Program Details

Educational Goals and Objectives for the Thoracic Surgery Residency Program

The overall goal of the Thoracic Surgery Residency is to graduate physicians proficient in providing safe, cost effective, timely, patient centered, high quality care in the following areas: Pre-operative, operative, post-operative including critical care of the patients with pathologic conditions within the chest. This includes surgical care of diseases of heart (coronary artery disease, valvular heart disease) and great vessels, lungs, airways, esophagus, chest wall, mediastinum, diaphragm and chest injuries. The necessary emphasis is also given to congenital cardiac surgery, cardiothoracic transplantation and mechanical circulatory assistance.

The resident selected into our program will have completed an accredited General Surgery Residency Program. This individual will have the necessary skills and knowledge in surgical principles, techniques, and management of disease processes. The focus of our program is to build on these strengths and accomplishments. He/she will be given graduated responsibilities with supervision to diagnose and treat thoracic illnesses, both surgically and non-surgically as indicated, in a patient centered environment. The clinical learning environment is conducive to delivering safe, effective, cost efficient, timely, compassionate care while preserving the patient confidentiality.

The educational goals and objectives we aim to achieve-

The resident will:

  1. Have intense training in the necessary basic sciences to understand and manage thoracic diseases in general and cardiac diseases in particular
  2. Gain competence in in the following: diagnosis, comprehensive treatment plan, counselling and advocating the patient/family regarding the disease, treatment options, prognosis with and without the proposed treatment, risks, benefits and alternatives to the planned therapy and details of the procedure being proposed.
  3. Be adept in preoperative preparation, conduct of safe, efficient, and effective surgery and post-operative care.
  4. Have the ability to utilize resources and tailor the best treatment for the patient in the current and evolving health care environment (systems-based practice)
  5. Understand his/her own abilities, limitations, and seek help in the best interest of the patient and refer the patient to a physician/place of excellence when appropriate.
  6. Function effectively and collegially in the health care environment
  7. Maintain a culture of life long education and scholarly activities to remain proficient in the knowledge of established and evolving biomedical, clinical, epidemiological, and social behavioral sciences and well as the application of this knowledge to patient care.
  8. Incorporate practice-based learning and continuously improve patient care
  9. Learn the methods and participate in quality improvement to implement appropriate changes in patient care throughout their career.
  10. Learn to be compassionate towards the patients and families, respectful of other professionals and colleagues, respect privacy, and maintain integrity and accountability.
  11. Participate in local, regional, and national organizations in thoracic surgery.

In order to achieve the stated goals the program will:

  1. Maintain regular didactic and clinical educational sessions
  2. Provide necessary tools both electronic and otherwise
  3. Provide assignments at each educational level
  4. Clearly delineate responsibilities in patient care and progress responsibility as appropriate
  5. Provide sufficient and constant faculty supervision throughout the program
  6. Cover all the topics and competencies in the curriculum as recommended by the ACGME/TSDA/STS
  7. Assist in accomplishing all procedural skills necessary to become an independent, proficient Cardiothoracic Surgeon
  8. Provide regular faculty member and program director’s evaluation and recommendations
  9. Organize a clinical competency committee and program evaluation committee to assess, evaluate, and take steps to improve any deficiencies on an ongoing basis.
  10. Provide the resident with the opportunity to evaluate program periodically and make recommendations.
  11. Provide the resident feed- back with the input of the Program Director, faculty members, and 360-degree evaluations on a biannual basis at minimum
  12. Provide clear guidelines for the trainee to follow.

The program will maintain didactic and clinical education, in an environment of learning, manage fatigue, provide for work-life balance, while evaluating and counselling on an ongoing basis to facilitate growth towards accomplishment of clinical proficiency and independence.

Block Schedule

Block Schedule

Site 1 – Newark Beth Israel Medical Center
Site 2 – Saint Barnabas Medical Center
Site 3 – Jersey City Medical Center

Adult and congenital cardiac training will take place at NBIMC concurrently. Residents will also participate in General Thoracic Surgery cases at this site when possible, specially emergencies and complex cases to gain additional experience without encroaching on the training of General Surgery Residents.

