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Department of Surgery

Thoracic Surgery Independent Fellowship Curriculum

Master
Content

Training Locations

Fellows receive rotational experience at the following hospitals:

Rotations

Thoracic Surgery Independent Fellowship Program

Each year, we match one general thoracic track and three cardiothoracic track fellows to our ACMGE thoracic surgery fellowship program.

First Year

During the first year, fellows on the general thoracic and cardiothoracic tracks spend three months on the cardiothoracic surgery service at each of the following institutions: Baylor St. Luke's Medical CenterTexas Children's HospitalMichael E. DeBakey Veterans Affairs Medical Center, and The University of Texas MD Anderson Cancer Center.
This provides a broad diversity of experience that includes adult thoracic and cardiac surgery at Baylor St. Luke's Medical Center; pediatric surgery at the nationally and internationally known pediatric surgical service at Texas Children's Hospital; experience on a thoracic oncology service at a world-respected oncology hospital, MD Anderson Cancer Center; and a large general thoracic and cardiac surgical experience at the Michael E. DeBakey Veterans Affairs Medical Center, one of the largest Veterans Affairs Medical Centers in the United States.

At Baylor St. Luke's Medical Center, first year fellows will rotate with on adult cardiac surgery that performs 1,100 cardiac surgical cases, more than 140 minimally invasive valve operations, 275 TAVRs, and more than 50+ Mitraclip cases annually. First year fellows will have a hands-on experience and learn the basics of cannulation, cardiopulmonary bypass, myocardial revascularization (off-pump, MIDCAB, and traditional CABG), and valvular heart disease, as well as management of cardiothoracic surgery patients in the CV ICU. At the Michael E. DeBakey Veterans Affairs Medical Center, the first-year thoracic fellow works with a second-year fellow to run a busy service that includes general thoracic and adult cardiac responsibilities and handles more than 500 cases annually. At Texas Children's Hospital, the fellow participates in an equally active pediatric cardiovascular service that does more than 900 cases each year. Similarly, the fellow participates in a thoracic oncology service at MD Anderson Cancer Center that undertakes more than 1,000 cases per year and in an adult cardiac and general thoracic service at Baylor St. Luke's that undertakes more than 2,500 cases per year.

Second Year

During the second year, fellow rotations differ depending on training track. General thoracic track fellows spend six months on the General Thoracic Surgery Service (as Chief Fellow), three months in Adult Cardiovascular Surgery at Baylor St. Luke's, and then three months as Chief Fellow of Cardiothoracic Surgery at the Michael E. DeBakey Veterans Affairs Medical Center. Cardiothoracic track fellows rotate six months in Adult Cardiovascular Surgery, one month in Structural Heart/Cardiac Cath Lab, two months in General Thoracic Surgery at Baylor St. Luke's. The general thoracic surgery hosts multi-disciplinary programs in mesothelioma treatment, reflux and swallowing disorders, esophageal cancer, and thoracic outlet syndrome. Through these programs, second year fellows are involved in pleurectomy/pneumonectomy for mesothelioma, thoracoscopic lobectomy, and robotic thoracic surgery, with more than 175 annual robotic thoracic operations. A robot curriculum is present to enable all fellows to receive robot certification prior to completion of the fellowship. Second year residents on adult cardiac surgery similarly participate in minimally invasive valve operations and robotic assisted CABG and valve surgeries. A dedicated structural heart rotation enables interaction with structural heart cardiologists and surgeons in TAVR and mitral clip.  Second year fellows rotate three months as Chief Fellow of Cardiothoracic Surgery at the Michael E. DeBakey Veterans Affairs Hospital. 

Third Year

The fellows in their third year return to Baylor St. Luke's where they serve as chief fellow on all rotations.  The Cardiothoracic surgery track fellows will rotate three months on the Complex aortic surgery service, three months on the adult cardiovascular surgery service, and three months on the heart/lung transplantation service at Baylor St. Luke's. The general thoracic track fellow will rotate six months on the general thoracic surgery service and three months on the heart/lung transplantation service at Baylor St. Luke's. The rotation in complex aortic surgery is under the leadership of Dr. Coselli, who performs a high volume (more than 200) of root replacements/reconstructions, arch replacements, and thoracoabdominal operations occur annually. Fellows also participate in TEVAR and novel aortic endografts. In addition, the chief fellow experience in mechanical circulatory support affords a robust exposure to a wide array of MCS devices, such as the Heartmate III, Heartware HVAD, Syncardia TAH, Impella, and ECMO. Transplant rotations include notable experiences with ex-vivo organ care systems and donation after cardiac death (DCD), which exist at few sites in the world. In addition, third-year fellows continue their experience with minimally invasive cardiac surgery, including MIDCAB, valve surgery, and robotic operations. Cardiothoracic and general thoracic surgery track fellows will rotate three months at the Ben Taub Hospital. On this rotation, they will be the only thoracic surgery fellow covering a large thoracic trauma, general thoracic, and adult cardiac service, with more than 300 cases per year. Residents gain experience in a broad array of cardiac surgery operations, including complex aorta, adult congenital cardiac diseases, valvular heart disease, TAVR, and thoracic oncology.

Content
 General Thoracic TrackCardiothoracic Track
First YearTexas Children's Hospital (three months)Texas Children's Hospital (three months)
Baylor St. Luke's Medical Center Cardiovascular Surgery (three months)Baylor St. Luke's Medical Center Cardiovascular Surgery (three months)
Michael E. DeBakey Veterans Affairs Medical Center (three months)Michael E. DeBakey Veterans Affairs Medical Center (three months)
University of Texas MD Anderson (three months)University of Texas MD Anderson (three months)
Second YearBaylor St. Luke's Medical Center General Thoracic Surgery (six months)Baylor St. Luke's Medical Center General Thoracic Surgery (two months)
Baylor St. Luke's Medical Center Cardiovascular Surgery (three months)Baylor St. Luke's Medical Center Cardiovascular Surgery (three months)
Michael E. DeBakey Veterans Affairs Medical Center (three months)Michael E. DeBakey Veterans Affairs Medical Center (three months)
 Baylor St. Luke's Medical Center Adult Cardiac, Minimally Invasive, Robotic Cardiac Surgery (three months)
Baylor St. Luke's Medical Center Structural Heart/Cardiac Cath Lab  (one month)
Third YearBaylor St. Luke's Medical Center General Thoracic Surgery (six months)Baylor St. Luke's Medical Center Adult Cardiac, Minimally Invasive, Robotic Cardiac Surgery (three months)
Baylor St. Luke's Medical Center Heart/Lung Transplant Surgery (three months)Baylor St. Luke's Medical Center Aortic Surgery                              (three months)
Ben Taub Hospital   (three months)Baylor St. Luke's Medical Center Heart/Lung Transplant Surgery (three months)
 Ben Taub Hospital    (three months)

Upon completion of this program, fellows will be board-eligible in Thoracic Surgery through the American Board of Thoracic Surgery (ABTS).