Regional Teaching Programme. Cardiothoracic Surgery

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1 Regional Teaching Programme Cardiothoracic Surgery Mahmoud Loubani

2 Introduction The Yorkshire and the Humber Training Programme in Cardiothoracic Surgery is delivered by training centres in St James s Hospital and Leeds General Hospital in Leeds, Northern General Hospital in Sheffield and Castle Hill Hospital in Hull. Selection into the programme is through national selection supervised by the Speciality Advisory Committee on annual basis. The first Regional Teaching Programme in Cardiothoracic Surgery was designed and introduced in September 2013 to cover all the topics in the Intercollegiate Surgical Curriculum Programme. It had successfully incorporated simulation, Wet Labs and problem based learning. It was delivered over two years by trainers at all the participating hospitals in the programme over a half a day normally on a monthly basis. The programme incorporates the Yorkshire Cardiothoracic Meeting which is held as an all day event every six months. This meeting has been ongoing for 4 years and is normally composed of teaching sessions in the morning with a possible guest speaker at lunchtime followed in the afternoon by presentations by trainees of research carried out in the region. There has been excellent feedback regarding the programme and it was commended by a visiting team of Health Education Yorkshire and the Humber to the training programme. This current programme for the next two and a half years builds on the success of the last two years incorporating all the successful elements. It also includes the innovative Cadaveric Simulation session which we have successfully bid for and will be supported by School of Surgery. The Yorkshire Thoracic Society Meeting will also be included. 2

3 The trainees will be released to attend the teaching and will be expected to attend at least 70% of the sessions over the two years. We also will be monitoring the attendance of trainees at their relevant Courses delivered by the SCTS Education Tutors. Castle Hill Hospital St James s Hospital Northern General Hospital 3

4 The Programme Date Topic Venue Time Format Oct 2015 Nov 2015 Dec 2015 Jan Feb March April May Intra-aortic Balloon Pumps CHH 2 hrs Principals and indication 2 hrs Simulation of insertion and management Cardiothoracic Emergencies CHH Morning Interactive Multi-professional Lectures Afternoon Simulation scenarios Cadaveric Simulation Leeds Morning Operative Simulation University Afternoon Operative Simulation Cardiopulmonary Bypass Investigation and surgical management of oesophageal disease and cancer 2 hrs CPB Simulation Scenarios 2 hrs Oesophageal Lab Lung Cancer: Staging and operability, Evidence base for adjuvant treatment The evidence for CABG, Conduit choice, Interpretation of angiograms 2 hrs Lung MDT simulation scenarios 2 hrs Wet Lab Coronary anastomosis Techniques June July Aug Surgery for pneumothorax, pleural sepsis, pleural effusion, empyema, emphysema/copd Aortic valve disease: Indications for surgery; Choice of prosthesis St James s 2 hrs Interactive Multi-professional Lectures 2 hrs Case Discussions 2 hrs Wet Lab AVR Techniques Sept ASD, VSD, PDA, Aortic Coarctation and Interruption LGI 2 hrs Interactive Multi-professional Lectures 2 hrs Interactive Multi-professional Lectures Oct 4

5 Nov Dec Jan Feb March April May June July Aug Sept Oct Nov Dec TTE, TOE, Stress Echo, Cardiac MRI exercise tests, radionuclide and PET scans. 2 hrs Echocardiography simulation Surgery for Heart Failure; Post Infarct VSD / Mitral Regurgitation 2 hrs Mitral Valve Surgery Wetlab Lung Transplantation/ Heart CHH 4 hrs Interactive Multi-professional Lectures Transplantation Action potential; Adrenergic receptors; Mechanisms of action of inotropes, receptor blockers and vasodilators; Anti-arrhythmics; Pharmacology of anti- and procoagulants Aortic Surgery and Aortic Root Enlargement 2 hrs ITU management Scenarios LGI 2 hrs Interactive Multi-professional Lectures 2 hrs Wet Lab Aortic Root Enlargement Techniques Pulmonary and pleural physiology. Interpretation of respiratory function tests, Flow-volume loops Management of the Brain During Cardiac Surgery; Autoregulation; CO2 Management; Carotid Artery Disease Statistics. Risk stratification. CUSUM, VLAD plots, Evidence Based Medicine, How to do research and publish St James s 2 hrs Interactive Multi-professional Lectures 2 hrs PFTs Lab 2 hrs TEVAR Simulation 2 hrs Interactive Multi-professional Lectures Angiography, Cardiac catheter data, exercise tests, Measurement of cardiac output. Measurement of shunts 2 hrs Cath Lab 5

6 Jan Feb March April May Mediastinal masses; Benign lung and oesophageal tumours and diseases Tetralogy of Fallot; Transposition of the Great Arteries, Single Ventricle; Hypoplastic Left Heart Syndrome 2 hrs VATS procdures LGI 2 hrs Interactive Multi-professional Lectures 2 hrs Interactive Multi-professional Lectures Myocardial preservation Medical and Surgical Treatment of Atrial and Ventricular Dysrhythmias Mitral valve disease: Indications for surgery; Valve repair. Tricuspid valve Surgery 2 hrs Electrophysiology Lab 2 hrs Tricuspid Valve Wet Lab June Yorkshire Cardiothoracic Meeting LGI All day Teaching and presentations 6

7 Portfolio of SCTS / SAC Curriculum-aligned Cardiothoracic Surgery Training Courses Narain Moorjani, SCTS Cardiac Surgery Tutor Sridhar Rathinam, SCTS Thoracic Surgery Tutor Key principle is to deliver a programme of continuing learning for Cardiothoracic Surgery Specialty Trainees Portfolio of 12 core courses (2 per year over the ST3-8 years) will be mapped out to mirror the ISCP Cardiothoracic Surgery curriculum, delivered through small group teaching, wetlab simulation and live operating simulation, as well as web-based progress monitoring Courses have been endorsed by SCTS Education, Cardiothoracic Surgery Specialty Advisory Committee (SAC) and Training Programme Directors (TPDs) Attendance at these courses by the trainees will be strongly encouraged and monitored through the ARCP process Course fees, accommodation and certain travel costs will be funded through an educational partnership with Ethicon, Sorin and other industry partners. ST2 Essential Skills in Cardiothoracic Surgery ST3 Introduction to Specialty Training in Cardiothoracic Surgery Course Cardiothoracic Intensive Care and Surgical Access Course ST4 Core Cardiac Surgery Course Core Thoracic Surgery Course ST5 Intermediate Viva Course Non-Technical Skills for Surgeons (NOTSS) ST6 Cardiac Surgery Sub-specialty Course Thoracic Surgery Sub-specialty Course ST7 Revision / Viva Course for the FRCS(C-Th) Birmingham or London Core Review Course ST8 Cardiac Surgery Pre-Consultant Course Thoracic Surgery Pre-Consultant Course Professional Development Course 7