My three goals for my General Surgery residency are, first, to reach the highest standards of clinical proficiency in surgery. Second, I plan to join ongoing research to develop my skills in research methodology, medical writing, and critical appraisal. And third, I hope to acquire the leadership skills essential to becoming a great surgeon.
Heart Center | Pediatric Cardiac Surgery International Fellowship
After residency I plan to pursue fellowship training in Surgical Critical Care. We will be providing them to those who ask them first. Please post your questions here. Step 1 tests the important concepts of basic sciences basic to the practice of medicine. It also places special emphasis on principles and mechanisms underlying health, disease, and modes of therapy.
Step 1 ensures mastery of the sciences that provide a foundation for the safe and competent practice of medicine. It also tests the scientific principles required for maintenance of competence through lifelong learning. And then you have three years of dedicated anesthesia training. Then the cardiac fellowship is one additional year where you deal with high-intensity programs. You basically do multiple cases a day, while getting good at providing anesthesia for patients in terms of anesthetic management.
Then you try to become sufficient and be certified in doing cardiography. Maninder describes matching to not as terribly competitive in general. Chronic pain and cardiac are the most competitive. Pediatric is getting more competitive as well. Understand the intensity to see if this is the right field for you. If you have the intensity and the dedication and the desire, Maninder says you will succeed no matter what. Maninder sees no roadblocks for osteopaths who are looking into taking this path.
He has met multiple cardiac anesthesiologists who are DOs, and he finds them phenomenal and even better. He has trained with DOs, and he has trained DOs. Sometimes, they do work with primary care providers depending on the situation. Other specialties he works the closest with include medicine, surgery, all kinds of surgical subspecialties, pathology, psychiatry, internal medicine, endoscopy, GI bleeds, and just about every subspecialty there is.
But if you wanted to go into the industry, Maninder admits all the big stuff is coming out. And a lot of things coming out related to assit devices for patients with heart failure. That said, the industry is booming as more and more procedures are getting available and people are getting well. He wished he knew about the intensity of it at times. And you only appreciate it when you have a nice easy day or case. So at times, he thinks the intensity gets a little bit too much.
But even if he had known that, he still would have gone down the same path. You do the best you can. Just be a good leader and be a good communicator.
Make sure you leave no stone unturned. Be loud and clear. This was the time when he was still considering between pediatric and cardiac anesthesiology. And so it was the last thing that made him switch over to cardiac anesthesiology. On the flip side, what he likes the least is not having enough cases.
Not enough crazy cases. But at this point, he says it would be nice to do more craziness.
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It is the duty of the cardiothoracic surgery resident to have an understanding of the patient's pathology and the plan of treatment. This includes collation and evaluation of all preoperative testing with the assistance of the physician's assistant staff and general surgical house staff. It is understood that the attending surgeon is available to review the plan of therapy with the resident at any time.
The program requires each resident to maintain a concurrent log of operative and clinic activities. The web-based database is used for operative logging and each resident is asked to submit a case list at the completion of each quarter of training. Cases lists are reviewed with the program director quarterly and the resident is made aware of any deficiencies in operative experience so that they may be corrected in a timely fashion. Additionally, the cardiothoracic surgery office employs a full time data collection nurse whose job it is to maintain records for New York State and for hospital-wide quality assurance.
These databases provide a backup source of information for residents since each case is logged with surgeon and assistant as well as patient identification, operative procedure, outcome and perioperative morbidity. The volume of cardiothoracic procedures has increased over the last several years, particularly in the area of general thoracic surgery. This has intensified the trainees' exposure to thoracoscopic pulmonary and mediastinal procedures, tracheal procedures, chest wall procedures, airway and upper GI endoscopy and multimodality thoracic oncologic approaches. Catheter based interventions are increasing relative to surgical referrals for ischemic cardiac disease, such as thoracic endografting for aortic pathology TEVAR and percutaneous valve placement, which are currently being performed at our facilities.
This has resulted in an increase in the number of referrals for patients with cardiac disease. The Zucker School of Medicine conforms rigorously to the working hour and resident supervision requirements of New York State. This means that there is adherence to both the Bell Commission Regulations and ACGME requirements, including a maximum average hour workweek and provision for adequate rest after extended hours.
The average workday begins at 6am and concludes between 6 and 7pm.
Henry J. Tannous, MD — Academic Profile | Renaissance School of Medicine at Stony Brook University
Weekends days are abbreviated since operative procedures are not booked electively on weekends. One day of rest is scheduled for each seven-day period. Cardiothoracic surgery residents are allowed to take calls from home and return to the hospital only for emergencies and for operative procedures. They are required to leave the hospital the next day if the work hour limits are exceeded. Each faculty member evaluates each resident quarterly on a formalized evaluation document.
During the quarterly meeting with the program director, the resident is allowed to review his evaluations and comments.
Residents are encouraged to be forthright in their evaluations of faculty and rotations. There is a formal policy for redress if the resident feels his comments have resulted in prejudicial treatment by the faculty. We offer patients a full range of surgical options, including minimally invasive and beating heart techniques for patient requiting valve or coronary artery surgery, as well as advanced minimally invasive techniques for surgery of the aorta, lung, mediastinum and esophagus.
These techniques have become the standard of care here because they fit in so well with our philosophy of achieving optimal surgical repairs while preserving patients' quality of life. Our surgeons have access to the latest technologies and facilities. In fact, we are now offering transcatheter aortic valve replacement TAVR using a percutaneous device for patients with severe aortic stenosis who are at high or extreme risk for surgical aortic valve replacement.
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To ensure the best outcomes for TAVR patients, the health system has opened hybrid operating rooms that combine the functionality of a traditional catheterization lab with a cardiac operating room. This technology allows interventionalists and surgeons to collaborate on the most complex cardiac cases, and exemplifies our commitment to the latest advances in cardiac care.
The Traditional 2 Year Thoracic Residency
In addition to offering groundbreaking technology, our surgical program provides patients with the advantage of an onsite multi-disciplinary team of cardiologists, electrophysiologists, interventional radiologists, vascular surgeons, dietitians, physical therapists and social workers. This team often expands to include immediate care from on-site physicians from every medical specialty required. Our large volume, consisting of many complex and complicated procedures in all areas, assures that patients are receiving the best care possible from some of the most experienced and expertly skilled surgeons in the world.
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