Anesthesiology Residency and Fellowships

Adult Cardiothoracic Anesthesia

The Adult Cardiothoracic Anesthesiology Fellowship is a one-year clinical training program designed to prepare graduates for leadership positions in the subspecialty practice of cardiothoracic anesthesiology. The fellowship program is dedicated to provide state-of-the-art training and experience in a multidisciplinary academic environment to achieve competence in patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice in the field of cardiothoracic anesthesiology.

The fellowship program offers 4 Accreditation Council for Graduate Medical Education (ACGME) (www.acgme.org) accredited positions each year to qualified applicants. Completion of the fellowship program curriculum fulfills the minimum program requirements specified by the ACGME and fulfills the eligibility requirements for achieving certification in Advanced Perioperative Transesophageal Echocardiography from the National Board of Echocardiography http://www.echoboards.org/

Clinical instruction is provided in the cardiothoracic operating room under the supervision of faculty members. The fellow is assigned to provide comprehensive anesthetic and perioperative care that includes the performance and interpretation of the intraoperative echocardiographic examination.  The fellow is also responsible for the supervision and education of PENN Anesthesiology residents on the cardiothoracic anesthesiology rotation. A separate rotation to Penn Presbyterian Medical Center provides the opportunity to care for cardiac surgery patients in a community hospital setting. The intraoperative experience in cardiothoracic anesthesiology will be supplemented with clinical experience in the management of cardiac and thoracic surgical patients in the Cardiothoracic Surgical Intensive Care Unit staffed by the Cardiothoracic Anesthesiology Critical Care faculty. The CT-SICU is a multidisciplinary unit where the fellow will have the opportunity to work with PENN surgical residents, critical care medicine fellows, cardiology fellows, and nurse practitioners in the comprehensive management of the cardiothoracic surgical patient. Echocardiography training includes a period of formal instruction in the echocardiology laboratory followed by instruction and direct experience in the performance, interpretation, and reporting of comprehensive transesophageal echocardiographic examinations.

The PENN Cardiothoracic Anesthesiology and Surgery divisions will provide the opportunity to gain extensive clinical experience in the following areas:

- Transesophageal echocardiography (2-D and 3-D)
- Coronary revascularization
- Cardiac valve repair and replacement
- Thoracic Aortic Operations
- Heart and lung transplantation
- Mechanical ventricular assist
- Extracorporeal membrane oxygenation
- Catheter-based aortic valve replacement
- Endovascular aortic repair
- Port-access and minimally invasive cardiac operations
- Surgical ablation for arrhythmias
- Adult congenital heart disease
- Pediatric congenital heart disease (CHOP elective)
- Non-cardiac thoracic surgery
- Electrophysiology and cardiac catheterization laboratory procedures
- Surgical critical care medicine

The educational activities of the fellowship also include:

- Guided self-education with reading and subspecialty library.
- Introduction to TEE course.
- Introduction to Critical Care Medicine course.
- Weekly Advanced Topics in Cardiothoracic Anesthesiology Fellow conference*
- Weekly multidisciplinary Cardiac Surgical QA/QI meetings.
- Weekly Departmental Grand Rounds*
- Weekly Departmental research in progress conference.
- Weekly Cardiology, CT surgery, CT Anesthesiology Case Conference*

During the year, the fellow will prepare one case presentation for Department of Anesthesiology Grand Rounds, two case presentations for the Cardiology, CT surgery, CT Anesthesiology Case Conference, and two literature review presentations for the Advanced Topics in Cardiothoracic Anesthesiology Fellow conference.

Investigation is an important element of the fellowship experience for those planning careers in academic practice. Participation in clinical or laboratory research is encouraged. Academic time and support is provided to fellows based on their individual career pathway and area of investigation. For those dedicated to pursuing an academic career, the department offers several subspecialty academic career development training tracks (see below).  For more details, follow the links to the faculty http://www.uphs.upenn.edu/dripps/faculty/ and pursue the research section of the web site.



Subspecialty Academic Development Tracks:

In addition to the straight one-year clinical fellowship, candidates applying to the fellowship program have the option of entering one of several academic development tracks offered by the Department.

1) The combined Critical Care Medicine and Cardiothoracic Anesthesiology track is a two-year program for achieving board certification in both Adult Cardiothoracic Anesthesiology and Critical Care Medicine with an emphasis in Cardiothoracic Surgical Critical Care.  Elective time is provided in order to pursue collaborative research with division faculty members.  

2) The Instructor track is a two-year program designed for candidates seeking board certification in Adult Cardiothoracic Anesthesiology with the intention of pursuing an academic career as a clinical and/or collaborative investigator in the clinician-educator or academic clinician tracks.  In the Instructor track, the candidate will be offered a faculty position as an Instructor in the division of cardiothoracic anesthesiology upon completion of the clinical requirements of the one-year fellowship.  As an Instructor within the division, the candidate will be provided with 50% non-clinical time to devote to research or educational projects.

