A Study Guide for Surgical Residents beginning in 1999
Welcome. The Thoracic Surgery Directors Association would like to congratulate you on your successful match into a Thoracic Surgery Residency program. We are pleased that you have chosen to continue your studies in thoracic surgery and are enthusiastic about the beginning of your residency. the field of Thoracic Surgery continues to grow at unparalleled rates, making the study of this discipline even more challenging and gratifying.
What can you do to best prepare for your residency? This is a question asked by residents after being matched into a thoracic surgery residency, and is answered in a variety of ways. This suggested Prerequisite Curriculum has been developed to assist you with your preparation for residency in a more standardized way.
What is the Prerequisite Curriculum?
The TSDA has developed this optional curriculum and study guide for general surgery residents matched into approved Thoracic Surgery Residency Programs. This will compliment the curriculum associated with the Thoracic Surgery Residency itself. this prerequisite curriculum represents an organized approach to those didactic areas of Thoracic Surgery that can be studied during the 12 months prior to the initiation of Thoracic Surgery Residency. The development of a solid fund of knowledge in these specified areas will facilitate a smooth transition into the Thoracic Surgery Residency and provide a base upon which to build the technical and cliniacl skills of Thoracic Surgery.
How should I use the Prerequisite Curriculum?
Within the prerequisite curriculum one finds 11 clinical sections and 1 non-clinical section. These sections span subjects inlcuding anatomy, phisology and pathophysiology. They also include an emphasis on diagnostic testing, perioperative management and critical care. These sections constitute a 'prerequisite textbook' and form the basis of the sudy guide.
The 12 sections of the curriculum are listed below. The subsections, suggested references and other information can be accessed through this web page by selecting the appropriate highlighted text and icons. This Web site is a work in progess and will continually be enhanced and expanded for your educational benefit. Case-based information and full text/video will hopefully be available with future releases of this curriculum.
Section Headings
Section I: Normal Thoracic Anatomy
Section II: Normal Thoracic Physiology
Section III: Adult Cardiac Diagnostic Studies
Section IV: Pediatric Cardiology Diagnosis
Section V: Thoracic Imaging Studies
Section VI: Thoracic Functional Studies
Section VII: Thoracic Anesthesia
Section IX: Fundamentals of Thoracic Endoscopy
Section X: Surgical Instrumentation & Basic Techniques
Section XI: Cardiopulmonary Bypass Techniques
Section XII: Research Methodology & Professional Information
Ideally each of these 12 sections would be studied over the ensuing months and completed proir to the initiation of Thoracic Surgery Residency. These subject headings correspond to chapter headings in many standard textbooks. However, it is recognized that the timeconstraints of your general surgery residency have priority for you now. This study guide is offered as an aid to direct your preparation for thoracic surgery residency should you have the opportunity to take advantage of it. Completion of this guide is not required. While it will add to your knowledge base, it will not supplant the study required to prepare for the thoracic surgery portion of your Surgery Board examinations.
How can I organize the study of the sections?
In order to facilitate the study of the 12 sections, several topics have been listed for each subject heading. These have been deemed the greatest importance and therefore worthy of the most study time. This is not intended to be an "all inclusive list" but merely a study guide.
Section I: Normal Thoracic Anatomy
1. Chest Wall
2. Mediastinum
3. Tracheobronchial Tree
4. Esophagus
5. Heart & Pericardium
6. Great Vessels
Section II: Normal Thoracic Physiology
1. Adult Cardiac
2. Pediatric Cardiac
3. Esophageal
4. Pulmonary
5. Chest Wall and Diaphragm
Section III: Adult Cardiac Diagnostic Studies
1. Electrocardiography
2. Echocardiography
3. Diagnostic Catheterization
4. Diagnostic Angiography
5. Physiologic Testing
6. Positron Emission Tomography
Section IV: Pediatric Cardiology Diagnosis
1. Electrocardiography
2. Echocardiography
3. Diagnostic Catheterization
4. Diagnostic Angiography
5. Physiologic Testing
Section V: Thoracic Imaging Studies
1. Chest X-rays
2. Computed Tomography (CT)
3. Magnetic Resonance Imaging (MRI)
4. Cardiac Nuclear Studies
5. Pulmonary Nuclear Studies
6. Positron Emission Tomography (PET)
7. Barium Contrast Imaging
Section VI: Thoracic Functional Studies
1. Pulmonary Spirometry
2. Pulmonary Diffusion
3. Esophageal Manometry
4. Esophageal Reflux Tests
Section VII: Thoracic Anesthesia
1. Monitoring & Anesthesia Techniques
2. Single Lung Isolation Strategies
3. Pediatric Cardiac Anesthesia
4. Perioperative Analgesia & Sedation
5. Intraoperative Transesophageal Echocardiography
Section VIII: Thoracic Critical Care
1. Perioperative Arrhythmias
2. Perioperative Low Cardiac Output
3. Perioperative Transfusion Therapy
4. Perioperative Nutrition
5. Ventilator Management
6. Perioperative Pharmacology
Section IX: Fundamentals of Thoracic Endoscopy
1. Laryngoscopy & Intubation
2. Tracheobronchoscopy
3. Esophagoscopy
4. Thoracoscopy
Section X: Surgical Instrumentation & Basic Techniques
1. Patient Positioning
2. Thoracic Incisions
3. Thoracic Drainage
4. Pacers & Defibrillators
5. Thoracic Reoperations
6. Neonatal Surgical Emergencies
Section XI: Cardiopulmonary Bypass Techniques
1.Anticoagulation & Hemostasis
2. Pumps & Oxygenators
3. Myocardial Protection
4. Neurologic Protection
5. Pediatrics & Circulatory Arrest
6. IABP & LVAD Support Devices
Section XII: Research Methodology & Professional Information
1. Critical Literature Review Techniques
2. Literature Search Techniques
3. National Societies & Resources
4. National Meetings & Courses
5. Resident Activities
6. Residency & Board Requirements
7. Internet/Computer Fundamentals
Where can I find the information to complete the prerequisite curriculum study?
