PMH Thoracic Surgery Rotation

1. To develop a knowledge base in general and thoracic surgery, including (a) surgical anatomy of a chest, mediastinum, lungs, tracheobronchial tree, esophagus, and diaphragm; (b) pulmonary physiology and ventilator management; (c) physiology of esophageal motility; (d) pulmonary neoplasms (benign, malignant, and metastatic); (e) lung infections, diffuse interstitial lung disease, and tuberculosis; (f) pleural space problems (pneumothorax, pleural effusion, and empyema); (g) esophageal tumors, benign and malignant; (h) esophageal motility disorders, including reflux; (i) mediastinal tumors and myasthenia gravis; and (j) thoracoscopic techniques.

2. To develop skills in (a) preoperative assessment including interpretation of pulmonary function tests, esophageal manometry, radiographic studies, and microbiologic and cytologic studies; (b) providing preoperative counseling to patient and families; (c) performing thoracic surgical procedures for the management of the disease process as listed above, with an emphasis on bronchoscopy, esophagoscopy, thoracotomy, pulmonary resection, and esophagectomy; (d) providing postoperative care, including ventilator management, pain management, chest tube and drain care, interpretation of postoperative radiographic studies, respiratory and cardiac monitoring, antibiotic therapy; and (e) providing intermediate-term follow-up at the Thoracic Surgical Clinic.

3. Residents are expected to develop skills enabling them to relate well with patients of all backgrounds, patients' families, other physicians, other health care personnel, and hospital administration.  Highly ethical conduct is expected.

Children's Medical Center Dallas Rotation

1. To develop a knowledge base in congenital heart surgery, including (a) cardiac physiology and pharmacology; (b) pacing and electrophysiology; (c) anatomy and embryology of the heart; (d) pathophysiology of cyanotic congenital heart disease; (e) pathophysiology of noncyanotic congenital heart disease; (f) cardiopulmonary bypass, circulatory arrest, and extracorporeal membrane oxygenation; (g) surgical management of patent ductus arteriosus, coarctation, and anomalies of the aortic arch; (h) surgical management of atrial septal defect, ventricular septal defect, atrioventricular canal defects, partial and total anomalous pulmonary venous return, tetralogy of Fallot, pulmonary atresia with intact ventricular septum, truncus arteriosus, transposition of the great vessels, congenital aortic stenosis, congenital malformations of the mitral valve, tricuspid atresia, univentricular heart, Epstein's abnormality, and hypoplastic left heart syndrome.

2. To develop skills in (a) preoperative assessment, including interpretation of cardiac catheterization data, echocardiography, and radiographic studies; (b) providing preoperative counseling to patients and families; (c) performing surgical procedures, especially division of patent ductus arteriosus, closure of atrial septal defect, cannulation for cardiopulmonary bypass, and pacemaker implantation; and (d) to provide postoperative care, including ventilator management, arrhythmia monitoring and treatment, interpretation of postoperative radiographic studies, transfusion therapy, and management of inotropic suort in critically ill infants and children.

3. Residents are expected to develop skills enabling them to relate well with patients of all backgrounds, patients' families, other physicians, other health care personnel, and hospital administration.  Highly ethical conduct is expected.

VAMC Cardiac Surgery Rotation

1. To develop a knowledge base in adult cardiac surgery including: (a) anatomy of the heart and great vessels; (b) cardiac physiology; (c) pathophysiology of the coronary circulation, acquired vascular disease, pericardial disease, thoracic aortic disease, and cardiac tumors; (d) valvular prostheses and their complication; (e) alternate conduits for coronary artery bypass grafting; (f) cardiopulmonary bypass, myocardial protection, and ventricular assistance (intra-aortic balloon pump and ventricular assistance devices); and (g) cardiac pacing and electrophysiology.

2. To develop skills in (a) preoperative assessment including interpretation of cardiac catheterization data, coronary arteriography, echocardiography, and radiographic studies; (b) assessing surgical risks and providing preoperative counseling to patients and families; and (c) performing surgical procedures, including coronary revascularization, valve replacement or repair, replacement of the thoracic aorta and surgery of the pericardium.

3. Residents are expected to develop skills enabling them to relate well to patients, their families, and other members of the healthcare team in an ethical manner.

University Hospital-St. Paul Adult Cardiac Surgery

1. To develop a knowledge base in adult cardiac surgery including (a) anatomy of the heart and great vessels; (b) cardiac physiology; (c) pathophysiology of the coronary circulation, acquired valvular disease, pericardial disease, thoracic aortic disease, and cardiac tumors; (d) valvular prostheses and their complications; (e) alternate conduits for coronary artery bypass grafting; (f) cardiopulmonary bypass myocardial protection, and ventricular assistance; (g) cardiac pacing and electrophysiology; and (h) cardiac and pulmonary transplantation.

2. Development of skills including (a) preoperative assessment including interpretation of cardiac catheterization data, coronary arteriography, echocardiography, and radiographic studies; (b) assessing surgical risks and providing preoperative counseling to patients and families; (c) performing surgical procedures including coronary revascularization, valve replacement or repair, replacement of thoracic aorta, surgery of the pericardium, and cardiac and pulmonary transplantation; and (d) providing postoperative care including ventilation management, arrhythmia monitoring and treatment, interpretation of postoperative radiographic studies, transfusion therapy, and management of inotropic support.

3. Residents are expected to develop skills enabling them to relate well with patients of all backgrounds, patients' families, and other members of the healthcare team in a highly ethical fashion.