The goal of the Adult Cardiothoracic Anesthesia (ACTA) Fellowship training program is to develop consultants with expertise in providing anesthesia care for patients undergoing cardiac surgery with and without extracorporeal circulation as well as thoracic surgery, including operations on the lungs, esophagus and thoracic aorta.
The fellow will become proficient in the care of patients undergoing non-operative diagnostic and interventional cardiac, thoracic and electrophysiological procedures. Graduates of the fellowship program will be well-equipped to succeed in either academic or private-practice environments.
Specific skills to be developed include the conduct of preoperative patient evaluation and interpretation of cardiovascular and pulmonary diagnostic test data, hemodynamic and respiratory monitoring, and advanced-level perioperative transesophageal echocardiography (TEE); management of cardiopulmonary bypass (CPB), pharmacological and mechanical hemodynamic support and perioperative pain management. Successful completion of the Advanced Perioperative Transesophageal Echocardiography Exam and fulfillment of the National Board of Echocardiography Board Certification requirements are expected of all fellowship graduates.
A comprehensive didactic program has been developed to assure adequate knowledge and cognitive skills pertaining to cardiothoracic anesthesia. The program fosters knowledge of the development, physiology, pathophysiology, anesthetic implications and perioperative management of a wide array of cardiac, vascular, renal, neurological and pulmonary disease processes. Knowledge of surgical procedure indications, complications and supportive adjuncts, including cardiopulmonary bypass, is necessary. Health care systems, resource utilization, quality assurance, and resource methodology training are included.
In addition, didactic training includes aspects of invasive and non-invasive diagnostic procedures, including perioperative transesophageal echocardiography (TEE). The didactic program includes:
- Weekly cardiothoracic anesthesia conference
- Weekly perioperative TEE conferences
- Departmental and divisional Morbidity and Mortality Conference
- Journal Club presentations
- Perfusion lecture series and simulation sessions
- Critical care lecture series
- Clinical research didactic program
The ACTA Fellowship training program consists of 12 months of clinical and didactic training. Clinical training opportunities include*:
- Adult cardiac anesthesia rotation (6-7 months)
- Adult thoracic anesthesia rotation (1-2 months)
- Adult cardiology echocardiography rotation (2 weeks)
- Cardiovascular intensive care rotation (1 month)
- Anesthesia research rotation (1 month)
- Perfusion services rotation (2 weeks)
- Pediatric cardiac anesthesia rotation (2-4 weeks)
Fellows take at-home call throughout their fellowship. Call frequency is variable but averages between 1:4 and 1:5. Fellows are required to be present for emergent procedures within 30 to 60 minutes of being notified. Fellows do not take in-house call. Duty requirements, specified by ACGME, are strictly followed.
*Additional elective opportunities are available. Training will be tailored to specific clinical interests.
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