Aortic Surgery Fellowship

The Aortic Surgery unaccredited fellowship is a 12-month* training program. The fellow will have direct management of patients on the Cardiovascular Surgery Service under the supervision of the attending cardiac surgeons. Duty hours will include weekday nights and weekend days and nights for the Cardiovascular surgery service. The fellow will have a current, unrestricted or institutional Pennsylvania medical license; experience in cardiology, cardiac surgery, and/or critical care medicine. The fellow will not maintain an independent surgical practice or perform independent elective cardiovascular ac surgical procedures without direct supervision by the Chief of Cardiovascular Surgery or his designee.

Duration: 12 months (*there is an option for a 6-month abbreviated program)

Educational Goals and Objectives:

• Develop skills in the preoperative assessment of complex adult cardiac surgical problems, including aortic surgery.
• Develop skills in the preoperative assessment of heart failure patients.
• Develop skills in the medical management of complex adult cardiac surgical problems and patients in heart failure.
• Develop skills and techniques of intraoperative repair of complex adult cardiac surgical problems.
• Develop skills and techniques of the surgical management of heart failure patients including high risk revascularization and mitral valve repair.
• Develop skills in implantation of ventricular assist devices, including the various types of ventricular devices.
• Be responsible for post-operative management of patients with complex cardiac surgical problems including aortic surgery.
• Be responsible for the post-operative management of ventricular assist devices.
• Participate in original research of the surgical management of heart failure.
• Be expected to experience a broad out-patient exposure and will be expected to attend the Aortic Surgery Clinic with the Aortic Surgery team.
• Be expected to attend out-patient cardiopulmonary transplant initiatives as requested by the Directors of Lung Transplantation and Cardiac Transplantation.
• Participate in the teaching activity of the Department of Surgery and the Division of Cardiothoracic Surgery. This includes presentation of cases at Wednesday Combined Cardiac Surgery/Cardiology Conference if he/she was involved in the case.  
• Be responsible for giving one Professor Rounds talk to junior residents and medical students every two months. These can be either didactic sessions in 5 Founders SICU or “true classic” teaching patient rounds.

Optional abbreviated program of 6 months

The Aortic Surgery unaccredited fellowship is either a 6-month or one-year training program. A 6-month fellowship and a 1-year fellowship will have the same percentages devoted to clinical surgery and clinical research. The 6-month fellow’s time will be spent:

• 60% Clinical Surgery
• 30% Clinical Research
• 10% Outpatient Cardiac Surgery Clinics

The Aortic Surgery unaccredited fellowship and educational goals and objectives remain the same for both a 6-month and 1-year fellowship.

On-Call Responsibilities

1. The Aortic Fellow will have weekday nights and weekend days and nights.
2. The Aortic Fellow will make rounds on all patients on the cardiovascular surgery step-down unit.
3. The Aortic Fellow will be available for consultation.
4. The Aortic Fellow will be immediately available to respond to all calls for assistance from other healthcare providers at the Hospital.
5. The Aortic Fellow will promptly involve the attending surgeon in any evaluation or management issue requiring attention.
6. The Aortic Fellow will assume his position within the regular in-house on-call schedule for cardiac surgery residents when one of the cardiac surgical residents is gone.

Educational Service

1. They will be responsible for attending all 7am-8am conferences: Monday Case Conferences, Tuesday Cardiac Transplant, Wednesday Cardiac Service and Cardiovascular Conferences, Thursday Lung Transplant, and Friday Cardiac Grand Rounds.
2. The Aortic Fellow occasionally will be responsible for presentation of cases at Wednesday Combined Cardiac Surgery/Cardiology Conference if he/she was involved in the case. 

Out-Patient Activity

1. The Aortic Fellow will be expected to experience a broad out-patient exposure.
2. He/she will be expected to attend with the Aortic Surgery team the Aortic Surgery Clinic.
3. He/she will be expected to attend occasional out-patient cardiopulmonary transplant initiatives as requested by the Directors of Lung Transplantation and Cardiac Transplantation.

Facilities

All clinic and inpatient care will take place within the University of Pennsylvania Health System at the Hospital of the University of Pennsylvania and/or Presbyterian Medical Center.

Core Competencies

Patient Care
The fellow must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. The fellow is expected to:

• Communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and their families.
• Gather essential and accurate information about their patients.
• Make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment.
• Develop and carry out patient management plans.
• Counsel and educate patients and their families.
• Use information technology to support patient care decisions and patient education.
• Perform competently all medical and invasive procedures considered essential for the area of practice.
• Provide health care services aimed at preventing health problems or maintaining health.
• Work with health care professionals, including those from other disciplines, to provide patient-focused care.

Medical Knowledge
The fellow must demonstrate knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care. The fellow is expected to:

• Demonstrate an investigatory and analytic thinking approach to clinical situations.
• Know and apply the basic and clinically supportive sciences which are appropriate to their discipline. 

Practice-Based Learning and Improvement

The fellow must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence, and improve their patient care practices. The fellow is expected to:

• Analyze practice experience and perform practice-based improvement activities using a systematic methodology.
• Locate, appraise, and assimilate evidence from scientific studies related to their patients' health problems.
• Obtain and use information about their own population of patients and the larger population from which their patients are drawn.
• Apply knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness.
• Use information technology to manage information, access on-line medical information; and support their own education.
• Facilitate the learning of students and other health care professionals.

Interpersonal and Communication Skills

The fellow must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, their patient’s families, and professional associates. The fellow is expected to:

• Create and sustain a therapeutic and ethically sound relationship with patients.
• Use effective listening skills and elicit and provide information using effective nonverbal, explanatory, questioning, and writing skills.
• Work effectively with others as a member or leader of a health care team or other professional group. 

Professionalism

The fellow must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.  The fellow is expected to:

• Demonstrate respect, compassion, and integrity; a responsiveness to the needs of patients and society that supersedes self-interest; accountability to patients, society, and the profession; and a commitment to excellence and on-going professional development.
• Demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practice.
• Demonstrate sensitivity and responsiveness to patients' culture, age, gender, and disabilities.

Systems-Based Practice

The fellow must demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value. The fellow is expected to:

• Understand how their patient care and other professional practices affect other health care professionals, the health care organization, and the larger society and how these elements of the system affect their own practice.
• Know how types of medical practice and delivery systems differ from one another, including methods of controlling health care costs and allocating resources.
• Practice cost-effective health care and resource allocation that does not compromise quality of care.
• Advocate for quality patient care and assist patients in dealing with system complexities.
• Know how to partner with health care managers and health care providers to assess, coordinate, and improve health care and know how these activities can affect system performance.