A very limited list of the most widely available and most commonly quoted textbooks, journals and Internet sites appear below. As a starting point, it should provide adequate amounts of basic information on the prerequisite curriculum.
Textbooks of Thoracic Surgery
1. Cardiac Surgery (Kirkland & Barratt-Boyes 1993-Churchill, Livingstone-New York, NY)
2. Glenn's Thoracic & Cardiovascular Surgery ( Baue, Geha, Hammond, Laks & Neunheim 1996-Appleton, Lange-Stamford, CT)
3. Surgery of the Chest (Sabiston & Spencer 1994-Saunders-Philadelphia, PA)
4. Esophageal Surgery (Pearson, Deslauriers, Ginsberg, Hiebert, McKneally, Urschel 1995-Churchill, Livingstone-New York, NY)
5. Thoracic Surgery (Pearson, Deslauriers, Ginsberg, Hiebert, McKneally, Urschel 1995-Churchill, Livingstone-New York, NY)
Textbooks of Adult & Pediatric Cardiology
1. Heart Disease in Infants, Children & Adolescents (Moss & Adams 1995-Williams & Wilkins-Baltimore, MD)
2. Heart Disease (Braunwald 1993-Saunders-Philadelphia, PA)
3. Transesophageal Echocardiography (Oka & Goldiner 1992-Lippincott, Raven-Philadelphia, PA)
Textbooks of Thoracic Anesthesia
1. Anesthesia for Thoracic Surgery (Berrumhoff 1992-Saunders-Philadelphia, PA)
2. Anesthesia for Cardiac Surgery (Dinardo 1998-Appleton, Lange-Stamford, CT)
3. Cardiovascular Anesthesia (Kaplan 1993-Saunders- Philadelphia, PA)
Textbooks of Cardiopulmonary Bypass
1. Cardiopulmonary Bypass: Principles & Techniques of Extracorporeal Circulation (Mora 1995-Springer Verlag-New York, NY)
Textbooks of Critical Care
1. Pharmacology & Physiology in Anesthetic Practice (Stoelting 1993-Saunders-Philadelphia, PA)
2. Critical Care (Barie 1993-Little Brown-New York, NY)
Journals of Thoracic Surgery and Anesthesia
1. The Journal of Thoracic & Cardiovascular Surgery (Editor: J. Waldhausen, MD - Mosby- St. Louis, MO)
2. The Annals of Thoracic Surgery (Editor: T. Ferguson, MD - Elsevir-New York, NY)
3. The Journal of Thoracic & Cardiovascular Anesthesia (Editor: J. Kaplan, MD - Saunders-Philadelphia, PA)
Internet sites & search engines
http://www.ctsnet.org
http://www.medline.cos.com
http://www.aats.org
http://www.acc.org
Thoracic Surgery CD-Rom Materials
1997 Postgraduate Course in Cardiothoracic Surgery (Amadeus Multimedia http://www.amadeusmultimedia.com)
1998 Postgraduate Course in Cardiothoracic Surgery (Amadeus Multimedia http://www.amadeusmultimedia.com)
1997 AATS Adult Cardiac Surgery Symposium (Med. Support Systems 1-800-375-2586)
1998 AATS Adult Cardiac Surgery Symposium (Med. Support Systems 1-800-375-2586)
Heart ROM Medical Journal (Amadeus Multimedia http://www.amadeusmultimedia.com)
The Journal of Valvular Heart Disease (ICR Publishers)
What should I do if I have questions regarding the prerequisite thoracic surgery curriculum?
Contact your program director for program related issues or Dr. Jeff Gold regarding questions or comments related to the process, goals or format of the curriculum. it is the intent of the TSDA to continue to develop the prerequisite curriculum, and to produce and publish in hybrid Web/CD-ROM format a package of interactive multimedia educational learning materials specifically geared to the interests and needs of the pre-thoracic surgery residents.
Jeffrey P. Gold, MD
Chairman, Department of Cardiothoracic Surgery
Albert Einstein College of Medicine
Montefiore Medical Center
111 East 210 Street
Bronx, NY 10467
jpgold@montefiore.org
Also, visit the TSDA Web site http://www.tsda.org
Comments about this Web site can be directed to webadmin@tsda.org.
