Adult Cardiothoracic Anesthesia Fellowship

Overview

In 2007, Massachusetts General Hospital’s Cardiothoracic Anesthesia Fellowship in the Department of Anesthesia, Critical Care and Pain Medicine (DACCPM) was one of the first programs in the country to achieve Accreditation Council for Graduate Medical Education (ACGME) certification. It remains the beacon for training in cardiothoracic anesthesia education, patient management, and research.

Our one-year program is accredited for six fellowship positions in cardiothoracic anesthesiology. Mass General’s cardiac anesthesia division considers the training of fellows as one of our primary missions, along with patient care and safety. We recognize that a strong combination of didactic education and clinical training, with progressive responsibility and independence, leads to strong clinicians who champion safe and whole-health patient care.

Requirements

The Cardiothoracic Anesthesia Fellowship is a 12-month program begun after successful completion of an ACGME-accredited anesthesiology residency program. 

The DACCPM at Mass General follows all minimum selection criteria as delineated in the Institutional Policy on Selection (PDF). As a prerequisite for entry, all applicants for the fellowship must be a graduate of one of the following:

• American Osteopathic Association Commission on Osteopathic College Accreditation (AOACOCA)
• Liaison Committee on Medical Education (LCME)-accredited medical school
• Medical schools outside of the U.S. or Canada must hold:
  • A currently valid Education Commission for Foreign Medical Graduates (ECFMG) certificate
  • A full and unrestricted license to practice medicine in the U.S.
• USMLE completion requirement for clinical trainees

Applicants must have also completed an anesthesia residency program accredited by one of the following:

• Accreditation Council for Graduate Medical Education (ACGME)
• Royal College of Physicians and Surgeons of Canada (RCPSC) or CFPC-accredited residency program located in Canada

Visa Information

All who are not United States citizens or legal permanent residents must have the appropriate visa in order to receive a Mass General appointment.

For questions regarding a J-1 visa, please call the Mass General Registrar/Credentialing Office at 617-726-5316. Questions on all other types of visas should be directed to the Mass General Brigham International Office at 617-726-9211.

Curriculum

The Cardiothoracic Anesthesiology Fellowship at Mass General prides itself on the education of fellows both in the operating room and lecture room setting. This includes protected time for cardiac lectures and echocardiogram readings by leaders in the specialty.

The didactic curriculum includes:

• Anesthesia Grand Rounds
• Boston Area Combined Echo Conference
• Cardiac Anesthesia Lecture Series
• Cardiac Anesthesia Journal Club
• Echo Boards review
• Interdisciplinary Cardiac Morbidity and Mortality (M&M) Conference
• Thoracic Aortic Rounds
• Transesophageal echocardiography (TEE) lecture series

Clinical Experience

The cardiac anesthesia clinical experience at Mass General is unparalleled given the surgical volume and complexity. ACTA fellows cover the most complex cases every day and enjoy tremendous autonomy in patient management and intraoperative echocardiography.

Fellows perform a variety of challenging procedures, including:

• Coronary artery bypass grafting
• Excision of intra-cardiac masses
• Extracorporeal membrane oxygenation
• Heart and lung transplants
• Repair of congenital heart defects in adults and children
• Thoracic aorta repairs
• Transcatheter procedures on the mitral and aortic valves
• Valve repair and replacement
• Ventricular-assisted device placement

Thoracic Anesthesia

Over the course of two weeks, fellows will manage the operative care of patients undergoing non-cardiac thoracic surgery such as lung resection and airway surgery. Fellows work under the guidance of an attending anesthesiologist who is trained in adult thoracic anesthesia.

Echocardiography (Echo)

Echocardiography is an integral part of the ACTA fellowship experience and consists of approximately eight weeks of dedicated intra-operative transesophageal echocardiography training. Fellows perform echocardiography exams for potentially any of the above surgical cases, guiding surgical management of these patients. Echo is also being used more frequently for non-cardiac cases, including rescue Echos, eCPR, organ transplantation, vascular surgery, neurologic surgery, and trauma. Our fellows easily surpass the requirements for examinations (300 interpreted and 150 performed) as required by the National Board of Echocardiography for advanced perioperative certification.

Electrophysiology and Cardiac Catheterization Lab

Our team provides anesthesia coverage in the cardiac catheterization lab where fellows participate in the anesthetic management of percutaneous closure of atrial and ventricular defects, high risk coronary interventions, percutaneous mechanical support, and percutaneous removal of intravenous thrombus. The electrophysiology suite places nearly 1,000 pacemakers and defibrillators annually in addition to performing pulmonary vein isolation, ablation of ventricular tachycardia, and percutaneous placement of devices to exclude the atrial appendage.

Heart Center Intensive Care Unit (HCICU)

Fellows rotate through the HCICU for a one-month experience in the perioperative care of cardiac surgical patients. The Blake 8 HCICU is an 18-bed unit devoted to the pre-and post-operative care of these patients. The patient population includes individuals who have undergone any of the above surgeries and those on mechanical support devices. This rotation provides a full immersion experience into the cardiovascular pathophysiology of patients with complex cardiac ailments.

Electives

The ACGME encourages fellows to pursue additional expertise in other disciplines of heart surgery. We have established electives in:

• Blood bank
• Electrophysiology
• Extracorporeal technology
• Interventional cardiology
• Pediatric cardiac surgery at Boston Children's Hospital
• Perfusion
• Research
• Transthoracic echocardiography

Leadership Opportunities

In addition to providing masterclass education, we pride ourselves in helping our fellows transition to becoming leaders in the field. Fellows develop their leadership skills by taking on departmental QI projects, wellness initiatives, medical student, and resident education under the mentorship of the departmental faculty who in turn are leaders in their respective fields.

Research Avenues

The division is involved in cutting-edge research in cardiothoracic perioperative research. Our faculty are NIH-funded and conduct prolific research to advance the field. Key areas of research include the prevention of postoperative delirium, infection control, extracorporeal membrane oxygenation, perioperative sepsis, and stress echocardiography. The research projects are supported by dedicated statisticians, programmers, and data science experts. Fellows are highly encouraged to participate in these research endeavors where they are closely mentored to bring important research work to fruition as publications and presentations in leading society meetings.

How to Apply

Selection for the fellowship is highly competitive. Only completed applications are reviewed.

Please submit a copy of your medical school transcript to mghanesfellowapps@partners.org.

SF Match

The Mass General Cardiothoracic Anesthesia Fellowship Program is participating in the SF Match. Registration for the 2024-2025 academic year opens on November 7, 2022. The target date for completed applications to the SF Match is March 1, 2023.

Complete these items in the SF Match application database:

• Complete the SF Match application
• Upload three letters of recommendation, one from your program director or chief of service
• Add all test score results into the SF Match application

Application Deadline

The program deadline for completed applications is March 1, 2023. Interviews will be conducted from March to the end of May 2023. Match Day is June 15, 2023.