BMJ  2004;329 (21 August), doi:10.1136/bmj.329.7463.0-a

New cardiac surgeons improve their results over time

The outcome of surgery under newly appointed cardiac surgeons improves during the first four years of independent practice. Reviewing surgical outcomes in 18 913 people undergoing coronary artery surgery in northern England between 1997 and 2003, Bridgewater and colleagues (p 421) found that mortality in patients operated on by 15 newly appointed surgeons was similar to mortality in patients of established colleagues, and that it decreased from 2.2 % in the first year to 1.2% in the fourth year of independent practice. These data should be interpreted with caution, says Treasure in a commentary (p 424), as conclusions about learning curves based on such a small difference in mortality are insecure.

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Improving mortality of coronary surgery over first four years of independent practice: retrospective examination of prospectively collected data from 15 surgeons

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