Adult Cardiothoracic Anesthesiology Fellowship
Message from the Program Director
The goal of the Adult Cardiothoracic Anesthesiology Fellowship at the University of Maryland is to train leaders in perioperative cardiovascular care. Our cardiac surgery program is currently the largest in the state of Maryland and offers a complex case mix that allows fellows to grow tremendously in their skills and confidence. Fellows in our program are exposed to the full gamut of contemporary cardiothoracic surgery procedures including: complex mitral valve repairs, major aortic surgery, coronary revascularizations (both robotic and on-pump), pulmonary embolectomies and thromboendarterectomies, transcatheter aortic valve replacements, heart and lung transplantations, and LVAD implantations.
Our center also has one of the largest adult ECMO programs in the country and many cardiac surgery patients are bridged to operations or recovery with ECMO. In addition to training outstanding clinicians, we are committed to our fellows’ professional growth and achieving the highest possible levels in all ACGME competencies including communication, teamwork, professionalism, and systems based practice. Our diverse faculty provides fellows with the opportunity to learn from a variety of past experiences and recent graduates have had great success in both academic medicine and private practice. Our division offers unique research opportunities with nationally recognized faculty in areas that include bleeding/coagulation, epidemiology, and outcomes research for cardiac surgery patients.
We welcome your interest in our training program and look forward to meeting you.
Michael A. Mazzeffi, MD, Associate Professor and Program Director
The Department of Anesthesiology at the University of Maryland School of Medicine has three ACGME-approved cardiothoracic anesthesia fellowship positions. Given our current surgical volume (over 1400 cases), CT anesthesia fellows receive ample opportunity to gain both personal and supervisory experience in managing the most interesting and challenging cases in anesthesia. Each cardiothoracic anesthesia fellow will participate in a total of six months in the cardiovascular operating rooms where he or she will both supervise and individually perform CT anesthesia cases (approximately 1/3 and 2/3). Fellows take approximately four weekday calls and one weekend of call coverage per month and have a guaranteed post call day free of clinical duties after every call period. In addition to the cardiac operating rooms fellows spend one month in the CSICU, have two months of elective time, two months of dedicated TEE time, and one month of thoracic anesthesia experience.
The CT anesthesia fellows are allotted ample time to pursue scholarly activities and the faculty are highly supportive of these endeavors. The fellows have a professional development/education fund that can be used to attend meetings or to purchase educational materials. The department pays for attendance of the SCA Perioperative TEE meeting in Atlanta, GA and fellows have the opportunity to attend other local and national meetings such as the Society for Cardiovascular Anesthesiologists Annual Meeting.
Fellows gain proficiency in and exposure to the perioperative evaluation and intraoperative management of cardiac surgical patients including:
- elective and emergency revascularization procedures
- complex valve repairs and replacements including a high volume of endocarditis cases
- pericardial procedures
- neoplastic procedures
- heart and lung transplants and combined procedures
- thoracic aortic surgery including ascending, transverse and descending aortic surgery with and without circulatory arrest
- thoracic endovascular aortic repair
- ventricular assist device implantation
- minimally invasive cardiac surgery including MitraClip, TAVR, and repair of congenital defects including: ASDs, anomalous pulmonary veins, etc.
- robotic CABGs
- pulmonary embolectomies and thromboendarterectomies
The cardiac fellow will gain experience with thoracic surgery including:
- thoracoscopic and open lung resections
- bronchopulmonary lavage
- bronchoscopy and related procedures
- radical pleurectomy for mesothelioma
- esophageal surgery and resection
- robotic lung resection
Our fellows gain competence in TEE training with two months of dedicated echo time in both the cardiology echo lab as well as operating rooms. They receive training in TEE, TTE, epiaortic and 3D technologies. We currently have five Phillips IE33 machines and Phillips Xcelera acrchiving, which allows for easy review of previous echoes outside of the operating room. All IE33 machines have 3D capability.
Our fellows perform well over the required number of TEE examinations each year for the advanced PTE certification. We offer and pay for our fellows to attend the echo week course offered by the Society of Cardiovascular Anesthesiologists in preparation for taking the Advanced PTE exam. The department has four echo technicians that are themselves skilled practitioners who support the technical aspects of the echo service, so that our fellows can concentrate on learning the techniques of echocardiography.
The didactic program includes a weekly lecture series, journal clubs, cardiac morbidity and mortality conferences, as well as echo reading sessions outside of the operating room. Didactics are provided on Thursday mornings between 6:15 and 7 am prior to our departmental grand rounds.
Each fellow will have an assigned mentor who is usually a member of the Cardiothoracic Anesthesiology faculty. The cardiac anesthesia fellow will have a defined project and will be expected to submit findings for presentation at a national meeting, typically the SCA annual meeting. Areas of active investigation in the division include coagulation and hemostasis, outcomes research in cardiac surgery, ECMO related bleeding, disseminated intravascular coagulation, intracardiac thrombosis, and infectious complications of transfusion. Members of the division have received recent grant funding from both industry and foundations including the SCA and APSF.
How to Apply
Applicants who have successfully completed their anesthesia residency in an ACGME accredited program with an interest in Cardiac Anesthesia are encouraged to apply. Applicants should register with the San Francisco Match at www.sfmatch.org. We start accepting applications in September and stop accepting applications at the end of March 31. Selected applicants will be invited for a formal interview. Interviews are held from early January until April.