Graduate medical education in cardiothoracic surgery is a major focus of our faculty's academic commitment and of our clinical activities at all three participating institutions. The residency in Thoracic Surgery, the official title of graduate medical education in our specialty as approved by the ACGME and leading to Board Certification by the American Board of Thoracic Surgery, is a highly competitive, extremely well-balanced educational experience that covers all aspects of the specialty. The two-year program matriculates one or two qualified residents in alternating years. Residents match from ACGME approved residencies in general surgery during the latter part of their fourth year of general surgery training. The match is managed by the NRMP.
During the two years of training, the resident receives dedicated rotations in each of the three subspecialties with twelve months of adult cardiac, eight months of general thoracic, and four months of pediatric cardiac surgery. Exposure to thoracic trauma occurs during the adult rotations. The educational experience is based upon two very fundamental precepts: continuity of care and graduated responsibility. Since on each rotation the thoracic resident is the senior resident, his or her level of responsibility for decision making and for primary operative roles depends upon the accrual of appropriate skills and knowledge and the demonstration of successful performance of both the rudiments and the fine points of the specialty.
Residents participate together in three major teaching conferences. A working case conference is held at the beginning of each week to review new patients and to discuss judgmental decision about operative approach. At a time in American medicine when virtually all elective patients are admitted the same day as surgery, this conference affords an opportunity to deliberate jointly on preoperative evaluation and is the foundation in many cases for the continuity of care experience. A midweek morbidity and mortality/quality assurance conference combines focused discussion of complications in an educational atmosphere that expands knowledge through problem-oriented presentations of didactic material. The third weekly conference is a detailed discussion of syllabus material on fundamental physiology and basic background clinical information specific to adult cardiac and to general thoracic surgery. During the rotation at Children's Hospital, conferences on pediatric cardiac problems are held jointly with all pediatric sub-specialists involved in patient care.
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