I started my adult cardiothoracic anesthesiology fellowship officially on July 10, 2018. Unlike my critical care fellowship where rotations were broken down into two week blocks, this fellowship varies tremendously as shown below. We do two dedicated months of thoracic anesthesiology and are technically on-call 24/7 except every other weekend during those two months for lung transplants. Post-call days will be granted as appropriate per duty hours. These will likely be my most exhausting rotations, but I’m looking forward to them (as well as everything else!)
Clinical Schedule
- July 10 – July 22 (cardiac)
- July 23 – August 5 (imaging)
- August 6 – August 26 (cardiac)
- August 27 – September 23 (thoracic)
- September 24 – October 7 (elective)
- October 8 – January 6 (cardiac)
- January 7 – January 20 (elective)
- January 21 – February 10 (cardiac)
- February 11 – February 24 (elective)
- February 25 – March 24 (cardiac)
- March 25 – April 7 (elective)
- April 8 – May 5 (thoracic)
- May 6 – May 26 (cardiac)
- May 27 – June 9 (imaging)
- June 10 – July 9 (cardiac)
Electives can be anything we want from pediatric congenital heart to cardiac imaging (ie, MRI, stress tests), private practice cardiac cases, and even time with the perfusion service. Because I did an ICU fellowship, I’m excused from doing a full month in the cardiac ICU, so I get extra elective time. 🙂
The imaging rotations are two weeks a piece and designed to allow fellows to perform pre and post TEEs on cases where it’s being utilized (ie, valve repairs, MitraClip, etc.) It’s a great chance for us to practice our comprehensive exams, work on acquiring 3D data sets, and see a wide variety of pathologies without having to do the full cases.
We are allowed to moonlight up to ~25 hours per month which I’ll be carrying out through moonlighting as a night float attending in the thoracic ICU.
We also take complex case call (CCC) during our clinical time on cardiac anesthesia. Fellows do cases during the day and remain available for cases every night and weekend during their CCC week that are “fellow-level” like transplants, aortic dissections, VADs, pulmonary embolectomy, right heart failure, mechanical circulatory support, low ejection fraction, and complex multi-valve cases. The point of this is to ensure that fellows get exposed to these high complexity cases during their training. My CCC schedule is as follows:
- August 13 – August 19
- October 22 – October 28
- November 19 – November 25
- December 17 – December 23
- January 28 – February 3
- March 11 – March 17
- May 20 – May 26
- June 17 – June 23
Study schedule
Just like everything else, I wanted to have a “study” plan going into this fellowship.
- Perrino’s A Practical Approach to Transesophageal Echocardiography
- Vegas’Â Perioperative Two-DImensional Transesophageal Echocardiography: A Practical Handbook
- PTE Masters
- Fellowship didactics
- Online resources like University of Toronto’s TEE page, YouTube, UpToDate, etc.
During the year, I’ll be responsible for presenting at a city-wide echo conference, studying for my ICU boards in October, constructing an abstract to present at the Society of Cardiovascular Anesthesiologists conference in Chicago next year, job hunting, and trying to round out the last of my formal years of medical education. 🙂
