Cardiothoracic Surgery Residency Program

Overview

The goal of the Cardiothoracic Residency Program at Massachusetts General Hospital is to prepare our trainees for independent practice in cardiothoracic surgery at the completion of the program, without the need for additional postgraduate fellowship training. Separate cardiac and thoracic tracks have been established within the program to allow for subspecialty emphasis in contemporary aspects of the field. Both conventional and 4+3 pathways are available.

Mass General has a long tradition of excellence in cardiothoracic surgery. Some highlights include:

• 11 graduates have served as presidents of the American Association for Thoracic Surgery (AATS) and seven have been presidents of the Society of Thoracic Surgeons (STS)
• Edward D. Churchill and W. Gerald Austen led the Department of Surgery for 60 years
• Over a 100 cardiothoracic surgeons have graduated from the program to date
• More than 20 surgeons have become either chiefs of their divisions or chiefs of surgery
• Two graduates have become CEOs of health care organizations
• One graduate has become a majority leader in the United States Senate

Cardiac and Thoracic as Separate Teaching Units

One of the many strengths of our program is the caliber of training offered in both general thoracic surgery and cardiac surgery. From the inception of sub-specialization within the Mass General Department of Surgery into divisions, cardiac surgery and thoracic surgery have stood as units with distinct faculty and development opportunities, and are both among the top units in their respective subspecialty.

While residents enter the training program defined by their track, all receive adequate exposure to the sister specialty and benefit from the caliber of that unit. Each division is supported by separate nursing units and occupies separate operating room space. At any given time, residents are assigned to one or the other service rather than both, affording them the ability to focus their attention in that area of specialty during the rotation.

Thoralf Sundt, III, MD, is the chief of Division of Cardiac Surgery and the associate program director of the Cardiothoracic Residency Program.

Yolonda Colson, MD, PhD is the chief of Division of Thoracic Surgery.

Residency Exposure

The cardiac surgery practice at Mass General is broad, providing residents with exposure to all aspects of the field including:

• Aortic surgery, the full spectrum from complex aortic root surgery—including valve sparing root repair to hybrid approaches—to complex disease in collaboration with vascular surgery. The Mass General Thoracic Aortic Center is the oldest such clinic in New England and is complemented by the Marfan Disease Clinic. The Mass General Heart Center is a regional referral center for treating acute aortic dissection
• Complex valve surgery, ranging from complex endocarditis to minimally invasive approaches to valve repair, including robotic
• Catheter-based approaches to treat of structural heart disease in close collaboration with our colleagues in interventional cardiology
• Contemporary approaches to treat coronary artery disease occluding complex arterial grafting
• Adult congenital heart disease—the large adult congenital heart disease practice at Mass General is supported by four dedicated cardiology staff and two surgeons
• Arrhythmia surgery
• Surgical treatment of end-stage disease—mechanical circulatory support, heart transplantation and lung transplantation

In thoracic surgery, residents experience the full gamut, including:

• Complex airway reconstruction including tracheal resection and reconstruction, carinal reconstruction and advanced endoscopic procedures
• The full spectrum of surgical approaches including both open and minimally invasive/robotic surgery to treat esophageal cancer
• Complex esophageal procedures including the use of alternative conduits and multiple revision surgery for benign disease
• Mediastinal surgery with a focus on minimally invasive techniques
• Complicated pulmonary surgery with a focus on parenchymal preserving procedures and bronchoplastic techniques
• Advanced robotic surgery as applied to all facets of thoracic surgery

Curriculum

The didactic curriculum is standardized for all residents and includes broad education in both cardiac and thoracic topics, as is required by the American Board of Thoracic Surgery. However, clinical rotations are tailored to the resident’s subspecialty interest within cardiac or thoracic surgery.

For residents on the cardiac track, a total of six months is dedictated to thoracic surgery with the remaining time focused on contemporary intensive care and temporary mechanical circulatory support. The latter is organized into three-month rotations—three months will be focused on catheter-based approaches to treat structural heart disease, and three months will be spent at Boston Children's Hospital and focused on congenital heart disease. The cardiac surgical training experience is set in a preceptorship format and involves collaboration with each of the cardiac surgery attendings.

Residents on the thoracic track will spend nine months dedicated to cardiac surgery with a focus on general thoracic, including three months in multispecialty and interdisciplinary care, and three to six months engaging in away rotations at institutions such as Mayo Clinic, Memorial Sloan-Kettering Hospital, Toronto General Hospital and more. All aspects of thoracic surgery are covered with a particular focus on robotic techniques. Residents actively participate in multidisciplinary care of thoracic surgery, including exposure to cutting-edge clinical trials in thoracic oncology.

Two months of vacation are permitted to each resident during training.

Diversity of Clinical Experience

Thoracic Surgery Case Mix

The following chart shows the Thoracic Surgery Case Mix for residents in the program. 5% of time will be dedicated to Open Esophagectomy. 41% of time will be dedicated to Lobectomy. 4% of time will be dedicated to Primary Thymectomy. 4% of time will be dedicated to MIE. 28% of time will be dedicated to Wedge. 3% of time will be dedicated to Primary Tracheal Resection. 7% of time will be dedicated to Primary Fundoplication.

