE LIST, DO NOT ANSWER ANY FURTHER QUESTIONS.

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* 6. Year of Specialty training in Thoracic Surgery (only reply if still a Trainee)

first year

second year

third year

fourth year

fifth year

sixth year

seventh year

Other (please specify):

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* 7. Please type the NUMBER of years in practice in Thoracic Surgery as a board certified surgeon:

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* 8. Postgraduate Qualifications (mark all that apply)

MSc

PhD

National Exam thoracic surgery passed

European Board certified (EBTS, EBCTS)

Master's of Business Administration in Healthcare (MBA)

American Board Certified (ABTS)

Other (please specify):

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* 9. Are you an active member of (mark all that apply)

ESTS

EACTS

AATS

STS

CATS

ESDE

ISDE

ESOT

ESA

ERS

ACCP

IASLC

National Thoracic Surgery Society

Other:

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* 10. In your Country what is the minimum length of training to become a certified thoracic surgeon after finishing medical school, i.e., years between medical school completion and the first day of your certified surgical practice?

>10

I cannot answer this question because the specialty of Thoracic Surgery does not exist in my country.

Other (please specify)

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* 11. Which of the following options matches your training system most?

Thoracic Surgery only

Thoracic Surgery + Lung Transplant

General Surgery + Thoracic Surgery

General Surgery + Cardiothoracic Surgery

Cardiothoracic Surgery only

General Surgery + Vascular and Thoracic Surgery

Vascular and Thoracic Surgery only

Other Specialties you did (please specify):

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* 12. Did you also rotate in other departments (i.e., medicine and radiology) during your specialty training?

Yes

Yes. I have it in my specialty program, but I prefer to stay in in the same field (i.e. Thoracic Surgery) and move in different hospital accredited for.

No. But I would like to have it.

No. I think it isn't worth it to do.

Other (please specify):

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* 13. Is/was esophageal surgery part of your training?

Yes

No It is/was not part of my training but I wish to do it

No It is/was not part of my training but and I don't care

It is/was partly in my training program

Other:

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* 14. Will esophageal surgery be part of your training? Please answer if you are a certified Thoracic Surgeon

Yes

Yes preferably trained in a certified center

No and I don't want to consider this as an option

Other:

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* 15. Did you have any part (i.e., specialty, fellowship) of your training abroad?

another European country

another continent (non-European country)

I have/had my full training in the same institution and affiliated hospitals.

I have/had my training in different institutions in the same European country.

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* 16. Do you feel comfortable performing the following as a FIRST SURGEON? Please answer NOT APPLICABLE if you do not have at least five years of thoracic surgery experience or you are in Specialty

