Cardiac Surgery Fellow

Thomas Jefferson University and Jefferson Health is pleased to announce an opening for the unaccredited Cardiac Surgery Fellowship. The selected fellow will actively participate in the management of patients on the Cardiovascular Surgery Service under the direct supervision of the attending cardiac surgeons.

Responsibilities

• Participate in weekday nights and weekend days and nights for the service.
• Become proficient in the preoperative workup, indications, and postoperative care of common adult cardiac conditions.
• Review cases preoperatively with the attending and function as primary surgeon or first assistant during operative procedures, depending on case complexity and ability.
• See patients preoperatively and postoperatively in the hospital and outpatient clinics.
• Interact with the cardiac surgery team, including attendings, physician assistants, nurse practitioners, surgical assistants, medical students, and perfusionists.
• Attend all mandatory core curriculum conferences, including aortic conference, cardiac cath lab conference, and cardiology M & M.
• Present cases at the weekly educational conference, Cardiac Surgery M & M, and Department of Surgery M & M.
• Make rounds on patients in the cardiovascular surgery step-down and intensive care units.
• Be available for consultation and immediately respond to calls for assistance from other healthcare providers.
• Promptly involve the attending surgeon in any evaluation or management issue requiring attention.
• Attend the Cardiac Surgery Clinic with the Cardiac Surgery team for broad outpatient exposure.
• Perform competently all medical and invasive procedures essential for the area of practice, including:
  • Cardiopulmonary bypass cannulation (via variety of arterial and venous access)
  • Coronary revascularization conduit harvest (IMA, saphenous vein, radial artery)
  • Coronary artery bypass grafting (on- and off-pump)
  • Aortic surgery (aortic root, ascending aorta, aortic arch, descending aorta, aortic dissection)
  • Aortic valve surgery (AVR, repair)
  • Transcatheter aortic valve replacement
  • Tricuspid valve surgery (TVR, repair)
  • Mitral valve surgery (MVR, repair)
  • Ventricular septal defect repair
  • Atrial septal defect repair
  • Pericardial surgery (pericardial window, pericardiectomy)
  • Arrhythmia surgery (MAZE procedure)
  • Pacemaker and ICD surgery and programming
• Assess patients referred for adult cardiac surgery in inpatient and outpatient settings, performing history and physical exams relevant to adult cardiovascular disease.
• Arrive at an appropriate differential diagnosis and order diagnostic tests/procedures, demonstrating knowledge in their interpretation.
• Use history, physical exam, and diagnostic tests to develop patient assessment and management plans, including operative and nonoperative management.
• Care for adult cardiac surgery patients throughout their hospital stay, including management in intensive care settings.
• Provide follow-up plans for outpatient care after hospital discharge.
• Demonstrate adequate technical skills, including proper tissue handling, surgical instrument use, and strict adherence to sterile technique.
• Demonstrate operating room awareness, managing interactions with first assistants, perfusionists, anesthetists, scrub technicians, and circulating nurses.
• Act as first assistant in procedures, anticipating surgical maneuvers and contributing to a positive operating room atmosphere.
• Communicate effectively with patients, families, physicians, and other healthcare professionals.
• Write concise, clear operative reports, consultation notes, discharge summaries, and clinic notes in a timely fashion.
• Lead a team of surgical fellows, medical students, physician assistants, and nurse practitioners.
• Participate in practice-based learning, including self-evaluation, critical review of medical information, and incorporation of scientific evidence into patient care.
• Prepare for and participate in organized conferences aimed at practice-based learning, including M&M and Grand Rounds.

Requirements

• Current, unrestricted or institutional Pennsylvania medical license.
• Experience in cardiology, cardiac surgery, and/or critical care medicine.
• US Citizenship or US permanent resident status.

Educational Goals and Objectives

• Demonstrate knowledge of established and evolving biomedical, clinical, and cognate sciences and their application to patient care, including:
  • Anatomy, physiology, and pathophysiology of the pericardium, heart, and great vessels.
  • Natural history of treated and untreated cardiovascular surgical conditions (e.g., ischemic heart disease, valvular heart disease, thoracic aortic disease).
  • Interpretation of noninvasive diagnostic methods (EKG, CXR, CT, MRI, ECHO, viability studies).
  • Procedures and potential complications of invasive diagnostic methods (coronary angiography, cardiac catheterization).
  • Pharmacology, indications, and complications of drugs commonly used by adult cardiac surgeons (anti-arrhythmics, inotropes, diuretics, anti-lipid, anticoagulants, thrombolytics, pain medications).
  • Anesthetic management of adult cardiac surgical patients, including preanesthetic evaluation, cardiopulmonary bypass, and anesthesia conduct.
  • Physiology, technology, indications, and complications of cardiac pacemakers, defibrillators, and mechanical assistance (ECMO, ventricular assist devices, artificial heart).
  • Principles and techniques for myocardial and cerebral protection.
• Analyze practice experience and perform practice-based improvement activities using systematic methodology.
• Locate, appraise, and assimilate evidence from scientific studies related to patient health problems.
• Apply knowledge of study designs and statistical methods to appraise clinical studies.
• Use information technology to manage information, access online medical resources, and support education.
• Facilitate the learning of students and other healthcare professionals.

Core Competencies

Patient Care

• Provide compassionate, appropriate, and effective patient care for health problems and health promotion.
• Communicate effectively and demonstrate caring, respectful behaviors with patients and families.
• Gather essential and accurate patient information.
• Make informed decisions about diagnostic and therapeutic interventions based on patient information, preferences, and evidence.
• Develop and carry out patient management plans.
• Counsel and educate patients and families.
• Use information technology to support patient care decisions and education.

Medical Knowledge

• Demonstrate knowledge of established and evolving biomedical, clinical, and cognate sciences and their application to patient care.
• Demonstrate an investigatory and analytic approach to clinical situations.
• Apply basic and clinically supportive sciences appropriate to the discipline.

Practice-Based Learning and Improvement

• Investigate and evaluate patient care practices, appraise and assimilate scientific evidence, and improve patient care practices.
• Analyze practice experience and perform practice-based improvement activities.
• Use information technology to manage information and support education.
• Facilitate the learning of students and other healthcare professionals.

Interpersonal and Communication Skills

• Demonstrate interpersonal and communication skills that result in effective information exchange and teamwork.
• Create and sustain therapeutic, ethically sound relationships with patients.
• Use effective listening, nonverbal, explanatory, questioning, and writing skills.
• Work effectively as a member or leader of a healthcare team.
• Communicate effectively with patients, families, physicians, and other healthcare professionals.
• Act as a consultant for other physicians and healthcare professionals.

Professionalism

• Demonstrate respect, compassion, integrity, and accountability to patients, society, and the profession.
• Commit to ethical principles, including confidentiality, informed consent, and business practice.
• Demonstrate sensitivity and responsiveness to patients' culture, age, gender, and disabilities.
• Demonstrate respect for patient privacy and autonomy.
• Demonstrate openness to constructive criticism.

Duration

12 months

Facilities

All clinic and inpatient care will take place within the Jefferson Health system.