Years 1 & 2
The first two years are dedicated to learning the fundamentals of each specialty and enhancing skills with each endeavor. The initial month, 1st year rotation is spent within the cardiac simulation laboratory learning and practicing the core principals of cardiopulmonary bypass, basic cardiac procedures (CABG, AVR), and on-pump complications. The acquisition of such requisite skills lays groundwork for success during the ensuing clinical years and compresses the learning curve in an intentional fashion. The following month is spent learning the key skills required to perform or interpret procedures and tests within the Interventional Pulmonary, GI Medicine, and Cardiology services. Having these skills further enhances success when the clinical months begin and provides each resident with a solid foundation upon which they can build during the following 22 months.
Year 3
The third year, chief year, is intended as a year to focus interest in a particular area and to further refine practice skills leading to graduation and independent practice. During this time, each resident is provided a climate of growth with careful oversight during the conduct of each procedure. Depending upon the career path, time can also be spent conducting research or developing academic and educational skills.
Allied Service Rotations
Residents spend time with closely allied specialists in Cardiology, Pulmonary Medicine and Gastroenterology. During each of these rotations, the residents acquire interventional skills along with data interpretation that are unique to each specialty. These key skills attained during these experiences provide the resident the tools to adapt and function in a better fashion during their clinical rotations on the cardiac and thoracic services. These rotations have become integral components of our residency education program. The closely allied faculty remain enthusiastic to support and to participate in this specialty endeavor.
Resident Experience
The workload is extensive at each of the hospitals. Residents participate actively in the perioperative management of these patients. Approximately 1500 cardiac and 700 general thoracic operations are performed annually. The opportunity to gain expertise in monitoring critically ill patients, as well as, considerable exposure to cardiopulmonary physiology is also provided.
The VAMC provides primary, secondary, and tertiary care for veterans in the Mid-South Region (VISN 9), and provides a unique exposure to another healthcare system. On average, approximately 50 thoracic and 120 cardiac operations are performed each year.
The Cardiac Surgery experiences include rotations on the Adult and Pediatric Cardiac Surgery services, the Cardiac Transplant service, the CVICU, the Interventional Cardiology service, and the Echocardiography service. All components of minimally invasive, open, interventional, transplant, mitral valve, aortic valve, and aortic surgical procedures occur on these services.
The General Thoracic Surgery experience include all components of benign and malignant esophageal disease, open and minimally invasive antireflux procedures, robotics, chest wall and pleural operations, major airway surgery, benign and malignant pulmonary disease, transplantation, and interventional pulmonology procedures.
Other educational opportunities occur daily through CME conferences, the focused Thoracic Surgical Curriculum, Journal Club, and other venues.
Training Approach
Clinical training and education are accomplished using an apprenticeship-style model directed by departmental and allied health faculty. With supervised and graduated responsibility, the resident participates throughout the continuum of patient care in the clinic, wards, and operating room. Integration of skills in cardiac and thoracic surgery is expected to create an efficient, effective, and cost-conscious quality outcome for our patients in the inpatient and outpatient settings. Clinical and surgical task levels are determined by continuous milestones competency based evaluation using e-MTRCS, and resident advancement is decided by objective and subjective evaluations by faculty at spaced intervals throughout each year.
Mentorship
Each resident is assigned a mentor at the beginning of residency. In addition to the Program Director, each mentor helps to carefully monitor resident progress and works with the resident to develop skills and talents that not only will enable success within the residency process but also will facilitate progression and maturation into the phases beyond residency.