This article provides an overview of the current situation regarding domestic fellowships for young cardiovascular surgeons in Japan, based on the author's personal experience and the results of a nationwide survey. The author undertook a one-year domestic fellowship beginning in April 2023 at the Department of Cardiovascular Surgery, Fukuoka Children's Hospital. In addition to gaining extensive experience in pediatric cardiac surgery, the author had opportunities to engage in clinical research and present at academic conferences. Conducting research alongside hands-on clinical training offered valuable insights and deepened the author's understanding of various cardiac conditions. At the same time, practical considerations such as relocating with family and establishing childcare support systems required careful planning. Furthermore, a survey targeting U40 committee members was conducted to investigate the motivations, outcomes, and challenges associated with domestic fellowships. The results revealed that many young surgeons viewed domestic fellowships positively, citing benefits such as diverse clinical experience, acquisition of new knowledge, and the development of professional networks. However, several barriers were also identified, including limited access to information, personnel constraints due to institutional staffing systems, and disruptions to personal and family life. The findings suggest that enhanced cross-institutional support and improved information sharing are essential to facilitate the development of young surgical talent in Japan.

Surgical proficiency significantly impacts cardiovascular surgery outcomes. Regular training for surgical procedures is essential. Since 2018, cardiovascular surgery's specialty system has mandated Off the Job Training (OffJT), defined as non-clinical work training that fulfills certification criteria. A minimum of 30h of OffJT is required for specialty acquisition. Presently, a review is being conducted to examine disparities in OffJT credit acquisition across various facilities and the lack of a standardized OffJT curriculum. This report details a survey of the current OffJT landscape, focusing primarily on executives under 40 years old. We employed a questionnaire-based approach to explore the types of training being conducted and the innovative strategies being implemented, along with an analysis of the findings.

The first examination of the new board of the Japanese cardiovascular surgery took place in 2022. As it is a transitional period for the new system, many doctors are not familiar with the changes and details of the new system, and some have their concerns. Here, we held a round-table discussion with doctors who actually took the new board of the Japanese cardiovascular surgery under the new system, and we summarized their opinion.