FELLOWSHIP TRAINING IN CARDIOTHORACIC SURGERY The Division of Cardiothoracic Surgery is responsible for programs at the Medical College of Virginia Hospitals, the Hunter Holmes McGuire Veterans Administration Medical Center and Richmond Memorial Hospital. Strong programs exist in general thoracic surgery, pediatric cardiac surgery, surgical electrophysiology, heart and heart-lung transplantation and adult cardiac surgery. The Division participates in the national BARI randomized trial of multi-vessel angioplasty and coronary bypass surgery and the National and International Dr. Embrey and Betty Chiu, CCP, Pediatric Perfusionist with a patient. Transplant Registry. The Hunter Holmes McGuire Veterans Administration Hospital is one of three Veterans Administration Centers approved for heart transplantation in the country and the MCVH cardiac transplant program is a Medicare Regional Referral Transplantation Center which also performs neonatal cardiac transplantation. This program is the second oldest in the United States and currently follows about 300 survivors of transplantation. The Division is an investigative center for the TCI electric left heart assist device as a bridge to transplantation and is the primary site of the Telectronics cardiomyoplasty program. The Surgical Electrophysiology Program functions at both the Medical College of Virginia Hospitals and Veterans Administration Hospital and serves as a regional referral resource for these procedures. The Division accepts two trainees for post graduate clinical education each year. Ideally, future cardiothoracic surgeons are identified at the entry level to the general surgery training program, encouraged to obtain their laboratory experience within the Division and to continue their academic productivity while completing their and at initiation of their cardiothoracic fellowship training. Divisional conferences include: Transplantation Conference - Patients are reviewed before and after their cardiac or pulmonary transplantation and issues of management are discussed. Pediatric Catheterization - Patients are presented by the pediatric cardiologist and decisions regarding their optimal management are made. (MCVH) Chest Tumor Conference - A multidisiplinary conference during which both in and outpatients are discussed. Cardiac Catheterization - Two case presentations based on a cardiac catheterization are made. The literature relating to these case presentations is reviewed. (MCVH, VAH, RMH) Medical/Surgical Thoracic Conference - A weekly multidisplinary discussion, including review of x-rays, based upon clinical case presentations. Med-Surgery VA Transplant - Patients on the waiting list and those having transplantation problems are discussed. (VA.) Quality Assurance - All complications and deaths on the service are presented by the operating surgeon (usually a resident). Cases are reviewed by the faculty and resident staff with an attempt to identify what factors might lead to improved outcome. CT Teaching (CT Surgery and Basic Science Conference for Cardiac Physiology - Medicine/Surgery) The faculty in the Division of Cardiothoracic Surgery has a curriculum of 104 topics presented in a two-year cycle. These are didactic lectures for residents and students on the Cardiothoracic Service where specific topics are discussed, with opportunities for questions and answers. Cardiothoracic Visiting Professors - Experts from outside the institution present new ideas and methods. Resident research is presented for discussion and unusual cases are reviewed. Research Conferences - Separate conferences are held within the individual laboratory groups and multiple seminars of interest are conducted by the Division of Cardiology and by the Division of Physiology that are attended by members of the Division. Thoracic Chest X-ray Review - Daily review of x-rays of current inpatients on the Thoracic Surgery Service.

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