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.
Academic research is an important aspect of the fellowship experience for those planning careers in clinical or 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 more details, follow the links to the faculty http://www.uphs.upenn.edu/dripps/faculty/ and pursue the research section of the web site.
Clinical Caseload:
Department of Surgery- Division of Cardiovascular Surgery
Cardiovascular Surgery Division
http://www.uphs.upenn.edu/surgery/clin/cardiovascular.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 |
John Augoustides, MD |
A, T, TEE |
TEE, Aortic surgery |
Albert T. Cheung, MD |
A, ICU, TEE |
LV function, Clinical pharmacology |
Thomas F. Floyd, MD |
A, TEE |
Neurologic injury |
C. William Hanson, MD |
A, ICU, TEE |
Nitric Oxide, Information systems |
Jiri Horak, MD |
A, ICU, TEE |
Intensive Care |
Ben A Kohl, MD |
A, TEE, ICU |
|
Jeremy Kukafka , MD |
|
|
Warren J. Levy, MD |
A, TEE |
CNS monitoring, Computer technology |
Thomas Mickler, MD |
|
|
Bonnie Milas, MD |
A, ICU, TEE |
Coagulation, Monitoring |
Susan Nicolson, MD |
P |
Congenital heart disease |
E. Andrew Ochroch, MD |
T |
Thoracic postop pain |
Joseph S. Savino, MD |
A, ICU, TEE |
Epidemiology, Mitral Valve |
Stuart Weiss, MD, Ph.D |
A, T, ICU, TEE |
LV function, pharmacology |
William J Vernick, MD |
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 July or August to start the following July. Applications are generally accepted for the following year starting in January, with an application deadline of July 30th of the year before the fellowship start date. Interviews are required and conducted from January thru June each year.
Eligibility Requirements:
- Graduate of an ACGME-accredited Anesthesiology Residency Program
- Eligible for an unrestricted Pennsylvania Medical License (www.dos.state.pa.)
In order to be considered, please submit:
1. An updated CV
2. Personal statement
3. Copy of Dean's letter and medical school transcript
4. Three letters of recommendation – Please address all letters to our Program Director, Dr. Albert Cheung
5. USMLE scores
6. ABA/ASA In-training examination scores, when applicable
Send Application, all documents, and letters to the attention of:
Carole McMonagle
Administrative Coordinator
Department of Anesthesiology and Critical Care
University of Pennsylvania Health System
3400 Spruce Street, Suite 680 Dulles
Philadelphia, PA 19104
Tel.: 215.6627270; e-mail: McMonagC@uphs.upenn.edu
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
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