Curriculum

Goals and Objectives

The curriculum is based on a set of clear goals and objectives. The framework for these objectives originated from the Thoracic Surgery Directors Association (TSDA). They have been updated and modified based on the findings of our program evaluations. These evaluations incorporate input from our faculty, allied health care providers, prior trainees and our disciplines’ national societies (Society of Thoracic Surgeons, American Association of Thoracic Surgery, Thoracic Surgery Foundation for Research and Excellence). 

The instructional methods employed to achieve these objectives are dominated by clinical teaching direct observation. Faculty supervision is one-on-one in the first year with an increasing graded level of responsibility that is commensurate with the abilities of the trainee as they move towards completion of their training. Trainees are, of course, expected to perform those operations appropriate with their skill level but are also required to participate in the clinic at least once a week and work with the mid level providers to deliver efficient, timely, evidence-based and cost-effective postoperative care.

Rotations

The rotations are structured to allow trainees to gain exposure to the various clinical materials necessary to gain competence in all six core competencies. Rotation structure is based on educational needs as the primary determinant and is organized to fit the specific needs of the general thoracic track and the cardiothoracic track position. Service needs are achieved through the judicious use of mid level providers.

Additional instructional methods include bi-monthly small group teaching session and simulation. In addition, each institution has multidisciplinary conferences, case presentations, morbidity and mortality conferences.

The small group teaching session is a 1 year repeating curriculum and has 9 sessions assigned to General Thoracic Surgery, 100 to Cardiac Surgery, 2 sessions to Congenital Surgery, along with two mock oral exams built into the curriculum  Each session will be moderated by at least one faculty member.  Readings will be assigned and the focus of the two hour session will be on clinical decision making. Simulation sessions are built into the curriculum.

The multidisciplinary conferences and the morbidity and mortality conferences are self-evident. The weekly case presentations at MD Anderson allows trainees to choose a topic of their choice based on a recent clinical scenario. The evaluation and management of the patient are reviewed and expanded upon.  In addition, there is a monthly journal club that is somewhat unique in that its primary goal is to develop the tools necessary to access the literature and perform an evidence based analysis of clinical questions. 

Participation of two faculty librarians is a key feature of journal club. All incoming trainees spend four sessions reviewing the basics of designing and evidence based search, conducting the search using existing Internet-based search engines and assessing the quality of the literature. The remaining monthly meetings are then led by the trainees who pose their own clinical question, perform the literature search and then present the findings. The librarians participate at these meeting by presenting their approach to literature search and the surgical faculty assists in assessing the quality of the literature.

• Rotation Schedule (pdf)
• Small Group Teaching Sessions (pdf)

Resident Supervision

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.

Duty Hours

The program complies fully with all ACGME requirements regarding duty hours.

On-Call Activities

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.

Moonlighting

No moonlighting is allowed during the two-year residency at MD Anderson.

Evaluations

Resident, faculty and program evaluations are performed on a routine basis. Residents are evaluated after each rotation. Using online software, the evaluation process will eventually expand to include 360-degree evaluations. At this time residents are evaluated by the faculty, in and out patient midlevels, floor nurses and clinic patients.

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).

Resources

Fellows in the program will be provided with the following amenities:

• Books for the small group teaching sessions
• SESATS
• 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 in the second year