	Not comfortable at all	Somewhat comfortable	Neutral	Somewhat comfortable	Completely comfortable	Not applicable
Minor Procedures (ie. pleural or lung biopsy, VATS wedge resection)	Minor Procedures (ie. pleural or lung biopsy, VATS wedge resection) Not comfortable at all	Minor Procedures (ie. pleural or lung biopsy, VATS wedge resection) Somewhat comfortable	Minor Procedures (ie. pleural or lung biopsy, VATS wedge resection) Neutral	Minor Procedures (ie. pleural or lung biopsy, VATS wedge resection) Somewhat comfortable	Minor Procedures (ie. pleural or lung biopsy, VATS wedge resection) Completely comfortable	Minor Procedures (ie. pleural or lung biopsy, VATS wedge resection) Not applicable
Intermediate procedures (ie. mediastinoscopy, straightforward lobectomy, empyema, complex pleural effusions and decortications)	Intermediate procedures (ie. mediastinoscopy, straightforward lobectomy, empyema, complex pleural effusions and decortications) Not comfortable at all	Intermediate procedures (ie. mediastinoscopy, straightforward lobectomy, empyema, complex pleural effusions and decortications) Somewhat comfortable	Intermediate procedures (ie. mediastinoscopy, straightforward lobectomy, empyema, complex pleural effusions and decortications) Neutral	Intermediate procedures (ie. mediastinoscopy, straightforward lobectomy, empyema, complex pleural effusions and decortications) Somewhat comfortable	Intermediate procedures (ie. mediastinoscopy, straightforward lobectomy, empyema, complex pleural effusions and decortications) Completely comfortable	Intermediate procedures (ie. mediastinoscopy, straightforward lobectomy, empyema, complex pleural effusions and decortications) Not applicable
Complex Procedures (ie. esophagectomy, sleeve lobectomy, tracheal surgery, extrapleural pneumonectomy, lung transplantation)	Complex Procedures (ie. esophagectomy, sleeve lobectomy, tracheal surgery, extrapleural pneumonectomy, lung transplantation) Not comfortable at all	Complex Procedures (ie. esophagectomy, sleeve lobectomy, tracheal surgery, extrapleural pneumonectomy, lung transplantation) Somewhat comfortable	Complex Procedures (ie. esophagectomy, sleeve lobectomy, tracheal surgery, extrapleural pneumonectomy, lung transplantation) Neutral	Complex Procedures (ie. esophagectomy, sleeve lobectomy, tracheal surgery, extrapleural pneumonectomy, lung transplantation) Somewhat comfortable	Complex Procedures (ie. esophagectomy, sleeve lobectomy, tracheal surgery, extrapleural pneumonectomy, lung transplantation) Completely comfortable	Complex Procedures (ie. esophagectomy, sleeve lobectomy, tracheal surgery, extrapleural pneumonectomy, lung transplantation) Not applicable
Minor Robotic Surgery Procedures (ie. pleural or lung biopsy, hyperhidrosis, wedge resection for fibrous pleural tumor)	Minor Robotic Surgery Procedures (ie. pleural or lung biopsy, hyperhidrosis, wedge resection for fibrous pleural tumor) Not comfortable at all	Minor Robotic Surgery Procedures (ie. pleural or lung biopsy, hyperhidrosis, wedge resection for fibrous pleural tumor) Somewhat comfortable	Minor Robotic Surgery Procedures (ie. pleural or lung biopsy, hyperhidrosis, wedge resection for fibrous pleural tumor) Neutral	Minor Robotic Surgery Procedures (ie. pleural or lung biopsy, hyperhidrosis, wedge resection for fibrous pleural tumor) Somewhat comfortable	Minor Robotic Surgery Procedures (ie. pleural or lung biopsy, hyperhidrosis, wedge resection for fibrous pleural tumor) Completely comfortable	Minor Robotic Surgery Procedures (ie. pleural or lung biopsy, hyperhidrosis, wedge resection for fibrous pleural tumor) Not applicable
Intermediate Robotic procedures (ie. straightforward lobectomy)	Intermediate Robotic procedures (ie. straightforward lobectomy) Not comfortable at all	Intermediate Robotic procedures (ie. straightforward lobectomy) Somewhat comfortable	Intermediate Robotic procedures (ie. straightforward lobectomy) Neutral	Intermediate Robotic procedures (ie. straightforward lobectomy) Somewhat comfortable	Intermediate Robotic procedures (ie. straightforward lobectomy) Completely comfortable	Intermediate Robotic procedures (ie. straightforward lobectomy) Not applicable
Complex Robotic Procedures (ie. esophagectomy, sleeve lobectomy, extrapleural pneumonectomy, lung transplantation)	Complex Robotic Procedures (ie. esophagectomy, sleeve lobectomy, extrapleural pneumonectomy, lung transplantation) Not comfortable at all	Complex Robotic Procedures (ie. esophagectomy, sleeve lobectomy, extrapleural pneumonectomy, lung transplantation) Somewhat comfortable	Complex Robotic Procedures (ie. esophagectomy, sleeve lobectomy, extrapleural pneumonectomy, lung transplantation) Neutral	Complex Robotic Procedures (ie. esophagectomy, sleeve lobectomy, extrapleural pneumonectomy, lung transplantation) Somewhat comfortable	Complex Robotic Procedures (ie. esophagectomy, sleeve lobectomy, extrapleural pneumonectomy, lung transplantation) Completely comfortable	Complex Robotic Procedures (ie. esophagectomy, sleeve lobectomy, extrapleural pneumonectomy, lung transplantation) Not applicable

Question Title

* 17. Please state the approximate number of surgical procedures you are doing during ***your actual Residency Training Program* OR your actual first five years of your Thoracic Surgery Practice as a first surgeon**:
Please answer NOT APPLICABLE if you you have more than five years of certified thoracic surgery experience.

