Education

ACGME Accredited Cardiothoracic Anesthesia Fellowship

The ACGME accredited Cardiothoracic (CT) Anesthesia Fellowship is focused on providing a nurturing environment that supports the acquisition of knowledge and the development of technical skills necessary to provide superb cardiac clinical care and the cultivation of a high quality of research. The fellowship provides an incredibly rich academic experience that produces well trained and qualified CT Anesthesiologists who will become facile in the perioperative management of patients undergoing complex procedures such as off pump CABG, Pulmonary Thromboendarterectomy, aortic reconstruction, Mitral, Aortic and Tricuspid valve, as well as Ventricular Assist Devices, Heart Transplants, Congenital Heart Surgery, Pneumonectomies and Robotic/Minimally Invasive Cardiac surgery. The total number of cardiac cases performed at UCSD is over 1300 and this does not include Children’s Hospital.

The perioperative TEE service performs approximately 1200 exams per year, providing ample opportunities to become an expert at image acquisition and interpretation. The fellowship is a one to two year specialized training program designed to allow the individual maximal exposure to clinical, research, administrative, and teaching opportunities best suited to his or her own interests and ultimate career goals. Clinical cardiac anesthesia is the goal of the first fellowship year, with involvement in clinical research. The optional second fellowship year is available to fellows interested in basic or clinical research and pursuit of an academic career.

The twelve-month training of the Cardiothoracic Anesthesiology Fellowship is dedicated to mastering the principles, practices, and techniques of cardiothoracic anesthesia that adhere to the guidelines outlined by the Department of Anesthesiology, UCSD School of Medicine and the ACGME. The training will consist of at least six months in the main operating room providing anesthesia to patients undergoing cardiac procedures, one month of thoracic anesthesia, one month in the cardiac intensive care unit providing perioperative care for cardiac and thoracic surgery patients, one month dedicated to transesophageal echocardiography (TEE), two month of electives and one month echo/cardiac anesthesia at the end of the fellowship.

The Core 6-month main operating room cardiac anesthesia training will be at Sulpizio Cardiovascular Center (SCVC). Elective rotations are offered at Children’s Hospital, Scripps Memorial Hospital and the VA San Diego. All locations share the same educational goals and objectives. Each institution, however, will provide a distinct teaching milieu.

  • SCVC – offers unique experience in advanced Cardiothoracic cases, such as Pulmonary Thromboendarterectomy (PTE), robotic mitral procedures, heart and lung transplants, left ventricular assist devices, CABG and valve procedures and lead extractions.
  • San Diego VA – will offer an older patient population with its own challenges. At the VA Hospital fellows will assume the role of a senior fellow. Under the supervision and direction of the faculty attending anesthesiologists, they will contribute to the education of the residents.
  • Scripps Memorial Hospital – introduces the fellows to cardiac anesthesia in the private practice setting. Fellows will act as the primary anesthesiologists under the supervision of the faculty attending anesthesiologist.
  • Rady Children’s Hospital covering congenital pediatric cardiac cases.

TEE experience at all locations will adhere to the same educational standard. All attending anesthesiologists involved in TEE teaching have formal training in cardiothoracic anesthesia or TEE certification.

TOTAL Number of Positions: 3 accredited positions. 2 positions are in the match and one position is outside the match. We accept application in December and start interviewing in March/April. Our interviews are held on Saturdays. The exact dates will be announced in the new year.

Further Fellowship Program Information

Fellowship Completion - One Year

Surgical Procedures-

  • Acquire the knowledge, judgment, and skills requisite with recognition as a consultant anesthesiologist with subspecialty expertise in Cardiothoracic Anesthesia.
  • Develop specialized expertise in the performance and interpretation of perioperative evaluation and management of Chronic Thromboembolic Pulmonary Hypertension (CTEPH) patients with emphasis on Pulmonary Hypertension and Right Heart Failure.
  • Cardiac Electrophysiology: Fellows will get involved in the evaluation, diagnosis and management of cardiac arrhythmias, including noninvasive and invasive diagnostic and therapeutic electrophysiologic techniques, and cardiac implanted electronic device (CIED) implantation. Lead extraction and Lariat/Watchmen procedures.
  • Perfusion: Fellows will acquire expertise in the management of cardiopulmonary bypass during cardiac surgery.
  • Research: Fellows will develop experience in research pertaining to cardiovascular anesthesia. They will acquire skills in the development, planning, organization, collection of data, and presentation of a research project. Each fellow is required to participate in a publication before graduation.

