The primary goals of the Thoracic Surgery residency at the University of Virginia are to educate and train the next generation of cardiothoracic surgeons. These individuals have consistently been chosen from amongst the most superior candidates and are welcomed into the UVA family of cardiothoracic surgeons. In order to achieve our educational goals our primary focus is on the operative experience of the resident and the early and increased autonomy for the resident(s) as they gain experience in the preoperative, peri-operative and post-operative care and management of cardiothoracic surgical patients. We also have a number of didactic conferences.
Through participation in weekly interdisciplinary clinical conferences, residents are exposed to a wide variety of ideas and perspectives regarding the treatment of cardiovascular and thoracic diseases. Monthly conferences are also held in conjunction with General Surgery and special joint conferences are conducted with other Departments including Radiology and Adult and Pediatric Cardiology. In general, we follow the Thoracic Surgery Directors Association’s (TSDA) comprehensive didactic curriculum over the two year period of the residency.
Conferences and Clinics
The faculty conducts lectures, provide clinical correlations and assist the residents in self-study of the current literature. In conjunction with the presentation of clinical cases, residents will demonstrate their mastery of the current material by relating the disease processes to relevant citations from both peer-reviewed journals and textbooks. The resident will present topics for discussion at clinical case conferences, multi-disciplinary conferences, and at local and national cardiothoracic society meetings. Each cardiothoracic surgery resident will also attend one national scientific conference and one or two regional conferences and/or educational courses annually.
It is the goal of the University of Virginia Cardiothoracic Surgery faculty to teach by example, and with daily contact, demonstrate at all times the highest levels of integrity, professionalism, dedication to service and compassion toward those entrusted to their care.
Thoracic Surgery Curriculum: Design of the Two Year Program
We offer two RRC-approved tracks in Thoracic Surgery – the cardiothoracic (CT) track and the general thoracic surgical (GTS) track. These tracks have different match numbers. The CT track has two (2) positions annually, while the GTS track has one (1) position annually. Thus, three (3) residents participate in the program in each of the two final years of training.
Rotations for the residents are designed as noted in the cart below with exceptions made occasionally depending on discussions with the Program Director and the service needs of the program, and the educational needs of the individual resident. In general, the CT residents will spend 18 months on adult and pediatric cardiac surgery and 6 months on general thoracic surgery. The GTS track resident will spend 14 months on general thoracic surgery and 10 months on adult and pediatric cardiac surgery.
Cardiothoracic Surgery Rotations
The case variety and clinical experience at the University is extraordinarily varied and robust. All residents will be exposed to and will perform, with appropriate supervision, minimally-invasive valve surgery, off-pump coronary bypass procedures, complex aortic surgeries, redo cardiac procedures, aortic endograft procedures, minimally-invasive atrial fibrillation ablative procedures, and LVAD and cardiac transplantation procedures. The General Thoracic Surgical clinical experience includes VATS lobectomies and segmentectomies, all types of esophagectomies, laparoscopic benign esophageal disease procedures, extrapleural pneumonectomies, surgery for mediastinal tumors, lung transplantation, and lung volume reduction surgeries.
While the length of the Thoracic Residency is two years and the majority of the time is spent in clinical care responsibilities, residents are encouraged to participate in clinical research during their residency program. There is no time in the final two years for basic research as part of the curriculum. The Thoracic Surgery faculty is actively involved in a variety of clinical research studies which provide residents opportunities to participate in this type of research. The average number of publications from the Thoracic Surgical faculty is approximately 60-75 annually. There is also active solicitation of resident participation in manuscript and book chapter publications for peer-reviewed journals and texts.
The UVA faculty recognizes the value of integrating surgical simulation into the residency curriculum. Monthly labs have been developed for residents to receive additional training using inanimate models. Training sessions include such techniques as mechanical circulatory support, mitral valve repair, coronary artery anastomoses, and valve sparing root procedures. While the majority of surgical technical education still occurs in the operating room, we recognize that simulation can provide a low stress environment in which rare or complex procedures can be fully demonstrated and practiced.
In addition to these techniques labs organized by the TCV faculty, the UVA Graduate Medical Office has recently opened a medical simulation center. Complex ‘disaster scenario’ training can be conducted in a multidisciplinary environment that includes anesthesiology and perfusion in addition to the surgical team. Procedural trainers, including endoscopy and echocardiography, are also available to cardiothoracic residents in the simulation center. For the I-6 residents, a technical skills curriculum has been created that will also utilize the resources available at UVA. Regular faculty involvement will ensure that all residents continue to progress throughout their training.