	1-10	11-30	31-50	51-100	101-150	>150	Not applicable
Minor Procedures (i.e. pleural or lung biopsy, VATS wedge resection)	Minor Procedures (i.e. pleural or lung biopsy, VATS wedge resection) 1-10	Minor Procedures (i.e. pleural or lung biopsy, VATS wedge resection) 11-30	Minor Procedures (i.e. pleural or lung biopsy, VATS wedge resection) 31-50	Minor Procedures (i.e. pleural or lung biopsy, VATS wedge resection) 51-100	Minor Procedures (i.e. pleural or lung biopsy, VATS wedge resection) 101-150	Minor Procedures (i.e. pleural or lung biopsy, VATS wedge resection) >150	Minor Procedures (i.e. pleural or lung biopsy, VATS wedge resection) Not applicable
Intermediate procedures (ie. mediastinoscopy, straightforward lobectomy, empyema, complex pleural effusions and decortications)	Intermediate procedures (ie. mediastinoscopy, straightforward lobectomy, empyema, complex pleural effusions and decortications) 1-10	Intermediate procedures (ie. mediastinoscopy, straightforward lobectomy, empyema, complex pleural effusions and decortications) 11-30	Intermediate procedures (ie. mediastinoscopy, straightforward lobectomy, empyema, complex pleural effusions and decortications) 31-50	Intermediate procedures (ie. mediastinoscopy, straightforward lobectomy, empyema, complex pleural effusions and decortications) 51-100	Intermediate procedures (ie. mediastinoscopy, straightforward lobectomy, empyema, complex pleural effusions and decortications) 101-150	Intermediate procedures (ie. mediastinoscopy, straightforward lobectomy, empyema, complex pleural effusions and decortications) >150	Intermediate procedures (ie. mediastinoscopy, straightforward lobectomy, empyema, complex pleural effusions and decortications) Not applicable
Complex Procedures (i.e. esophagectomy, sleeve lobectomy, tracheal surgery, extrapleural pneumonectomy, lung transplantation)	Complex Procedures (i.e. esophagectomy, sleeve lobectomy, tracheal surgery, extrapleural pneumonectomy, lung transplantation) 1-10	Complex Procedures (i.e. esophagectomy, sleeve lobectomy, tracheal surgery, extrapleural pneumonectomy, lung transplantation) 11-30	Complex Procedures (i.e. esophagectomy, sleeve lobectomy, tracheal surgery, extrapleural pneumonectomy, lung transplantation) 31-50	Complex Procedures (i.e. esophagectomy, sleeve lobectomy, tracheal surgery, extrapleural pneumonectomy, lung transplantation) 51-100	Complex Procedures (i.e. esophagectomy, sleeve lobectomy, tracheal surgery, extrapleural pneumonectomy, lung transplantation) 101-150	Complex Procedures (i.e. esophagectomy, sleeve lobectomy, tracheal surgery, extrapleural pneumonectomy, lung transplantation) >150	Complex Procedures (i.e. esophagectomy, sleeve lobectomy, tracheal surgery, extrapleural pneumonectomy, lung transplantation) Not applicable
Minor Robotic Surgery Procedures (ie. pleural or lung biopsy, hyperhidrosis, wedge resection for fibrous pleural tumor)	Minor Robotic Surgery Procedures (ie. pleural or lung biopsy, hyperhidrosis, wedge resection for fibrous pleural tumor) 1-10	Minor Robotic Surgery Procedures (ie. pleural or lung biopsy, hyperhidrosis, wedge resection for fibrous pleural tumor) 11-30	Minor Robotic Surgery Procedures (ie. pleural or lung biopsy, hyperhidrosis, wedge resection for fibrous pleural tumor) 31-50	Minor Robotic Surgery Procedures (ie. pleural or lung biopsy, hyperhidrosis, wedge resection for fibrous pleural tumor) 51-100	Minor Robotic Surgery Procedures (ie. pleural or lung biopsy, hyperhidrosis, wedge resection for fibrous pleural tumor) 101-150	Minor Robotic Surgery Procedures (ie. pleural or lung biopsy, hyperhidrosis, wedge resection for fibrous pleural tumor) >150	Minor Robotic Surgery Procedures (ie. pleural or lung biopsy, hyperhidrosis, wedge resection for fibrous pleural tumor) Not applicable
Intermediate Robotic procedures (ie. straightforward lobectomy)	Intermediate Robotic procedures (ie. straightforward lobectomy) 1-10	Intermediate Robotic procedures (ie. straightforward lobectomy) 11-30	Intermediate Robotic procedures (ie. straightforward lobectomy) 31-50	Intermediate Robotic procedures (ie. straightforward lobectomy) 51-100	Intermediate Robotic procedures (ie. straightforward lobectomy) 101-150	Intermediate Robotic procedures (ie. straightforward lobectomy) >150	Intermediate Robotic procedures (ie. straightforward lobectomy) Not applicable
Complex Robotic Procedures (ie. esophagectomy, sleeve lobectomy, extrapleural pneumonectomy, lung transplantation)	Complex Robotic Procedures (ie. esophagectomy, sleeve lobectomy, extrapleural pneumonectomy, lung transplantation) 1-10	Complex Robotic Procedures (ie. esophagectomy, sleeve lobectomy, extrapleural pneumonectomy, lung transplantation) 11-30	Complex Robotic Procedures (ie. esophagectomy, sleeve lobectomy, extrapleural pneumonectomy, lung transplantation) 31-50	Complex Robotic Procedures (ie. esophagectomy, sleeve lobectomy, extrapleural pneumonectomy, lung transplantation) 51-100	Complex Robotic Procedures (ie. esophagectomy, sleeve lobectomy, extrapleural pneumonectomy, lung transplantation) 101-150	Complex Robotic Procedures (ie. esophagectomy, sleeve lobectomy, extrapleural pneumonectomy, lung transplantation) >150	Complex Robotic Procedures (ie. esophagectomy, sleeve lobectomy, extrapleural pneumonectomy, lung transplantation) Not applicable

