The University of Washington (UW) Adult Cardiothoracic Anesthesiology Fellowship is a one-year clinical fellowship based at University of Washington Medical Center (UWMC). The fellowship is accredited by ACGME, and provides extensive experience with anesthesia and perioperative/periprocedural management of patients undergoing cardiac, non-cardiac thoracic, and intrathoracic vascular surgery, as well as non-operative diagnostic and interventional cardiac, thoracic, and electrophysiological procedures.
It is the program's goal to produce graduates who are highly competent in anesthesia and perioperative care for the cardiothoracic/cardiovascular patient, proficient in advanced perioperative echocardiography, qualified to provide consultant advice, and dedicated to leading and advancing excellent Cardiothoracic Anesthesiology practice.
The Division of Cardiothoracic Anesthesiology provides anesthesia care for cardiac surgical procedures both at UWMC and at Northwest Hospital & Medical Center (NWH), a community hospital that is part of UW Medicine. Approximately 630 cardiac surgical cases, predominantly of high complexity, were performed in academic year 2012-2013:
In addition, 117 transcatheter aortic valve implantations (TAVI) were performed at UWMC in academic year 2012-2013, all under general anesthesia and involving periprocedural TEE.
Fellow responsibilities in the cardiac operating rooms balance personal delivery of anesthesia/perioperative care with supervision and instruction of junior Anesthesiology residents, all under appropriate, frequently one-to-one, supervision by Cardiothoracic Anesthesiology faculty.
Training in advanced perioperative transesophageal echocardiography is integrated into the Cardiac OR rotation experience. Perioperative TEE is utilized in virtually all cardiac surgical cases. Fellows personally perform the majority of intraoperative TEE studies, with direct supervision and guidance by Cardiothoracic Anesthesiology faculty who are either National Board of Echocardiography (NBE)-certified in Advanced Perioperative Transesophageal Echocardiography (8/12 faculty), NBE-certified in Adult Transesophageal Echocardiography (1/12), or testamurs of the PTEeXAM currently pursuing NBE-certification (2/12).
The required critical care rotation experience on the UWMC Cardiothoracic Intensive Care Unit (CICU) offers exposure to a population of critically ill patients recovering from cardiac, thoracic, and vascular surgery. The UWMC CICU is a high-acuity and high-complexity unit with an emphasis on the care of patients after thoracic organ transplantation, patients with adult congenital heart disease, and patients after implantation of cardiac assist devices. Through a combination of clinical experience, bedside teaching, didactic lectures and conferences, and directed fellow reading, the CICU rotation enables learning of a systematic approach to the management of critically ill adult cardiothoracic surgical patients.
All fellows complete a one-month elective rotation in the UWMC Echocardiography Lab. Fellows gain experience in lab-based and bedside 2D and 3D transthoracic and transesophageal echocardiography. The rotation experience will progress from the observation to the performance, under supervision, of echocardiographic examinations, and the offline interpretation and reporting of echocardiographic studies performed by registered medical or cardiac diagnostic sonographers.
The non-cardiac thoracic surgical case volume at UWMC averages approximately 800 cases per year. The program at UWMC provides experience with the full range of contemporary thoracic surgical practice including lung transplantation; open, video-assisted, and robotic lung resection including pneumonectomy; lung volume reduction surgery (both video-assisted and open); tracheal resection/reconstruction; pulmonary thrombendarterectomy; esophageal resection; and numerous endoscopic airway interventions. The lung transplant program at UWMC is one of the largest programs in the US. The rotation provides ample opportunities to become proficient in thoracic epidural catheter placement, lung isolation, management of one-lung ventilation, and anesthesia management for airway interventions.
Established elective rotation options include Adult Congenital Heart Disease (clinic), Cardiopulmonary Perfusion, Cardiothoracic Intensive Care Unit (in addition to the "required" cardiothoracic surgical critical care rotation), Echocardiography Lab, and Research. All elective rotations are currently based at UWMC. Other elective rotations may be arranged.
Weekly Cardiothoracic Anesthesiology fellow seminars cover didactic subjects required by ACGME, as well as providing didactic education in perioperative echocardiography. This perspective is supplemented and enhanced by fellow attendance of relevant didactic lectures and seminars of the Cardiology, Cardiothoracic Surgery, and Critical Care Medicine fellowship training programs at University of Washington.
The conference program includes the weekly interdisciplinary Cardiology Case Conference, a forum for review of interesting and challenging cases, often involving presentation of echocardiographic findings; weekly Cardiothoracic Anesthesiology TEE Review; weekly Anesthesiology & Pain Medicine Grand Rounds; and bimonthly Cardiothoracic Anesthesiology Journal Club.
ACGME now requires that "All required clinical education for entry into ACGME-accredited fellowship programs must be completed in an ACGME-accredited residency program, or in an RCPSC-accredited or CFPC-accredited residency program located in Canada."
Eligibility for appointment to fellowship training in Adult Cardiothoracic Anesthesiology requires completion of and graduation from an ACGME- or RCPSC- accredited Anesthesiology residency program. Current trainees in an ACGME- or RCPSC- accredited Anesthesiology residency program must have a realistic expectation of successful training completion and graduation by June 30, 2015, in order to be eligible.
Applicants should submit the following documents:
NOTE: Letters of recommendation must be submitted directly to the program by the referee. Official transcripts must be sent directly to the program either by the office generating the transcript, or its authorized agent for secure electronic transcript delivery.
The UW Cardiothoracic Anesthesiology Fellowship program will again be entering its fellowship positions in the nation-wide Adult Cardiothoracic Anesthesiology Fellowship Match organized by SF Match. Please note that SF Match does not provide a centralized application service for Adult Cardiothoracic Anesthesiology fellowships at this time. Applications and supporting documentation should be submitted directly to the fellowship program.
Please send application and supporting documentation to:
Ashley E. Walker
Program Administrator - Cardiothoracic Anesthesiology
Department of Anesthesiology & Pain Medicine
University of Washington, Box 356540
UWMC Room # SS-312
1959 NE Pacific Street
Seattle, WA 98195-6540
phone: 206-221-6453 / fax: 206-598-8269
Jörg Dziersk MD FRCA
Health Sciences Building, AA-117E, Box 356540