Clinical Education-

  • Large variety of clinical cases as described in this informational sheet.

Transesophageal Echocardiography Education-

  • Monthly didactic TEE lecture series.
  • Echo weekly review Sessions – 1-2 hrs.
  • Echocardiography sessions beginning with a brief mini-lecture/discussion on specific echo related topic followed by a review of TEEs with emphasis on the daily topic.
  • Extensive teaching with digital case reviews, CD-ROMS, and TEE textbooks, new echocardiographic, including 3D reconstruction.
  • TTE/TEE simulator.

Cardiac Education-

  • Monthly case conference session with fellows and faculty.
  • Monthly cardiac lecture series with faculty from other disciplines.
  • Opportunity to participate in departmental workshops at the UCSD Update Conference in San Diego and the Perioperative Transesophageal Echocardiography Review Course.
  • Perfusion workshops with hands on training on the bypass machine.
  • Cardiac lecture series by cardiac faculty.
  • Dedicated non-clinical time for scholarly activities.
  • Quarterly Journal Club for faculty and fellows.
  • Fellows attend CT surgery conferences and ICU conferences during elective and ICU rotation.

Paid Conferences and Cardiac Textbooks-

  • Dedicated time and paid fees for the Annual Comprehensive Review & TEE in San Diego held by the Department of Anesthesia.
  • Each Fellow is provided the following Cardiac Anesthesia textbooks.
    • Kaplan's Cardiac Anesthesia
    • Perrino's Practical Approach to Transesophageal Echocardiography
    • PTE Masters Echo Review

Cardiovascular Physiology Research Laboratory-

The cardiovascular physiology research laboratory at UCSD/VA San Diego Medical Center performs novel basic science inquiry into mechanisms of myocardial ischemia-reperfusion injury, cardiac remodeling and heart failure. A focus of the laboratory involves the study of volatile and opioid anesthetics as they relate to ischemia-reperfusion injury. The laboratory uses state of the art physiological monitoring, molecular biology, primary cell culture, transgenic animals, gene therapy, immunohistochemistry and electron microscopy to address novel mechanisms for cardiac injury and remodeling. The laboratory with its principal investigator David M. Roth, Ph.D., M.D., and co-investigators, Piyush M. Patel, M.D., Hemal H. Patel, Ph.D. and Yasuo Tsutsumi, M.D., Ph.D. within the Department of Anesthesiology have several collaborations with other clinical and research departments at UCSD including the Division of Cardiology, the Department of Pharmacology, the Department of Cellular and Molecular Medicine and the UCSD Cancer Center. The laboratory and its investigators are funded by the National Institutes of Health, The Veterans Administration and the American Heart Association.

Eligibility Criteria-

Candidates for admission to University of California San Diego Cardiothoracic Anesthesia Fellowship must have the following criteria:

  • Completed a core residency program within the United States.
  • Graduated from a 4-year ACGME accredited core Anesthesiology Residency Program.
  • Satisfactory residency performance, as evidenced by recommendation letters and performance evaluations.
  • ABA Board-Certified or candidate status.
  • Three letters of references.
  • Integrity, motivation, and overall interest in cardiac anesthesiology as a subspecialty.
  • The accepted applicant must hold a full and unrestricted license to practice medicine in the State of California.
  • We do not discriminate with regard to sex, race, age, and religion, color, national origin, disability or veteran status.
  • Applications and CV’s will be accepted starting in December. Interviews will be scheduled starting in March and are scheduled on a Saturday.

Graduates of schools outside of the United States or Canada must meet all of the following qualifications:

  • Completed a 4-year ACGME accredited core Anesthesiology Residency Program.
  • Must have a currently valid ECFMG certificate.
  • Must hold a full and unrestricted license to practice medicine in the State of California
  • Must hold a Permanent Residency in the United States.

Appointment is contingent upon:

  • Satisfactory criminal background check
  • Full compliance with the licensure regulations of the Medical Board of California and federal immigration laws.

Application process:

The application period runs from November through April. If applying after April 30th, please contact the program directly. Applicants should register through SF Match in order to apply to the program as well as arrange rank lists. This year we will be using the Central Application Service (CAS) offered through SF Match. Please follow the directions on sfmatch.org to complete the application process. In addition to the SF Match application please submit the following additional information:

1. Personal Statement
2. Current Curriculum Vitae (CV)

For further information contact:

Cardiac Anesthesiology Fellowship Program
Email: cardiacfellowship@ucsd.edu
Phone: 619-543-8274
Fax: 619-543-6162