Other (please specify)

Question Title

* 18. Please state the approximate number of surgical procedures you are doing during your actual Residency Training Program OR your actual first five years of your Thoracic Surgery Practice as assistant surgeon:
Please answer NOT APPLICABLE if you you have more than five years of certified thoracic surgery experience.

	1-10	11-30	31-50	51-100	101-150	>150	Not applicable
Minor Procedures (i.e. pleural or lung biopsy, VATS wedge resection)	Minor Procedures (i.e. pleural or lung biopsy, VATS wedge resection) 1-10	Minor Procedures (i.e. pleural or lung biopsy, VATS wedge resection) 11-30	Minor Procedures (i.e. pleural or lung biopsy, VATS wedge resection) 31-50	Minor Procedures (i.e. pleural or lung biopsy, VATS wedge resection) 51-100	Minor Procedures (i.e. pleural or lung biopsy, VATS wedge resection) 101-150	Minor Procedures (i.e. pleural or lung biopsy, VATS wedge resection) >150	Minor Procedures (i.e. pleural or lung biopsy, VATS wedge resection) Not applicable
Intermediate procedures (ie. mediastinoscopy, straightforward lobectomy, empyema, complex pleural effusions and decortications)	Intermediate procedures (ie. mediastinoscopy, straightforward lobectomy, empyema, complex pleural effusions and decortications) 1-10	Intermediate procedures (ie. mediastinoscopy, straightforward lobectomy, empyema, complex pleural effusions and decortications) 11-30	Intermediate procedures (ie. mediastinoscopy, straightforward lobectomy, empyema, complex pleural effusions and decortications) 31-50	Intermediate procedures (ie. mediastinoscopy, straightforward lobectomy, empyema, complex pleural effusions and decortications) 51-100	Intermediate procedures (ie. mediastinoscopy, straightforward lobectomy, empyema, complex pleural effusions and decortications) 101-150	Intermediate procedures (ie. mediastinoscopy, straightforward lobectomy, empyema, complex pleural effusions and decortications) >150	Intermediate procedures (ie. mediastinoscopy, straightforward lobectomy, empyema, complex pleural effusions and decortications) Not applicable
Complex Procedures (i.e. esophagectomy, sleeve lobectomy, tracheal surgery, extrapleural pneumonectomy, lung transplantation)	Complex Procedures (i.e. esophagectomy, sleeve lobectomy, tracheal surgery, extrapleural pneumonectomy, lung transplantation) 1-10	Complex Procedures (i.e. esophagectomy, sleeve lobectomy, tracheal surgery, extrapleural pneumonectomy, lung transplantation) 11-30	Complex Procedures (i.e. esophagectomy, sleeve lobectomy, tracheal surgery, extrapleural pneumonectomy, lung transplantation) 31-50	Complex Procedures (i.e. esophagectomy, sleeve lobectomy, tracheal surgery, extrapleural pneumonectomy, lung transplantation) 51-100	Complex Procedures (i.e. esophagectomy, sleeve lobectomy, tracheal surgery, extrapleural pneumonectomy, lung transplantation) 101-150	Complex Procedures (i.e. esophagectomy, sleeve lobectomy, tracheal surgery, extrapleural pneumonectomy, lung transplantation) >150	Complex Procedures (i.e. esophagectomy, sleeve lobectomy, tracheal surgery, extrapleural pneumonectomy, lung transplantation) Not applicable
