Adult Cardiothoracic Anesthesiology Fellowship
Overview
The Department of Anesthesiology at the University of Maryland School of Medicine has two ACGME-approved cardiothoracic anesthesia fellowship positions. Given our surgical volume (over 1460 cases), CT anesthesia fellows receive ample opportunity to gain both personal and supervisory experience in managing the most interesting and challenging cases in anesthesia. Each cardiothoracic anesthesia fellow will participate in a total of six months in the cardiovascular operating room service, of which a minimum of three months will be conducted with the fellow providing direct clinical care of patients under the supervision of a faculty anesthesiologist and the remainder supervising residents under the direction of the attending anesthesiologist.
The CT anesthesia fellows are allotted ample time to pursue scholarly activities. The fellows have a professional development/education fund that can be used to attend meetings or to purchase educational materials. Fellows are given time (five days per year) and fiscal support to present their research at national meetings. In addition, attendance at the SCA Perioperative TEE meeting in San Diego is required (and paid for by the department) for basic and advanced TEE training. Fellows also have the opportunity to attend local and regional conferences, especially those sponsored by the anesthesia department, cardiac surgery or cardiology.
Clinical Curriculum
Fellows gain proficiency in and exposure to the perioperative evaluation and intraoperative management of cardiac surgical patients including:
- elective and emergency cardiac patients undergoing primary and redo revascularization
- valvular repairs and replacements
- pericardial procedures
- neoplastic procedures
- heart and lung transplantation and combined procedures
- thoracic aortic surgery: ascending, transverse and descending aortic surgery with and without circulatory arrest
- endovascular techniques
- ventricular assist devices
- minimally invasive cardiac surgery
- robotics for single and multivessel revascularization, hybrid revascularization, pericardial surgery and cardiac tumor excisions
The cardiac fellow will gain experience with pulmonary surgery including:
- thoracoscopic and open procedures
- lung reduction
- bronchopulmonary lavage
- lobectomy
- pneumonectomy
- bronchoscopy
- endoscopic, fiberoptic, rigid and laser resections
- esophageal surgery
Experience will also be obtained with placement and utilization of thoracic epidurals for perioperative pain management.
Fellows are assigned for clinical duties so that their hours are limited to no more than 80 hours, averaged over a 4 week period. The fellows have no in-house call responsibilities.
Flexible Scheduling
The Cardiothoracic Anesthesia fellows can tailor the schedule according to their needs to gain competence in both cardiac and thoracic anesthesia cases. There are two months of elective rotations built into the curriculum including invasive cardiology, cardiac catheterization laboratory (adult and pediatric), perfusion services, pediatric cardiac surgery, cardiac surgical ICU and electrophysiology.
Echocardiography Training
Our fellows gain competence in TEE training with a minimum of two months of rotation in both the cardiology echo lab as well as intraoperative training. They receive training in TEE, TTE, epiaortic and 3D technologies. We insist that our fellows perform a minimum of 300 complete echocardiographic examinations, including 150 comprehensive intraoperative TEE examinations. Typically our fellows perform many more echocardiographic examinations over the course of a year. The goal will be to develop specialized expertise in the performance and interpretation of perioperative transesophageal echocardiography with the specific goal of attaining the American Board of Echocardiography's certification in perioperative TEE at the completion of the fellowship training. We typically offer fellows the opportunity to attend the week-long course offered by the Society of Cardiovascular Anesthesiologists in preparation for taking the ABE exam in TEE. The department has three echo technicians that are themselves skilled practitioners who support the technical aspects of the echo service, so the fellow can concentrate on learning the techniques of echocardiography.
Intraoperative Transesophageal Echocardiography 2D/3D
Didactics
The didactic program includes a weekly lecture series, journal club, cardiac morbidity and mortality conference, as well as a monthly multidisciplinary valve conference for cardiac surgery, cardiology and cardiac anesthesia. The fellows are relieved of clinical duties by attending staff to attend all conferences.
Research Training
Each fellow will have an assigned mentor who is usually a member of the Cardiothoracic Anesthesiology faculty. The cardiac anesthesia fellow will have a defined project and will be expected to submit findings for presentation at a national meeting. Areas of active investigation in the department include neurodegeneration, neuroprotection, acute lung injury, perioperative coagulation changes, human factors and telemedicine. While most of our fellows spend a total of one year for training, it is possible to extend the fellowship for an additional year for more extensive research training.
How to Apply
Department of Anesthesiology Fellowship Application Form
Policies and Information for applying to the Department of Anesthesiology Fellowship Programs:
Your file is complete when we receive:
- The completed University of Maryland Application for Fellowship in Anesthesiology. The application must have an original signature.
- Current curriculum vitae
- Your Personal Statement (name and credentials should appear on the personal statement)
- A copy of your medical school transcript
- Your USMLE I, II & III /COMLEX scores
- Your specialty specific In-Service, In-Training exam or Board Scores
- Three letters of reference; one of which should be from the chairman or program director of your training program
All documents (items 1-6) should be submitted and received in full.
All Letters of Recommendation should be sent directly from the respective writer, unless the LORs are in a sealed envelope with their signature across the back.
Applications and LORs can be sent by postal mail or courier to:
Dr. Wendy Bernstein, Cardiothoracic Anesthesiology Fellowship Program Director
c/o Residency & Fellowship Program Coordinator
Department of Anesthesiology
University of Maryland Medical Center
22 South Greene Street, Suite S11C00
Baltimore, Maryland 21201
Electronic submissions should be sent to: splunkett@anes.umm.edu
For more information, please view the Division of Cardiothoracic Anesthesiology webpage.