3) The Research Training Grant (RTG) track is a three-year program designed for candidates seeking board certification in Adult Cardiothoracic Anesthesiology with the intention of pursuing an academic career as an independent investigator in the tenure-track.  After fulfilling the clinical requirements of the fellowship, the candidate will devote two years of time pursuing clinical or basic research with an established investigator participating in the NIH-funded T-32 program that is in its 34th year at the University of Pennsylvania. Additional information on this program can be accessed through the following links: http://www.uphs.upenn.edu/dripps/education/fellowship/research_opportunities.htmlhttp://www.uphs.upenn.edu/dripps/research/, and http://grants.nih.gov/grants/guide/pa-files/PA-02-109.html



Clinical Caseload:

Cardiovascular Surgery Division
http://www.uphs.upenn.edu/surgery/Clinical/Cardiovascular/cardiovascular_home.html

 Division of Cardiovascular Surgery Clinical Activity Report
http://www.pennmedicine.org/cardiac/outcomes/cardiac_outcomes_08.pdf

- Cardiac procedures with CPB per year:

- UPHS = 2,000
- CHOP = 1,000
- Non-cardiac thoracic cases per year: 1,400
- Heart, lung and heart/lung transplants per year: 80
- Thoracic aortic operations with DHCA per year: 250
- Estimated Distribution of cardiac cases: 25% CABG, 50% Valves,
5% Congenital, 20% Thoracic aorta and other
- TEE examinations per fellow per year: 400



Faculty:

Name
Clinical Areas*
Research, Other interests
A, T, TEE
TEE, Aortic surgery
A, ICU, TEE
LV function, Clinical pharmacology
A, TEE
A, TEE, ICU
A, ICU, TEE
Nitric Oxide, Information systems
A, ICU, TEE
Intensive Care
A, TEE, ICU
A, TEE
 
A, TEE
CNS monitoring, Computer technology
A, TEE
 
A, ICU, TEE
Coagulation, Monitoring
Susan Nicolson, MD
P
Congenital heart disease
T
Thoracic postop pain
A, TEE
Adult Congenital Heart Disease, Coagulopathy
A, ICU, TEE
Epidemiology, Mitral Valve
A, T, ICU, TEE
LV function, pharmacology
A
 
*A: Adult cardiac; P: Pediatric cardiac (at CHOP); T: Thoracic; ICU: Cardiothoracic intensive care; TEE: Transesophageal echocardiography


Fellowship Application Process:

The fellowship program begins on July 1 of each year. Fellow candidates are selected in May or June to start the following July. Applications are accepted for the following year starting on January 1st with an application deadline of April 30th of the year before the fellowship start date. Interviews are required and conducted from January through May each year.

Our fellowship will participate in the SF Matching program this year. The match takes place in June and will be used to process all applicants who want to begin their fellowship training in July of the following year. In order to be considered for a position in any Adult Cardiothoracic Anesthesia fellowship program, you must register for the match at the following website:

http://www.sfmatch.org/fellowship/f_cardiothoracicanesthesiology/index.htm

The applicant should specify if they want to be considered for any of the following subspecialty academic career training tracks as part of the Adult Cardiothoracic Anesthesiology Fellowship. Additional application and arrangements will need to be made for the scheduled interview. Special attention will be provided for qualified applicants.

  1. Combined Critical Care Medicine and Adult Cardiothoracic Anesthesiology (2-year program).
  2. Instructor track in Adult Cardiothoracic Anesthesiology (2-year program)
  3. Research Training Grant (NIH T-32) track in Adult Cardiothoracic Anesthesiology (3-year program)

Eligibility Requirements:

  • Graduate of an ACGME-accredited Anesthesiology Residency Program
  • Eligible for an unrestricted Pennsylvania Medical License (www.dos.state.pa.)

Application:

In order to be considered, please submit:

  1. Passport-sized photo
  2. CV
  3. Personal statement (approximately 1 page single-spaced)
  4. 3 reference letters
  5. Medical school transcripts
  6. USMLE scores
  7. ITE scores

Send all documents (including letters of recommendation) to the attention of:

Diane McCarthy
Administrative Coordinator
Department of Anesthesiology and Critical Care
University of Pennsylvania Health System
3400 Spruce Street, 6th Floor Dulles
Philadelphia, PA 19104
Tel.: 215.662-7270; e-mail: Diane.Mccarthy@uphs.upenn.edu


Letters of recommendation should formally be addressed to:

Albert T. Cheung, M.D.
Program Director, Adult Cardiothoracic Anesthesiology
Professor, Department of Anesthesiology and Critical Care
University of Pennsylvania
3400 Spruce Street, 680 Dulles
Philadelphia, PA  19104-4283
Email: cheunga@uphs.upenn.edu
Fax:  215-349-8133