Minor Robotic Surgery Procedures (ie. pleural or lung biopsy, hyperhidrosis, wedge resection for fibrous pleural tumor)	Minor Robotic Surgery Procedures (ie. pleural or lung biopsy, hyperhidrosis, wedge resection for fibrous pleural tumor) 1-10	Minor Robotic Surgery Procedures (ie. pleural or lung biopsy, hyperhidrosis, wedge resection for fibrous pleural tumor) 11-30	Minor Robotic Surgery Procedures (ie. pleural or lung biopsy, hyperhidrosis, wedge resection for fibrous pleural tumor) 31-50	Minor Robotic Surgery Procedures (ie. pleural or lung biopsy, hyperhidrosis, wedge resection for fibrous pleural tumor) 51-100	Minor Robotic Surgery Procedures (ie. pleural or lung biopsy, hyperhidrosis, wedge resection for fibrous pleural tumor) 101-150	Minor Robotic Surgery Procedures (ie. pleural or lung biopsy, hyperhidrosis, wedge resection for fibrous pleural tumor) >150	Minor Robotic Surgery Procedures (ie. pleural or lung biopsy, hyperhidrosis, wedge resection for fibrous pleural tumor) Not applicable
Intermediate Robotic procedures (ie. straightforward lobectomy)	Intermediate Robotic procedures (ie. straightforward lobectomy) 1-10	Intermediate Robotic procedures (ie. straightforward lobectomy) 11-30	Intermediate Robotic procedures (ie. straightforward lobectomy) 31-50	Intermediate Robotic procedures (ie. straightforward lobectomy) 51-100	Intermediate Robotic procedures (ie. straightforward lobectomy) 101-150	Intermediate Robotic procedures (ie. straightforward lobectomy) >150	Intermediate Robotic procedures (ie. straightforward lobectomy) Not applicable
Complex Robotic Procedures (ie. esophagectomy, sleeve lobectomy, extrapleural pneumonectomy, lung transplantation)	Complex Robotic Procedures (ie. esophagectomy, sleeve lobectomy, extrapleural pneumonectomy, lung transplantation) 1-10	Complex Robotic Procedures (ie. esophagectomy, sleeve lobectomy, extrapleural pneumonectomy, lung transplantation) 11-30	Complex Robotic Procedures (ie. esophagectomy, sleeve lobectomy, extrapleural pneumonectomy, lung transplantation) 31-50	Complex Robotic Procedures (ie. esophagectomy, sleeve lobectomy, extrapleural pneumonectomy, lung transplantation) 51-100	Complex Robotic Procedures (ie. esophagectomy, sleeve lobectomy, extrapleural pneumonectomy, lung transplantation) 101-150	Complex Robotic Procedures (ie. esophagectomy, sleeve lobectomy, extrapleural pneumonectomy, lung transplantation) >150	Complex Robotic Procedures (ie. esophagectomy, sleeve lobectomy, extrapleural pneumonectomy, lung transplantation) Not applicable

Other (please specify)

Question Title

* 19. Please state the approximate number of surgical procedures done during your Residency Training Program OR Thoracic Surgery Practice in Emergencies (Specify):