The emphasis during the first two months of rotation at NBIMC is to gain experience in preoperative, post-operative, critical care of the cardiac surgical patient, completing all required courses for the hospital, system, graduate medical education and to the extent possible gain basic operative experience. All attempts should be made to attend structural heart courses to allow to participate in these cases throughout the residency.

The next four months of rotation at SBMC is intended to gain adult thoracic experience and adult cardiac surgery experience. However, it is at this time not an exclusive rotation, in cardiac surgery, but resident will be involved in all aspects, pre, intra, and postoperative care, of adult cardiac surgical patients.

Next four months rotation is at NBIMC in adult cardiac surgery. The training during this time is similar to the preceding rotation at SBMC, but added involvement in Heart failure, Heart transplantation, Mechanical circulatory assistance, and lung transplantation. Also, resident is encouraged to get involved in Congenital cardiac surgery service.

Last two months of the first academic year will be in adult Thoracic surgery service at SBMC. Again, although the emphasis is on Thoracic surgery, resident is also involved in Cardiac surgery service.

The remaining twelve months will be spent in adult cardiac surgery at NBIMC and SBMC along with congenital cardiac surgery at NBIMC.

The model that will be in effect is one where, for combined Cardiothoracic Service in NBIMC and SBMC, both the residents will be responsible as a team, with regular rounds, participation in surgery, postoperative care, outpatient practice, under close supervision by faculty with proper hand off between the two residents and other involved health care providers. This allows maximum exposure of clinical, research, educational material to both residents. The close proximity of both institutions lends itself to such a structure.

General Thoracic:

During the first year of residency, total of six months assigned to SBMC. At present four out of six months of that time the emphasis is on thoracic surgery. In near future, it is likely, given the large and growing thoracic volume, an exclusive, two to three-month rotation in Thoracic Service may be adequate to provide necessary experience in a concentrated fashion. This will further maximize the time spent in cardiac surgery.

Congenital Cardiac Surgery:

The congenital cardiac surgery at NBIMC/Children’s Hospital of New Jersey, is active and growing. In order to gain maximum exposure, the senior resident will avail himself to the extent possible, to participate in that service.

Outpatient:

During all rotations, residents will spend about twenty percent of their time in outpatient clinic. They will have(on average) one day per week dedicated to managing pre and postoperative patients during the office hours.

Research:

Residents will participate in research during all rotations. This is not a structured research time. The research projects will be assigned by the program director, faculty, and chair. Residents will work on research during their off-duty time.

Vacation:

Residents will have a total of four weeks of vacation per year. This will be taken in four seven- day periods of time, depending on resident’s preference. No more than a seven-day block is allowed in any given rotation provided the rotation is at least of than three months duration.

Conference Schedule

Monday

Tuesday

Wednesday

Thursday

Friday

7:30 am Mortality and Morbidity/Quality Improvement

(Mandatory)

Faculty development

3 PM till 5 pm Didactics

(TSDA/STS curriculum and lectures)

(Mandatory)

7 am till 9 am Cardiology lecture/conference (Optional)

7:30 am Structural heart conference

(Optional)

Third Wednesday of each moth Journal Club

(Mandatory)

7 am till 8 am Vascular multidisciplinary meeting.

(Optional) 8 am till11am Heart transplant meeting

(Optional)

7:30 am Congenital Cardiac meeting.

(Optional)

12 noon Thoracic Tumor Board Meeting

(Optional)

3 PM till 5 pm Didactics(TSDA/STS curriculum and lectures)

(Mandatory)

No vacation is allowed if the rotation is less than three months duration. Both residents are not allowed to be on vacation at the same time.

Conference Schedule:

The Journal Club is third Wednesday of every month.

Grand Rounds are in September, December, March, and June.
The Grand rounds are held Third Wednesday morning between 7:30am and 8:15am
June Grand Rounds speaker will be the graduating chief resident.

All meetings are either virtual or hybrid virtual and in person depending on the environment.

If the didactics are truncated or cancelled, every attempt is made to conduct them during similar timings of other week days.

Faculty development will be part of Monday morning meeting depending on the content reviewed by the faculty during previous week – Only faculty need to attend.