Anesthesiology & Pain Medicine >> Education >> Fellowship in Cardiothoracic Anesthesiology

Fellowship Training Program:
Fellowship in Cardiothoracic Anesthesiology

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.

Clinical Experience

Cardiac OR

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:

  • CABG (isolated) 17%
  • Congenital 22%
  • Heart transplantation / VAD implantation 11%
  • Thoracic aortic 15%
  • Valvular (including combined CABG + valve) 35%

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).

Cardiothoracic Intensive Care Unit

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.

Echocardiography Lab

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.

Thoracic OR

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.

Electives

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.

Didactic Education

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.

Conferences

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.

Faculty

  • Bowdle, T. Andrew, MD, PhD Professor, UWMC
    Regular Faculty
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    T. Andrew Bowdle, MD, PhD

    Professor & Director of TEE Simulation,
    Anesthesiology & Pain Medicine;
    Adjunct Professor, Pharmaceutics

    bowdle@uw.edu

    Primary Location: UW Medical Center

    Clinical Interests: Cardiothoracic anesthesiology, echocardiography, physiologic monitoring.

    Research Interests: Clinical pharmacology, patient safety and outcomes.

    Personal Interests: Skiing, photography and cycling.

  • Dziersk, Jorg, MD, FRCA Clinical Associate Professor, UWMC
    Regular Faculty
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    Jorg Dziersk, MD, FRCA

    Clinical Associate Professor,
    Anesthesiology & Pain Medicine

    jorgd@uw.edu

    Primary Location: UW Medical Center

    Clinical Interests: Anesthesia for Cardiothoracic Surgery, Intraoperative TEE.

    Personal Interests: Contemporary fiction, biking, hiking, jazz.

  • Ferreira, Renata, MD Assistant Professor, UWMC
    Regular Faculty
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    Renata G. Ferreira, MD

    Assistant Professor, Anesthesiology & Pain Medicine
    Staff Anesthesiologist, UWMC

    Primary Location: UW Medical Center

  • Hall, Michael, MD Acting Assistant Professor, UWMC
    Regular Faculty
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    Michael Hall, MD

    Acting Assistant Professor,
    Anesthesiology & Pain Medicine

    Primary Location: UW Medical Center

  • Jelacic, Srdjan, MD Acting Assistant Professor, UWMC
    Regular Faculty
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    Srdjan Jelacic, MD

    Acting Assistant Professor,
    Anesthesiology & Pain Medicine

    sjelacic@uw.edu

    Primary Location: UW Medical Center

  • Joffe, Denise C., MD Associate Professor, SCH
    Regular Faculty
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    Denise C. Joffe, MD

    Associate Professor,
    Anesthesiology & Pain Medicine

    denise.joffe@seattlechildrens.org

    Primary Location: Seattle Children's Hospital

    Clinical Interests: Adult and pediatric congenital heart disease.

    Research Interests: Use of dexmetetomidine in patients with single ventricle physiology and patients post-heart transplant.

  • Lombaard, Stefan A., MB ChB, FANZCA Clinical Assistant Professor, UWMC
    Regular Faculty
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    Stefan A. Lombaard, MB ChB, FANZCA

    Clinical Assistant Professor,
    Anesthesiology & Pain Medicine

    lombaard@uw.edu

    Primary Location: UW Medical Center

  • Mackensen, G. Burkhard, MD, PhD, FASE Professor, UWMC
    Regular Faculty
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    G. Burkhard Mackensen, MD, PhD, FASE

    Professor &
    Chief, Cardiothoracic Anesthesiology
    Anesthesiology & Pain Medicine
    UW Medicine Research & Education Endowed Professor in Anesthesiology
    Adjunct Professor of Medicine

    gbmac@uw.edu

    Primary Location: UW Medical Center

  • Natrajan, Krishna M., MB BS, FRCA Clinical Professor, UWMC
    Regular Faculty
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    Krishna M. Natrajan, MB BS, FRCA

    Clinical Professor, Cardiothoracic Anesthesiology
    Anesthesiology & Pain Medicine

    natrajan@uw.edu

    Primary Location: UW Medical Center

    Clinical Interest: Computers in medical education, trans-esophageal echo, automated anesthesia records.

    Research Interest: Adult congenital heart disease and trans-esophageal echo in those patients. Special expertise in lung transplant anesthesia, particularly avoiding bypass. Interest in management of pulmonary hypertension patients undergoing anesthesia.

    Personal Interest: Computing, sailing, photography, playing saxophone, cycling.

  • Oxorn, Donald C., MD, CM, FRCPC, FACC Professor, UWMC
    Regular Faculty
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    Oxorn, Donald C., MD, CM, FRCPC, FACC

    Professor, Anesthesiology & Pain Medicine

    oxorn@uw.edu

    Primary Location: UW Medical Center

    Professional Interest: Cardiothoracic anesthesiology, and more specifically in transesophageal echocardiography (TEE).

    Personal Interests: Jogging, golf, and family outings.

  • Togashi, Kei, MD Assistant Professor, UWMC
    Faculty Fellow
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    Kei Togashi, MD

    Assistant Professor, Anesthesiology & Pain Medicine

    ktogashi@uw.edu

    Primary Location: UW Medical Center

  • Von Homeyer, Peter, MD, FASE Assistant Professor, UWMC
    Regular Faculty
    photo of faculty member

    Peter Von Homeyer, MD, FASE

    Assistant Professor
    Anesthesiology & Pain Medicine

    peter2@u.washington.edu

    Primary Location: UW Medical Center

    Professional Interests: Cardiovascular physiology, coagulation, echocardiography, and adult congenital heart disease.

    Personal Interests: He loves to spend time outdoors with his family, cycling, mountaineering, and reading.

Application Process

Eligibility

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.

Application Documents

Applicants should submit the following documents:

  • Personal statement
  • Curriculum vitae
  • Three (3) letters of recommendation, including one letter from the applicant's current training program director or department chair
  • USMLE, COMLEX, or MCCQE transcript
  • Official medical or osteopathic school transcript
  • ITE scores
  • ECFMG certificate (if applicable)
  • Information about visa status (if applicable)

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.

Match Process

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. Candidates for 2015-2016 fellowship positions must be registered with SF Match before the deadline for rank list submission = June 2, 2014. 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.

NOTE: Our interview process for 2015-2016 fellowship positions is near complete, and we will not be offering any more interviews in this year's Adult Cardiothoracic Anesthesiology Fellowship Match cycle.

Please send application and supporting documentation to:

Kati Koszegvari
Fellowship Program Coordinator
Department of Anesthesiology & Pain Medicine
University of Washington, Box 356540
Health Sciences Bldg., BB-1440
1959 NE Pacific Street
Seattle, WA 98195-6540

phone: 206-221-6453 / fax: 206-543-2958
e-mail: actanes@uw.edu

Fellowship Director

For further information please contact:

photo of fellowship director

Jörg Dziersk MD FRCA
Clinical Associate Professor,
Anesthesiology & Pain Medicine

Health Sciences Building, AA-117E, Box 356540
1959 NE Pacific Street, Seattle, WA 98195
Phone: 206-598-4260
Email: jorgd@uw.edu

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