Our Programs

Overview

In partnership with ECU Health Medical Center, the Department of Cardiovascular Sciences offers a traditional two-year, fully-accredited training program in Cardiothoracic Surgery.  Our program provides the full complement of educational and clinical activities to produce high quality, well trained cardiothoracic surgeons.  All aspects of the training program are fully certified by the ACGME Residency Review Committee for Thoracic Surgery, and at the completion of training, residents are eligible for certification by the American Board of Thoracic Surgery.

Residents in our training program experience the complete continuum of care in cardiac, thoracic, and congenital surgery.  Training includes experience in both inpatient and outpatient settings, with significant exposure to the planning and execution of operations as well as critical care and post-operative management.  Our facilities are state-of-the-art and our large catchment area allows for exposure to a wide variety and high volume of patients and operative experiences.  In addition to the customary cardiothoracic training encompassing all types of ischemic and valvular heart disease and lung and esophageal resections, residents can expect to be exposed to an extensive breadth of new and innovative treatments.  This includes minimally invasive and robotic adult cardiac surgery, advanced laparoscopy and thoracoscopy, extensive exposure to benign and malignant esophageal surgery, advanced aortic surgery and percutaneous valve therapy, mechanical assist devices/ECMO, and advanced endoscopic and bronchoscopic techniques.  We pride ourselves on quality of care and excellent outcomes, and all of our programs are highly ranked nationally in multiple outcomes databases.  Clinical research opportunities are plentiful, and research productivity is encouraged.

We believe our program is an exciting place to learn and our faculty is committed to providing the knowledge and clinical/technical skills to produce competent, professional, and successful cardiothoracic surgeons.

Schedule

The Thoracic Surgery Residency is a fully-accredited ACGME two-year training program. The program is clinically oriented with a strong educational commitment coupled with clinical research opportunities.

During the first year, residents rotate on both the cardiac and thoracic services, spending approximately half their time on each service. A two-week introduction to the cardiovascular intensive care unit (CVICU) is scheduled early in the year. Towards the end of the first year of residency, the resident will select whether to continue on the cardiothoracic or general thoracic track during the second year, if appropriate within the constructs of the current makeup of the program. The second year will then be designed around the needs of the resident to meet the required case numbers for their designated track, as defined by the American Board of Thoracic Surgery (ABTS). Also during the second year, a congenital cardiac surgery rotation will be arranged, typically at an away location, to supplement to congenital experience at ECU/ECU Health Medical Center.

The curriculum follows the Thoracic Surgery Director’s Association (TSDA) standard curriculum and covers the entire curriculum over the two-year period of the residency program. The curriculum is assigned on a weekly basis, along with self-evaluation quizzes and a discussion is held twice monthly with an assigned faculty member.

The program incorporates multiple educational conferences held on a weekly, bi-monthly, and monthly basis. These conferences include, but are not limited to, Grand Rounds, Journal Club, Morbidity and Mortality, Thoracic Oncology Tumor Board, and Catheterization Conference.

Each resident is required to participate in a clinical research project. An annual research day is coordinated by the GME office and residents are expected to submit their research to this conference. Residents are encouraged to submit their work to regional and national conferences, and for publication. In addition, our department is involved in multiple, large-scale clinical trials and many smaller, single-center projects.

Year 1 (All)

Year 2 (Cardiac)

Year 2 (Thoracic)

Conferences & Curriculum

Conference Schedule

Conferences form an important part of the Thoracic Surgery Residency Program and a series of case-based and didactic lectures have been assembled to meet the educational goals of the program. These include:

1. TSDA Curriculum Conference – Bi-Monthly conference to discuss the designated topic from the TSDA Cardiothoracic Curriculum. The entire curriculum is covered over a two-year period.
2. Case Conference – Weekly conference led by residents to evaluate interesting and pertinent cases occurring during the course of the week.
3. Thoracic Oncology Tumor Board – Weekly conference led by thoracic oncology with participation from a multidisciplinary group of oncologists, surgeons, pulmonologist, radiation oncologists, and pathologists. All thoracic oncology patients presenting to the weekly thoracic oncology clinic are discussed along with interesting cases presented by the various subspecialties.
4. Grand Rounds – Monthly conference in which faculty, fellows, and visiting professors present core curriculum talks on cardiovascular sciences topics. Category 1 CME credits can be earned.
5. Departmental M&M – Morbidity and Mortality conference in which all designated cases are discussed for the cardiac and thoracic divisions, as well as case presentation from residents on other complications from the month.
6. Journal Club – Bi-monthly conference led by residents with faculty participation to discuss current medical literature.
7. Combined Cardiothoracic/Cardiology Conference – Monthly Resident/Fellow led multidisciplinary conference to discuss the interesting patients shared across disciplines.
8. Foregut Conference – Quarterly Resident/Fellow led multidisciplinary conference to discuss interesting cases involving multidisciplinary approaches to complex foregut problems.

Curriculum

The Thoracic Surgery Residency master curriculum follows the Thoracic Surgery Director’s Association (TSDA) standard curriculum and covers the entire curriculum over the two-year period of the residency program. The curriculum is assigned on a weekly basis, along with self-evaluation quizzes and a discussion is held twice monthly with an assigned faculty member. These discussions may include faculty presentations and lectures, quizzes, mock oral scenarios, and resident presentation.

Research

Research is a vital part of the Thoracic Surgery Residency.  The fundamental goals of the research component of resident training is that all residents will learn to:

1. Critically review scientific literature
2. Develop a hypothesis driven research project
3. Interpret and report scientific results

These goals will be obtained by the following teaching methods:

1. Attend and participate in bi-monthly Journal Club
2. Attend didactic lectures on research methodology held in conjunction with the Internal Medicine Residency Program.
3. Perform, with faculty guidance, a hypothesis driven research project.  The following is an expected time-line for completion of this project:
   1. Identify a research mentor by January 31 of the first year. Most faculty have various projects going on at all times and we may ask you to participate in those. Alternatively, you may elect to develop your own project.  You should select a faculty member in your area of interest to work with on this in the first six months of training.
   2. Perform a literature search, develop a hypothesis and study variables, and complete IRB paperwork (if necessary) by July 31 at the end of the first years.
   3. Collect and analyze data, prepare presentations and a manuscript and submit to various conferences during the second year of training.  At a minimum this project should be submitted to the annual GME research day at Vidant Medical Center, but we encourage submission to regional and national meetings.  Residents should plan to submit a completed manuscript to a journal for publication by the completion of training.

Clinical Competency Committee (CCC)

Purpose

In accordance with the ACGME regulations 2013, a Clinical Competency Committee (CCC) has been formed (ACGME 2013 Core Requirement). The CCC will serve as an early warning system if a fellow fails to progress as expected in the training program, and will assist in early identification and move toward improvement and remediation. To make consensus decisions on the progress of each fellow in the program.

Policy Statement

The members of a CCC have responsibility for:

1. Determining fellows’ progression on the educational Milestones
2. Making recommendations on promotion and graduation decisions
3. Recommending remediation or disciplinary actions to the program director
   1. The committee may make the following recommendations:
      1. No further action necessary
      2. Letter of concerns with specific terms and remediation recommendations
      3. Probation with specific terms and remediation recommendations
      4. May be with or without extension of time at level of training
      5. Termination
      6. Delay or denial of promotion or board recommendation

Committee Responsibilities

Evaluation and Reporting:

The CCC shall meet on a semi-annually basis in June and December of every academic year and:

1. Review all fellows’ evaluations by all evaluators semi-annually at each PGY level
2. Preparing and assure the reporting of Milestones evaluations of each fellow semi-annually to ACGME
3. Making recommendations to the program director for –
   1. promotion
   2. remediation
   3. dismissal

The PD will used the CCC recommendations as part of the fellows’ semi-annual review.

Administrative Responsibilities:

The CCC will meet on an ad hoc basis to:

1. Develop and manage systems for evaluation of fellows from multiple sources (e.g., faculty, peers, patients, self, other professional staff).
2. Manage a faculty advisor system to provide fellow mentorship and feedback about performance at least semi-annually.

These meetings should –

1. Guide curriculum development
2. Develop evaluation tools