The Cardiac Surgery Fellowship Program at The Heart Center at Boston Children’s Hospital is a one to two-year training program designed for fellows to receive additional training in congenital heart surgery. The Department of Cardiac Surgery at Boston Children’s Hospital has been training fellows under this program for periods of six to 24 months since 1972. The duration of the fellowship has been tailored to the needs of the trainees and of their home institutions. The pre-requisite criteria for selection are individuals who have completed their training in Cardio-Thoracic Surgery and who wish to subspecialize in pediatric cardiac surgery. Typically, they will have had some exposure to surgery for congenital heart defects, but this has usually been limited.

The goals of the program are to provide an introduction to all forms of congenital heart defects and also to provide a graded progression of responsibility in the intraoperative and postoperative management of patients with congenital heart defects. The details of an individual trainee’s educational program depend both on the level of experience and expertise of the trainee and on the particular needs and resources of his/her home institution. In the earlier years of the program, trainees spent as short a period of time as six months, but with the expanded knowledge base for congenital heart disease and the increasing variety and complexity of the surgical management of congenital heart disease, the minimum length of the training program has been increased to one year.

Program Requirements:

USMLE Step 1 and Step 2; CS and CK and a valid ECFMG certificate is required to be considered for a position.

Application requirements:

To be considered for a fellowship position starting in July, an application must be requested and completed by no later than the preceding October 31^st. In addition to the application, we require:

1. Three (3) letters of recommendation
2. Personal statement outlining goals for training and future plans

All of these documents and correspondence should be addressed to:

Fellowship Program Director
Department of Cardiac Surgery
Boston Children’s Hospital
300 Longwood Avenue, BCH 3084
Boston, MA 02115

Contacts:
Program Director:  Francis Fynn-Thompson, MD
Alternate Program Contact:  John E. Mayer, Jr., MD

Jaye Espy
+1-617-355-1914
Jaye.Espy@cardio.chboston.org

Fellowship Program Detail

Twelve Month Program (Introduction to Pediatric Heart Surgery)
This is a twelve month fellowship designed for surgeons who anticipate that they will be primarily responsible for the less complex forms of congenital heart disease in their home institution and will have more senior mentors available for assistance with the more complex forms of congenital heart disease.  Trainees will receive instruction in the following areas:

Nomenclature and Pathology for Congenital Cardiac Disease
Trainees will receive weekly instruction for two hours in the study of congenital cardiac pathology.  This course is supervised by Dr. Steve Sanders, who has specialized in congenital cardiac morphology, and has access to the over three thousand specimens found in the Cardiac Pathology Registry at Children’s Hospital Boston.  The trainees have the opportunity to study specimens from the cardiac pathology registry, which covers the entire spectrum of congenital heart disease.  The program is set to cover all the major classifications of defects over the six month period.

Peri-operative Management of Congenital Cardiac Disease
Trainees spend one night in five “on call” in the thirty bed Cardiac Intensive Care Unit.  They are also out of the operating room for approximately one full day in five.  During this time they will receive instruction from the Cardiac Intensive Care specialist regarding indications and timing of surgery for cardiac disease as well as peri-operative stabilization and management of patients.  Further training and decision making and management occurs at the cardiac surgical combined conference, which is held Tuesday mornings from 7:00am to 8:30am. In addition, trainees will spend one week every 2 months rotating in the ICU to learn more in depth about the postoperative management of children and adults with congenital heart disease.

Didactic Teaching in Surgery for Congenital Heart Disease
Trainees attend one-hour teaching sessions on Wednesday mornings from 7:30am to 8:30a conducted by the attending staff in the Department of Cardiac Surgery.  In addition, trainees participate in the didactic teaching sessions from 7am-8am on Saturday mornings, covering the full range of topics in congenital heart surgery over a twelve month time period.

Graduated Operating Room Experience
In the twelve-month fellowship-training program, the trainees have the opportunity to undertake a number of surgical procedures as the operating surgeon while directly supervised by an attending staff surgeon.  The operative experience is gained in a progressive fashion starting with procedures such as coarctation repair, modified Blalock shunt, ductus ligation, and division of vascular ring.  Open heart procedures on cardiopulmonary bypass are also performed including atrial septal defects (secundum and primum), ventricular septal defects, and bi-directional Glenn.

Advanced Program
This program is aimed at individuals who expect to primarily practice pediatric cardiac surgery and will be required to deal with all forms of congenital heart disease in their home institution and generally is offered as a second year after the introductory program. Therefore, they require an extended period of training and increased surgical responsibility.  In addition to the Pathology Conferences, Peri-operative Management experience, and didactic teaching sessions available for the twelve-month fellowship, fellows in the advanced (second twelve month) program will continue to have more advanced, graduated operating room experience.  The trainee will have the opportunity to undertake as the operating surgeon, assisted by an attending surgeon, procedures that are much more complex and involve neonates, transplantation, valve repair, and ventricular assist device insertion.  The goal will be to provide the trainees with sufficient experience to perform most congenital heart procedures as an independent surgeon, particularly those in the neonatal age group.  Examples of the type of procedures they will be expected to perform include an arterial switch procedure, repair of truncus arteriosus, repair of interrupted aortic arch, Norwood procedure for hypoplastic left heart syndrome, and Fontan operation.

Resources

The Department of Cardiac Surgery includes seven full-time, board certified cardiac surgeons, all of whom have extensive experience in congenital cardiac surgery including congenital heart surgery procedures in adults.  Faculty members include Drs. Pedro J. del Nido, John E. Mayer, Jr., Frank Pigula, Francis Fynn-Thompson, Sitaram Emani, AK Kaza and Christopher Baird.  Additional instruction will be provided by Dr. Steven Sanders, from the Department of Cardiology and Cardiac Pathology, and faculty members of the Cardiac Intensive Care Unit under the direction of Dr. Thomas Kulik.

Evaluation

At the end of either the introductory (twelve month) or the advanced (second twelve months) fellowship program, the trainees receive an evaluation from each of the staff surgeons in the Department.  Their evaluations are discussed with the trainee.  For the individuals that spend a twelve month period, an interim review is done after the first six months, and for those in the advanced program, an additional review is carried out at 6 months through the advanced year.