The curriculum includes both clinical teaching (in the operating room, on the wards, and in the outpatient clinic) as well as classroom teaching (lectures, small group discussions, and simulation). In addition, we liberally allow trainees to engage in courses offered by industry, our professional societies, and other institutions when the goals and objectives of those courses supplement our curriculum.
The goals and objectives for our curriculum are based on the ACGME milestones supplemented by additional goals that are identified by the American Board of Thoracic Surgery. All of these objectives are based on the 6 core competencies required by the ACGME (Patient Care and Technical Skills, Medical Knowledge, Practice-Based Learning and Improvement, Interpersonal and Communication Skills, Professionalism, and System-Based Practice). Our rotation structure and classroom teaching as well as additional conferences and external courses are all organized in an effort to allow the trainees to achieve all the objectives outlined in these documents.
Clinical teachings (in the OR, the wards, and the clinic) focus mostly on patient care competencies as well as medical knowledge. They are also the best place to model and teach the other 4 competencies. The classroom teaching is focused mostly on medical knowledge and is delivered every Friday for 2 hours. These Friday morning sessions are organized into a 1 year repeating schedule of small group discussion sessions and at least 7 dedicated simulation sessions. The small group discussion sessions focus on a single topic and are run by a faculty member. They are comprised of a short lecture or discussion on medical knowledge followed by case presentations in an oral board format. The simulation sessions cover both cardiac and thoracic simulation and are well staffed.
Readings are based on the Thoracic Surgery Curriculum (TSC) which is in turn organized around the two curricular documents cited above. This e-learning platform includes readings (textbook and journal articles), case presentations, some videos and formative quiz questions for all trainees in the US and Canada. All this content is organized into roughly 88 topics covering all the objectives in the American Board of Thoracic Surgery. Our weekly teaching sessions’ reading assignments are based on the topics in the TSC and thus are available from any web browser.
Other teaching activities include more work based conferences like cath conferences, multidisciplinary tumor conferences and our monthly journal club that is organized and run with the help of our librarians. The cath and tumor boards are more working conferences and are not directly for teaching but are valuable resources. Additional short rotations in interventional pulmonary, radiation oncology, medical oncology, and interventional radiology are all available and offered based on the needs of individual trainees. Finally, we have organized away rotations at University of Toronto or Washington University to meet other specific needs.
Assessments include standard in training exams but also use direct observations (twice weekly) and monthly evaluations by allied health care workers (advanced practice nurses on our service, floor nurses, OR nurses, and faculty). In addition we have twice yearly mock oral examinations that are also used for assessments and monthly walk rounds for more socratic teaching and assessment.
Resident supervision is available 24/7. Residents are encouraged to call with any and all questions. Pager, cellular and home telephone numbers for each of the faculty will be provided.
The program complies fully with all ACGME requirements regarding duty hours.
All ACGME requirements regarding on-call duties are adopted. At-home call is monitored both to record duty hours and for signs of abuse that would lead to diminished quality of care. The majority of call is home-call.
No moonlighting is allowed during the two-year residency at MD Anderson.
As of July 1, 2014, Thoracic Surgery is part of the Next Accreditation System (NAS) by the ACGME. Along with case logs, duty hours, and the annual resident survey we will now have multiple direct observation of clinical activity to provide data for assessment of trainee’s milestones. Milestones are calculated and assigned for each trainee every six (6) months by the Clinical Competency Committee (CCC).
Personal review with the program director is performed biannually. Faculty is evaluated at the end of each rotation, but the evaluations are released at six-month intervals to protect the anonymity of the residents. Evaluations by rotating residents are included to further protect the identity of our residents. Program evaluations are also performed every four months (to match the rotating resident schedule).
Fellows in the program will be provided with the following amenities:
- Laptop computer provided during the two years
- iPad provided during the two years
- Statistical support within the department
- Database within the department
- Funded trip to the Doty course
- Funded trip for presentation at any national meetings
- Funded trip to a national meeting, STS, in the second year