Cardiac Surgery Case Mix

The following chart shows the Cardiac Surgery Case Mix for residents in the program. 5% of time will be dedicated to Open Esophagectomy. 34% of time will be dedicated to Isolated CABG. 7% of time will be dedicated to CABG and other. 6% of time will be dedicated to AVR + CABG. 10% of time will be dedicated to Isolated AVR. 8% of time will be dedicated to MV Repair. 1% of time will be dedicated to MV Repair and CAB. 2% of time will be dedicated to Isolated MVR. 2% of time will be dedicated to MVR + CAB. 2% of time will be dedicated to AVR + MVR. 5% of time will be dedicated to Other Valve. 1% of time will be dedicated to VSARR. 4% of time will be dedicated to Non Valve Sparing ARR. 7% of time will be dedicated to Other Aortic Procedure. 1% of time will be dedicated to Aortic Dissection Repair. 1% of time will be dedicated to Adult Congenital. 3% of time will be dedicated to Heart Transplant. 10% of time will be dedicated to Other CBP Cases. 1% of time will be dedicated to Other Non CBP Cases.

Data source: Cardiac/Thoracic Surgery STS Data Nurses

Cardiothoracic Education Schedule

Didactics

Didactic conferences are held weekly, with 45 minutes dedicated to topics in general thoracic surgery and 45 minutes dedicated to topics in general cardiac surgery.

Example topics include

• Adult congenital
• Echocardiography
• Esophageal perforation
• Paraesophageal hernia
• Principles of cardiopulmonary bypass
• Stage one lung cancer

Thoracic Track

Thoracic residents receive a rich clinical experience at Mass General. With an extraordinarily busy clinical service, the thoracic team provides a high volume of pulmonary, esophageal (both benign and malignant), mediastinal and tracheal procedures. The clinical and operative experience offers a referral base for complex procedures.

Residents are exposed to an array of clinical experience, and case-based learning is emphasized. We believe this is truly the best way for residents to learn. Didactic conferences are held weekly for residents to gain more exposure to thoracic surgery.

The Mass General Division of Thoracic Surgery includes attending physicians, advanced practice providers, data mangers and research nurses.

The goal of the program is to train thoracic residents in the full breadth of thoracic surgery including endoscopy, open and minimally invasive surgery, robotic surgery and airway surgery. In addition, there is an opportunity for thoracic track residents to experience elective opportunities at other institutions.

Cardiac Track

The Mass General Division of Cardiac Surgery clinical service is supported by advanced practice providers (physician assistants and nurse practitioners) in the preoperative clinic and postoperative step-down unit. The Heart Center intensive care unit at Mass General is an open, multidisciplinary format that includes both surgical and medical patients. It is staffed 24/7 by surgeons, anesthesiologists, cardiologists and other boarded intensivists as well as advanced practice staff. Residents are expected to play an active role in the care of cardiac surgical patients postoperatively. There are also data managers and research personnel to facilitate clinical research projects.

The goal of the cardiac track is to offer comprehensive training in cardiac surgery. Trainees on the cardiac track spend sufficient time dedicated to the general thoracic service, which is a major strength of the program. By getting experience in both clinical areas, trainees can exceed their case requirements in all areas, but more importantly become comfortable in and around the entire chest, anatomically and surgically. The Mass General and cardiac surgical service culture is one of collaboration and cooperation with associated services, such as cardiology and vascular surgery, which fosters trainees' growth more broadly in all areas.

Research

Faculty in cardiac surgery and thoracic surgery are active participants in research and publications, helping to advance science and health care.

How to Apply

We will accept applications from resident physicians who have/will have successfully completed a five-year Accreditation Council for Graduate Medical Education (ACGME)-accredited general surgery residency program in the United States or Canada. We do not directly accept or process applications for this residency. You must apply through the Electronic Residency Application Service (ERAS).

Our deadline for the July 1, 2023 residency start date is January 31, 2022. Please note we are accepting cardiac track and thoracic track applicants. Spring 2022 interview season will take place in March 2022.

Program Faculty

Each unit, thoracic and cardiac, is taught by individuals completely dedicated to the field.

Christopher Morse, MD

Program Director
Division of Thoracic Surgery

Thor M. Sundt, MD

Associate Program Director
Chief, Division of Cardiac Surgery

Jennifer Manu

Cardiothoracic Residency Program Coordinator

Our Residents

PGY8

Jordan Bloom, MD

Track: Cardiac

Asishana Osho, MD

Track: Cardiac

Michael Onwugbufor, MD

Track: Thoracic

PGY7

Paul Furlow, MD

Track: Thoracic

Jarrod Predina, MD

Track: Thoracic

Ali Rabi, MD

Track: Cardiac

Brittany Potz, MD

Track: Cardiac

PGY6

Andrea Axtell, MD

Track: Thoracic

Antonia Kreso, MD

Track: Cardiac

Adam Paine, MD

Track: Cardiac

Fernando Ramirez Del Val, MD

Track: Cardiac

4/3—PGY5

Travis Hull, MD

Track: Cardiac

Philicia Moonsamy, MD

Track: Thoracic

Christina Costantino, MD

Track: Thoracic

4/3—PGY4

Maggie Connolly, MD

Track: Cardiac

Jordan Secor, MD, MS

Track: Cardiac

Nikhil Panda, MD

Track: Thoracic

Meet our Alumni