	NONE	1-10	11-30	31-50	51-100	>100
Minor Procedures (i.e. chest tube insertion under local anaesthesia)	Minor Procedures (i.e. chest tube insertion under local anaesthesia) NONE	Minor Procedures (i.e. chest tube insertion under local anaesthesia) 1-10	Minor Procedures (i.e. chest tube insertion under local anaesthesia) 11-30	Minor Procedures (i.e. chest tube insertion under local anaesthesia) 31-50	Minor Procedures (i.e. chest tube insertion under local anaesthesia) 51-100	Minor Procedures (i.e. chest tube insertion under local anaesthesia) >100
Intermediate procedures (i.e. removing clots in VATS)	Intermediate procedures (i.e. removing clots in VATS) NONE	Intermediate procedures (i.e. removing clots in VATS) 1-10	Intermediate procedures (i.e. removing clots in VATS) 11-30	Intermediate procedures (i.e. removing clots in VATS) 31-50	Intermediate procedures (i.e. removing clots in VATS) 51-100	Intermediate procedures (i.e. removing clots in VATS) >100
Complex Procedures (i.e. bronchial rupture)	Complex Procedures (i.e. bronchial rupture) NONE	Complex Procedures (i.e. bronchial rupture) 1-10	Complex Procedures (i.e. bronchial rupture) 11-30	Complex Procedures (i.e. bronchial rupture) 31-50	Complex Procedures (i.e. bronchial rupture) 51-100	Complex Procedures (i.e. bronchial rupture) >100

Other (please specify)

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* 20. Do you provide Emergency cover for thoracic trauma as part of your duties?

Yes, in a designated Major Trauma Centre/Regional Unit

Yes, for inpatients and also for Emergency Ward

Only for inpatients in your hospital

None

Don’t Know

Other (please specify):

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* 21. How important is/was scientific research for your career during your period of Specialist Training OR Thoracic Surgery Practice?

	Very important, I dedicated most of my time to it	Very important, I dedicated some time to it	It is essential, but I had little time to do it	Not so important. Others wanted me to do it	Not very important, and I didn’t have much time to do it	Not at all	It is/was not requested by anyone
Cinical Research	Cinical Research Very important, I dedicated most of my time to it	Cinical Research Very important, I dedicated some time to it	Cinical Research It is essential, but I had little time to do it	Cinical Research Not so important. Others wanted me to do it	Cinical Research Not very important, and I didn’t have much time to do it	Cinical Research Not at all	Cinical Research It is/was not requested by anyone
Experimental Research	Experimental Research Very important, I dedicated most of my time to it	Experimental Research Very important, I dedicated some time to it	Experimental Research It is essential, but I had little time to do it	Experimental Research Not so important. Others wanted me to do it	Experimental Research Not very important, and I didn’t have much time to do it	Experimental Research Not at all	Experimental Research It is/was not requested by anyone

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* 22. How many scientific papers in peer-reviewed journals did you publish as an author or co-author during your Specialist Training OR Thoracic Surgery Practice?

	none	1-2	3-5	6-10	>10
First Author	First Author none	First Author 1-2	First Author 3-5	First Author 6-10	First Author >10
Co-author	Co-author none	Co-author 1-2	Co-author 3-5	Co-author 6-10	Co-author >10

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* 23. Is there any infrastructure research in your institution? If yes, follow the other question

Yes

Don't know

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* 24. Do you have clinical or experimental research opportunities in your CURRENT position? (Please choose the most appropriate answers)

I design studies and publish as the first or last author and corresponding author

I design studies, and my name appears as a co-author

All studies are designed in groups, and we publish papers together

I have the opportunity to work on data and publish as the first author

I work on the data, and my name appears in the manuscripts

I work on the data, and my name does not appear in the manuscripts

I have no opportunity to do research

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* 25. Have you published or presented at a National or International meeting?

Yes

Other (please specify):

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* 26. Do you follow any source of education, such as:

