Abstract
The increasing complexity of heart disease manifestations and treatments as well as technological advancements make cardiovascular surgery an evolving specialty. In this review, we provide an overview of the factors leading to new developments in this field and discuss the adopted pathways to train cardiovascular surgeons in the United States. We also review the current challenges to the existing training culture and discuss the need to adopt adjuvant strategies to fulfill the societal expectations of what it means to be a competent cardiovascular surgeon.