Acceptance in the two-year Cardiothoracic Surgery residency requires satisfactory completion of a five-year General Surgery program. In addition, prospective Cardiothoracic residents are encouraged to spend a year or two in laboratory research prior to beginning their specialty training. Four Chief Residents comprise the Residency Training Program with two being appointed each year.
In addition to the Cardiothoracic training program, the Division of Cardiothoracic Surgery has educational programs for residents in the PGY-1 and PGY-2 years.
The Division of Cardiothoracic Surgery is staffed by full-time faculty members based at the UCLA Medical Center and at the West Los Angeles VA Medical Center. Faculty members from Surgical Oncology and Pediatric Surgery also participate in the program. Clinical faculty members provide additional teaching support.
The surgical residents attend numerous interdisciplinary weekly conferences with participation by Cardiology, Radiology, Pathology, etc., as well as daily teaching rounds led by faculty members.
The patient mix is balanced between those with general thoracic problems (of the lung, esophagus, and mediastinum) and those with cardiac lesions (coronary artery disease, valve malfunction, congenital heart disease, etc.). Residents have the opportunity to work with both adult and pediatric patients. They participate in the pediatric and adult heart transplant program, the heart/lung transplant program, and the lung transplant program.
Training in cardiac surgery focuses on mastering accurate assessment of cardiac performance and effective medical management of myocardial dysfunction. Management methodologies considered include pacing, drugs, and application of intra-aortic balloons and left ventricular assist devices. Residents also become knowledgeable in fluid and electrolyte management relative to the endocrine response to stress, blood chemistry interpretation, and renal dysfunction. Pathology staff provide histologic reviews of surgical specimens to help residents correlate pathologic findings with intraoperative observations. The residents also become familiar with those problems in pulmonary function that require the interpretation of perfusion and ventilation abnormalities, understanding of lung compliance, and blood gas analysis.
Basic Surgical Training Program residents in the PGY-1 and PGY-2 years have ample opportunity to perform thoracentesis and pericardiocentesis. During their rotation in Cardiothoracic Surgery, they place chest tubes, central venous catheters, and intra-arterial lines. The resident will assist in the operating room, and will be trained to appropriately handle tissues, repair arteriotomies, open and close thoracotomy incisions, perform lung biopsies, tracheostomies and bronchoscopies, and insert pacemakers. The resident assists the senior surgeon on major operations.
Constant emphasis is placed on the principles involved in making patient management decisions. Under supervision, the resident is responsible for postoperative patient care. Residents are expected to acquire skill in diagnosing and treating patients with hypovolemia, depressed cardiac performance, arrhythmias, pericardial tamponade, oliguria, arterial hypertension, and respiratory insufficiency.