	YES	NO	Don't know
YouTube	YouTube YES	YouTube NO	YouTube Don't know
ESTS platform (link https://www.ests.org/educational_activities/online_educational_resources/videos.aspx)	ESTS platform (link https://www.ests.org/educational_activities/online_educational_resources/videos.aspx) YES	ESTS platform (link https://www.ests.org/educational_activities/online_educational_resources/videos.aspx) NO	ESTS platform (link https://www.ests.org/educational_activities/online_educational_resources/videos.aspx) Don't know
CTSNET platform (link https://www.ctsnet.org)	CTSNET platform (link https://www.ctsnet.org) YES	CTSNET platform (link https://www.ctsnet.org) NO	CTSNET platform (link https://www.ctsnet.org) Don't know
MEDtube platform (link https://medtube.net)	MEDtube platform (link https://medtube.net) YES	MEDtube platform (link https://medtube.net) NO	MEDtube platform (link https://medtube.net) Don't know
Robotic Thoracic Surgery (link https://www.roboticthoracic.surgery)	Robotic Thoracic Surgery (link https://www.roboticthoracic.surgery) YES	Robotic Thoracic Surgery (link https://www.roboticthoracic.surgery) NO	Robotic Thoracic Surgery (link https://www.roboticthoracic.surgery) Don't know
JOVE (link https://www.jove.com)	JOVE (link https://www.jove.com) YES	JOVE (link https://www.jove.com) NO	JOVE (link https://www.jove.com) Don't know
Mentorship program	Mentorship program YES	Mentorship program NO	Mentorship program Don't know
I follow my Colleagues at work	I follow my Colleagues at work YES	I follow my Colleagues at work NO	I follow my Colleagues at work Don't know

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* 27. Do you practice with simulators?

	Yes routinely	Yes occasionally in my institution	Yes occasionally during courses or conference	Yes occasionally during courses or conferences	No, never had access
Open Surgery	Open Surgery Yes routinely	Open Surgery Yes occasionally in my institution	Open Surgery Yes occasionally during courses or conference	Open Surgery Yes occasionally during courses or conferences	Open Surgery No, never had access
VATS	VATS Yes routinely	VATS Yes occasionally in my institution	VATS Yes occasionally during courses or conference	VATS Yes occasionally during courses or conferences	VATS No, never had access
RATS	RATS Yes routinely	RATS Yes occasionally in my institution	RATS Yes occasionally during courses or conference	RATS Yes occasionally during courses or conferences	RATS No, never had access

Other (please specify):

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* 28. Is simulation training compulsory in your Institution?

Yes

Don't know

Other (please specify):

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* 29. If simulation training IS compulsory in your Institution, do you do (MULTIPLE ANSWER CAN BE CHOSEN):

Open

VATS

RATS

SUGGESTIONS:

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* 30. If yes, with (please answer each row once):

	Often	Sometimes	Never
Virtual bronchoscopy	Virtual bronchoscopy Often	Virtual bronchoscopy Sometimes	Virtual bronchoscopy Never
Minimally invasive virtual Reality Simulators	Minimally invasive virtual Reality Simulators Often	Minimally invasive virtual Reality Simulators Sometimes	Minimally invasive virtual Reality Simulators Never
Endoscopy training (simulation boxes)	Endoscopy training (simulation boxes) Often	Endoscopy training (simulation boxes) Sometimes	Endoscopy training (simulation boxes) Never
Dry Lab with porcine lungs or with disposable artificial lungs or in trainer boxes	Dry Lab with porcine lungs or with disposable artificial lungs or in trainer boxes Often	Dry Lab with porcine lungs or with disposable artificial lungs or in trainer boxes Sometimes	Dry Lab with porcine lungs or with disposable artificial lungs or in trainer boxes Never
Dry Lab with human rib cage model with bony ribs and polyvinyl-alcohol hydrogel (PVA) lungs	Dry Lab with human rib cage model with bony ribs and polyvinyl-alcohol hydrogel (PVA) lungs Often	Dry Lab with human rib cage model with bony ribs and polyvinyl-alcohol hydrogel (PVA) lungs Sometimes	Dry Lab with human rib cage model with bony ribs and polyvinyl-alcohol hydrogel (PVA) lungs Never
Dry Lab on cadaver	Dry Lab on cadaver Often	Dry Lab on cadaver Sometimes	Dry Lab on cadaver Never
Wet Lab with living animals such as porcine, or sheep or dog according to directive 2010/63EU	Wet Lab with living animals such as porcine, or sheep or dog according to directive 2010/63EU Often	Wet Lab with living animals such as porcine, or sheep or dog according to directive 2010/63EU Sometimes	Wet Lab with living animals such as porcine, or sheep or dog according to directive 2010/63EU Never

Other (please specify)

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* 31. If simulation training IS NOT compulsory in your Institution, which platform are you using?

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* 32. Is preoperative 3D simulation routinely used in your settings?

