Cardiac Surgery Training in the Transcatheter Era.

Cardiac surgery training has evolved over the past 60 years since the development of cardiopulmonary bypass and its recognition as a distinct specialty. The emergence of newer technologies and a traditional emphasis on open chest surgery has produced disparities in the dissemination and adoption of less invasive transcatheter techniques. As such, it is essential for contemporary training programs to begin developing "hybrid" surgeons, competent in open and percutaneous domains. Formalized pathways, including Competence by Design and Areas of Focused Competency, are being developed to further ensure the acquisition of transcatheter skills by cardiac surgery trainees.