Cardiothoracic Surgery Integrated Residency

Simulation

Our residency program uses a dedicated skills lab which is available to residents on their own time as well as part of structured technical skills sessions. The residents participate in an average of four to six wet labs each year that are arranged through industry sponsors. These labs allow residents to perform complete operations on porcine hearts using prostheses and other materials provided by sponsors.

Additionally, MUSC facilities are equipped for simulative training in endoscopy, bronchoscopy, laparoscopy and robotics. These facilities are easily accessible to residents at any time.

Lastly, through a collaborative effort with the MUSC School of Clinical Perfusion, the cardiothoracic surgery residents participate in an annual simulation reviewing cardiopulmonary bypass crisis scenarios using a state-of-the-art cardiopulmonary bypass simulator.

Educational Activities & Conferences 

Below is a list of educational activities and conferences that are provided for all CT residents. Most happen on a weekly or monthly basis. 

The Teaching Conference meets every Tuesday morning for CT residents and attending faculty, following the TSDA Curriculum in thoracic, adult cardiac and congenital cardiac surgery, and critical care. Residents review assigned readings and discussed key topics with attending surgeons.

Department of Surgery Grand Rounds is held monthly on Tuesdays and includes all divisions within the Department of Surgery. Guest speakers include invited guests from other academic institutions as well as current faculty members.

Service Conference is held every Tuesday morning to review the previous week’s surgical cases, focusing on complications and patient deaths.

Cardiothoracic Surgery Journal Club meets monthly at local restaurants, where residents present and critically evaluate articles selected by faculty from leading cardiothoracic surgery journals.

Heart & Vascular Morbidity and Mortality Conference is held monthly. This conference for the Heart and Vascular Service Line is attended by the faculty and residents from Cardiothoracic Surgery, Cardiology and Vascular Surgery.

Service-Specific Multi-Disciplinary Conferences

Structural Heart and Valve Conference is held every Wednesday morning and brings together residents, fellows and faculty from cardiac surgery, interventional cardiology and cardiac anesthesiology. The team reviews upcoming valve interventions, discusses complex cases and treatment approaches, and examines a relevant publication presented by a resident or fellow.

Advanced Heart Failure Therapies Selection Committee meets every Wednesday afternoon to develop treatment plans for patients being evaluated for heart transplantation or durable mechanical circulatory support. The multidisciplinary team also reviews postoperative patients with complications.

Lung Transplant Selection Committee is held every Wednesday morning. This conference is attended by residents, fellows and faculty in Thoracic surgery and Transplant Pulmonology, in addition to a multi-disciplinary group of allied health professionals. Patients undergoing evaluations for lung transplantation are discussed in detail.

General Thoracic Preop Conference is held every Tuesday afternoon. This conference is attended by residents and attendings on the General Thoracic Service. The senior resident(s) on the service present each operative case for the following week. Rationale, approach and supporting literature are reviewed

Thoracic Surgery Tumor Board meets every Wednesday afternoon, bringing together thoracic surgery, medical oncology, radiation oncology and pulmonology to develop treatment plans for patients with thoracic cancer. Attendance is mandatory for the residents assigned to the General Thoracic Service.

Pediatric Cardiology Conference meets Monday and Thursday afternoons to review patients scheduled for surgery the following week, including their medical history and diagnostic findings. Attendance is mandatory for the CT resident on the congenital heart rotation and optional for other CT residents.

Research

All Residents: According to Department of Surgery requirements, cardiothoracic surgery residents must write two publishable manuscripts and complete a quality improvement project during their time in residency. Active involvement in research is encouraged throughout the cardiothoracic training program, and residents frequently exceed the Department of Surgery research requirements. Outcomes research and translational research are supported by faculty within the Division of Cardiothoracic Surgery. Additionally, the Cardiovascular Research Laboratory is accessible to residents who wish to be involved in translational research projects.

Dedicated Research Tract: One to two years of dedicated research time is supported and encouraged for our research tract residents. These dedicated years have provided time, mentorship and opportunities which have resulted in many national and international meeting presentations including several Plenary sessions presented by our residents.

Residents pursuing basic science research are supported by a rich environment of scientists at MUSC. In addition to the Cardiovascular Research Laboratory, our residents and faculty collaborate with investigators in the Transplant Immunobiology and Surgical Oncology laboratories.

In Training Examination

Residents receive access to both the TSDA online curriculum and question bank, as well as being provided subscription access to STATPearls online question bank for in-training and board preparation.

In addition, the Society of Thoracic Surgeons (STS) offers the STS Learning Center. Residents can build customized quizzes to review topics in adult cardiac, general thoracic, and congenital surgery. All residents and faculty members have full access to the STS Learning Center library which features textbooks, videos, and case presentations. The information available in the STS Learning Center is the same used by the American Board of Thoracic Surgery to create its certification exams.

Evaluations

Throughout training, residents are evaluated through multiple methods to monitor progress, ensure competency and support professional development.

Case Logs: Reviewed semiannually to assess operative volume, case variety and surgical responsibility.

End-of-Rotation Milestone Evaluations: Completed by attending faculty after each rotation and reviewed by the Clinical Competency Committee (CCC) for semiannual ACGME Milestones reporting.

In-Training Examinations: Residents take the TSDA in-service examination each spring. Scores above the 30th percentile are required for advancement. Lower scores result in academic remediation, and two consecutive years at this level may lead to dismissal.

Oral Examinations: Senior residents complete faculty-administered oral examinations in general thoracic, adult cardiac and pediatric cardiac surgery to assess knowledge and prepare for American Board of Thoracic Surgery (ABTS) examinations. Unsatisfactory performance requires retesting.

Health Professional Assessments: Advanced practice providers provide semiannual 360-degree feedback for CCC review.

Peer Evaluations: Conducted semiannually and reviewed by the CCC.

Self-Evaluations: Residents complete semiannual milestones self-assessments for CCC review.

Semiannual Milestones Reporting: In November/December and May/June, the CCC reviews evaluations, case logs, examination results and other assessments. The program director meets individually with each resident to review progress and develop improvement plans as needed.