	YES often	YES rarely	NO but I wish to use it	NO and honestly I don't care
Before surgery (software)	Before surgery (software) YES often	Before surgery (software) YES rarely	Before surgery (software) NO but I wish to use it	Before surgery (software) NO and honestly I don't care
Before surgery (software with 3D printing)	Before surgery (software with 3D printing) YES often	Before surgery (software with 3D printing) YES rarely	Before surgery (software with 3D printing) NO but I wish to use it	Before surgery (software with 3D printing) NO and honestly I don't care
During Surgery (i.e. ipad or glasses)	During Surgery (i.e. ipad or glasses) YES often	During Surgery (i.e. ipad or glasses) YES rarely	During Surgery (i.e. ipad or glasses) NO but I wish to use it	During Surgery (i.e. ipad or glasses) NO and honestly I don't care

Other (please specify)

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* 33. Do you use any artificial intelligence for your:

	YES often	YES rarely	NO but I wish to use it	NO and honestly I don't care
Clinical diagnostics	Clinical diagnostics YES often	Clinical diagnostics YES rarely	Clinical diagnostics NO but I wish to use it	Clinical diagnostics NO and honestly I don't care
Radiology diagnostics and follow-up	Radiology diagnostics and follow-up YES often	Radiology diagnostics and follow-up YES rarely	Radiology diagnostics and follow-up NO but I wish to use it	Radiology diagnostics and follow-up NO and honestly I don't care
Planning surgery	Planning surgery YES often	Planning surgery YES rarely	Planning surgery NO but I wish to use it	Planning surgery NO and honestly I don't care
Writing papers	Writing papers YES often	Writing papers YES rarely	Writing papers NO but I wish to use it	Writing papers NO and honestly I don't care
Writing protocols	Writing protocols YES often	Writing protocols YES rarely	Writing protocols NO but I wish to use it	Writing protocols NO and honestly I don't care
Preparing presentations for Meetings or teaching classes	Preparing presentations for Meetings or teaching classes YES often	Preparing presentations for Meetings or teaching classes YES rarely	Preparing presentations for Meetings or teaching classes NO but I wish to use it	Preparing presentations for Meetings or teaching classes NO and honestly I don't care

Other (please specify)

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* 34. Do you have an electronic case log in your hospital?

Yes

Don't know

Other (please specify):

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* 35. If yes, it is (multiple answers allowed):

Hospital platform

ESTS data recording

National Board Training program platform

National lung cancer or other pathology registry

Other (please specify):

Question Title

* 36. How satisfied are you with the surgical education component as an undergraduate

Very satisfied

Satisfied

Neither satisfied nor dissatisfied

Dissatisfied

Very dissatisfied

Question Title

* 37. How satisfied are you with the clinical training in Thoracic Surgery?

Very satisfied

Satisfied

I am neither satisfied nor dissatisfied

Dissatisfied

Very dissatisfied

Question Title

* 38. How satisfied are you with the research (experimental and/or clinical) training in Thoracic Surgery?

Very satisfied

Satisfied

I am neither satisfied nor dissatisfied

Dissatisfied

Very dissatisfied

Question Title

* 39. If part of your training was abroad or outside your training program, how satisfied were you with the educational value of the experience?

Very satisfied

Satisfied

I am neither satisfied nor dissatisfied

Dissatisfied

Very dissatisfied

Question Title

* 40. What was the purpose of training abroad?

It was a mandatory part of my training program

It was an optional part of my training program

To learn a new technique

Own initiative

Other (please specify):

Question Title

* 41. If you could be trained in a place other than your Institution, which part of your country or Nation would you like to be in?

Question Title

* 42. How are your feelings when you think about your future in five years?

I am happy I have been offered a permanent position in my training country.

I am happy I have been offered a permanent position in another hospital.

I am happy that I have been offered a temporary position.

Unhappy, I have/was offered a temporary position but am still looking for a permanent position.

I am still trying to figure out how to win a temporary position.

Dramatic, it will take much work to find a position.

Don't know

Other (please specify)

Question Title

* 43. Would you choose thoracic surgery again if you would start your career again?

Yes

Maybe

Don't know

I prefer not to answer

Question Title

* 44. Please share any other comments you have below:

Question Title

* 45. For authorship purposes only, please write your full name, email and affiliation as you would like to appear in the manuscript (these details will be dealt with confidentiality) . Those who opt not to write their name would not be listed among the collaborators.

Name *

Company *

Address

Address 2

City/Town *

State/Province *

Country *

Email Address