Two-Year Cardiothoracic Surgery Residency
The traditional independent two-year cardiothoracic surgery residency training program at Yale is designed to train future leaders in the field that are proficient in a broad spectrum of cardiac and thoracic surgical techniques. In addition to providing robust exposure to conventional cardiac surgery, including surgical coronary revascularization and valve repair and replacement, our program emphasizes cutting-edge advances. Residents will be exposed to minimally-invasive approaches, including robotic coronary and valve operations, percutaneous interventions, arrhythmia surgery, and mechanical circulatory support. Close collaborative relationships with the Divisions of Thoracic Surgery, Vascular Surgery, and Cardiovascular Medicine present many opportunities for the acquisition of endovascular (including TEVAR), robotic, and thoracoscopic skills. The internationally-recognized Yale Center for Thoracic Aortic Disease provides robust training in thoracic aortic reconstruction. Our established and high volume minimally-invasive and surgical heart failure programs are designed to provide our trainees with cutting edge experiences in these subspecialties.
Program Overview
The Yale Traditional Two-year Cardiothoracic Surgery Residency program is designed for graduates of general surgery or vascular surgery residency who seek additional training to become ABTS-certified cardiothoracic surgeons. We offer pathways designed to emphasize either general thoracic or cardiac surgery. One’s pathway does not need to be declared prior to beginning the program. While the training is necessarily condensed within two years, there is room for flexibility, allowing for additional time in the second year to focus on their pathway of choice. For the general thoracic pathway, an individualized schedule is created to include additional time with interventional pulmonology, gastroenterology, and radiation and medical oncology. The cardiac pathway includes additional time with cardiology and vascular surgery, focusing on structural heart diseases and thoracic aortic reconstruction.
This program is designed to train future leaders in academic cardiothoracic surgery. Graduates will be proficient in a broad spectrum of open and minimally-invasive, including endovascular, robotic, and thoracoscopic, approaches to cardiac and thoracic diseases. Through our close collaborative relationships with other divisions, our program offers trainees additional skills in percutaneous valves, endovascular stenting, and advanced endobronchial and endoscopic procedures.
Clinical Rotations
The first year of our traditional program is comprised of rotations on the General Thoracic and the Adult Cardiac Surgery Services at Yale-New Haven Hospital plus the cardiothoracic service at the West Haven Veterans Administration Hospital. The second year of our traditional program consists of a return to either the Adult Cardiac Surgery service or the Thoracic Surgery service, depending on the trainee’s interest, plus time on the Congenital Cardiac Surgery Service. This base curriculum is intended to be flexible and can accommodate a one to two-month elective rotation, which can include structural cardiology and catheterization laboratory, interventional pulmonology, radiation oncology, and other services tailored to the trainee’s interest.
Year 1 | Year 2 |
---|---|
VA Connecticut | Thoracic |
VA Connecticut | Thoracic |
VA Connecticut | Thoracic |
Adult Cardiac | Adult Cardiac |
Adult Cardiac | Adult Cardiac |
Adult Cardiac | Adult Cardiac |
Adult Cardiac | Adult Cardiac/Thoracic |
Thoracic | Adult Cardiac/Thoracic |
Thoracic | Structural Cardiology/Interventional Pulmonology |
Thoracic | Structural Cardiology/Interventional Pulmonology |
Thoracic | Cardiac - Congenital |
Structural Cardiology/Interventional Pulmonology | Cardiac - Congenital |
Operative Case Breadth and Depth
The Division of Cardiac Surgery consists of a diverse group of adult and congenital cardiac faculty who perform the breadth of cardiac surgical procedures, including complex coronary, valvular, aortic, and heart failure operations and repairs of complex congenital heart defects. Trainees will gain experience in basic and complex surgical techniques, including minimally invasive and off-pump coronary artery bypass, robotic mitral valve repair, valve-sparing aortic root operations, transcatheter aortic and mitral valve procedures, endovascular aortic procedures, hybrid arch operations, extracorporeal membrane oxygenation, ventricular assist devices, and heart transplantation.
The faculty of the Division of Thoracic Surgery treat the entire spectrum of thoracic pathologies. Nearly all of these cases are performed minimally-invasively via VATS and robotic approaches for lung and mediastinal diseases, and via laparoscopic, endoscopic, and robotic approaches for esophageal cancer and benign foregut diseases. Trainees will gain ample open experience through complex lung, airway, mediastinal, chest wall, and esophageal cases.
Training Facilities
Yale-New Haven Hospital
The health system’s main campus located across the street from Yale School of Medicine, YNHH is a 1,541-bed tertiary medical center receiving national and international referrals. Yale New Haven Hospital includes Smilow Cancer Hospital and Children's Hospital. Yale New Haven Hospital is one of four Level 1 trauma centers in Connecticut and one of only two Pediatric Level 1 trauma centers. This is the main location for clinical rotations including Adult Cardiac Surgery, General Thoracic Surgery, and Congenital Cardiac Surgery.
West Haven VA Hospital
Located about five miles west of New Haven, the West Haven VA Hospital is a 216-bed hospital and the only tertiary care Veteran’s Administration Hospital in Connecticut. As such, it is the only VA hospital between New York and Massachusetts offering cardiothoracic surgery services. This is an important training location for general adult cardiac and thoracic cases.
Didactics and Simulation
We provide a strong educational foundation in cardiothoracic surgery, preparing our trainees to be well-versed in not only basic and advanced concepts, but also the latest evidence-based practices from the cardiac and thoracic surgical literature. Trainees actively participate in weekly, trainee-led education sessions, following the comprehensive TSDA curriculum. These sessions are moderated by the faculty, and discussion of case scenarios and multiple-choice-question assessments are incorporated into every session. Special attention is paid toward preparing for the yearly thoracic surgery in-training exam (TSITE) and the qualifying and certifying ABTS board exams. Wet/dry lab simulations, moderated by faculty, supplement trainees’ education. In addition, we have developed a robotic thoracic and cardiac surgery curriculum that prepares trainees for future practice and meets the requirements of Intuitive Surgical Inc’s certification for operating the da Vinci Surgical System. This curriculum defines the pre-operative (online modules, training with the device representative(s), and simulation experience), bedside (defining graduated bedside autonomy), and console (with milestones by case type and training year) requirements to obtain certification.
Research Support
Many cardiothoracic faculty lead outcomes research and basic science groups, with substantial resident involvement. Traditional pathway trainees are encouraged to contribute to ongoing research efforts in clinical, translational, and/or basic science. Cardiac faculty with active research include Drs. Assi, Bonde, Elefteriades, Gruber, Tellides, and Vallabhajosyula. The Thoracic Division offers robust support for clinical outcomes and basic research experiences, led by Drs. Boffa, Detterbeck, and Woodard. The research activities cover a broad array of cardiac and thoracic physiology and pathology. Open weekly meetings are held for both the Cardiac and Thoracic clinical outcomes research groups, and residents are encouraged to become involved early in the research endeavors.
There are opportunities across the University’s Schools and Departments for mentorship and collaboration, including with the Yale Center for Outcomes Research and Evaluation (CORE). Opportunities within other Departments of the School of Medicine, including Medicine, Anesthesiology, Pathology, Immunobiology and others are numerous. These activities provide opportunities for animal operations and work in molecular biology, immunobiology, biochemistry, and biomedical or mechanical engineering. The laboratories are staffed by full-time basic scientists, surgical research fellows, and technical staff. Although finding the time to conduct independent research during our residency training programs can be challenging, projects can be undertaken during clinical rotations, and the development of an academic career in cardiothoracic surgery is supported and encouraged.