Residency Training in General Surgery


Competency-Based Performance Objectives for Residents
Cardiac Surgical Resident's Handbook
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PGY-2 and -3

Overall Objectives

l To learn pathophysiology of the cardiothoracic surgical patient
l To learn the evaluation of a patient for cardiothoracic surgery
l To learn the indications for cardiothoracic surgical intervention
l To learn fundamental cardiothoracic surgical procedures and techniques
l To learn the postoperative management of cardiothoracic surgical patients

Specific Objectives


l Preoperative workup
    n Concentration areas for history, physical exam and laboratory workup
        o Cardiac
        o Pulmonary
        o Esophageal
l Operative intervention
    n Fundamental procedures in cardiac surgery
        o Coronary revascularization
        o Valve repair and replacement
        o Aortic replacement
    n Fundamental procedures in thoracic surgery
        o Lung resection
        o Esophageal resection
l Postoperative care
    n Cardiovascular/hemodynamic management
    n Pulmonary/respiratory management
    n Complications
        o Diagnosis
        o Treatment
l Procedures
    n Insertion of chest tube
    n Insertion of central venous line
    n Insertion of pulmonary artery catheter
    n Insertion of arterial monitoring catheter, femoral and radial
    n Saphenous vein harvest
    n Removal of intra-aortic balloon pump
    n Emergency sternotomy
    n Lateral thoracotomy and closure

PGY-3 (Much of this is building on the PGY-2 curriculum)

l Preoperative workup
    n Review of specific tests and criteria
        o Coronary angiograms
        o Pulmonary function tests
        o Esophageal manometry, pH
        o Aortography, CT, MRI/MRA
l Operative intervention
    n Advanced procedures in cardiac surgery
        o Arrhythmia surgery
        o Ventricular volume reduction
        o MID-CABG
    n Advanced procedures in thoracic surgery
        o Colonic interposition
        o Pulmonary segmentectomy
        o Chest wall resection
l Postoperative care
    n Intra-aortic balloon pump management
    n Ventricular assist device management
    n Open chest resuscitation
    n Advanced methods of ventilation
l Procedures
    n Insertion of IABP
    n Femoral artery cutdown
    n Sternotomy and closure
    n Lobar resection

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