The global objective of the thoracic residency program is to teach residents the skills necessary to become well-rounded cardiothoracic surgeons. In addition, it is our interest to align our training program with modern career objectives. The rotation schedule for the residency is designed to achieve this global objective, while at the same time permitting enough flexibility within the program to accommodate the desire of a resident to focus on a particular sub-specialty, such as general thoracic or adult cardiac surgery. Throughout the residency, the resident is given graded responsibility both in and outside the operating room.
Year 1 - Adult Cardiac Surgery
During the first year a resident’s time will be divided between the adult cardiac service and the general thoracic service. The goals and objectives during the first year focus on understanding the following:
- Medical management and indications for surgery of ischemic and valvular heart disease
- Preoperative evaluation of patients
- Risks of the operations and how to counsel patients appropriately
- Perioperative management of patients following complicated cardiac and general thoracic procedures
- ICU care, including ventilator management, nutritional support, inotropic management, and management of intra-aortic balloon pumps
- Acquire graded responsibilities as primary surgeon to perform operations for coronary revascularization, valve repair and replacement, and aortic disease
- Acquire graded responsibilities as primary surgeon for heart and lung procurement's for transplantation
Year 1 - General Thoracic Surgery
- Evaluation and management of thoracic malignancies including lung esophageal and mediastinal tumors
- Evaluation and management of surgical lung infections of the chest
- Staging of thoracic malignancies
- Utilize appropriate adjunctive protocols for chemo and radiation therapy
- Intra-operative airway management and planning of major airway resections
- Evaluation, management, and operative treatment of patients undergoing lung transplantation
- Acquire graded intra-operative responsibility as surgeon for operations on the lung, chest wall, mediastinum and esophagus
Year 1- Related Specialties
Acquire a working knowledge of echocardiography, nuclear cardiology, cardiac stress tests, pulmonary function studies, chest imaging (CT and MRI), and esophageal motility. The resident will become sufficiently familiar with these to be able to independently interpret them.
By the end of the first year, it is the expectation of the Program Director that the resident is fully capable of performing straightforward cardiac surgery with minimal assistance and virtually all general thoracic cases are performed by the resident with faculty assistance.
Year 2 - Adult Cardiac Surgery
The second year is devoted to the practice of adult cardiac surgery at the University of Colorado Hospital, the VA Medical Center, as well as gaining exposure to pediatric cardiac surgery at The Children’s Hospital of Colorado. It is expected during the second year that resident’s will develop an increased understanding of the following:
- Medical management of heart failure
- Indications and contraindications for heart transplantation
- Management of heart transplant recipients
- Indications for ventricular assist devices
- Continue to assume more responsibilities as primary surgeon for operations for myocardial revascularization and valvular heart disease
- Assume responsibility as primary surgeon on heart procurements
- Assume graded responsibility as primary surgeon in the placement of ventricular assist devices
Year - 2 Pediatric Cardiac Surgery
- Learn the pathophysiology of the common congenital heart anomalies
- Lean the fundamentals of cardiopulmonary bypass in infants and children
- Learn the perioperative hemodynamic management for pediatric cardiac surgical patients
- Acquire graded intra-operative responsibility as surgeon for operations to correct atrial septal defects, ventricular defects, patent ductus arteriosus, and coarctation of the aorta.
Year 3 - Adult Cardiac and/or General Thoracic Surgery
By the beginning of the third year, the resident is expected to have made a decision regarding his/her ultimate career goals and sub-specialization. Once this decision has been made, and the resident has demonstrated skills to be ABTS eligible, the resident’s experience is focused in this area. This is typically for the final six to nine months of the residency. Such areas might include particular emphasis on esophageal surgery, minimally invasive thoracic surgery, valve repair, etc. In addition, all residents will assume responsibility as primary surgeon on heart and lung transplants as well as insertion of ventricular assist devices.