Acceptance in the two-year Cardiothoracic Surgery residency requires satisfactory completion of a five-year General Surgery program. In addition, prospective Cardiothoracic residents are encouraged to spend a year or two in laboratory research prior to beginning their specialty training. Two new residents join the Residency Training Program with two being appointed Chief Resident each year.
     In addition to the Cardiothoracic training program, the Division of Cardiothoracic Surgery has educational programs for residents in the PGY-1 and PGY-2 years. Post graduate fellowships in cardiac transplantation/circulatory support, general thoracic, and congenital heart disease are available.

Working Environment

The Division of Cardiothoracic Surgery is staffed by full-time faculty members based at the UCLA Medical Center and at the West Los Angeles VA Medical Center. Faculty members from Surgical Oncology and Pediatric Surgery also participate in the program. Clinical faculty members provide additional teaching support.
     The surgical residents attend numerous interdisciplinary weekly conferences with participation by Cardiology, Radiology, Pathology, etc., as well as daily teaching rounds led by faculty members. Rotation on interventional and diagnostic cardiology services are available.

Patient Mix

The patient mix is balanced between those with general thoracic problems (of the lung, esophagus, and mediastinum) and those with cardiac lesions (coronary artery disease, valve malfunction, congenital heart disease, endstage cardiac failure, etc.). Residents have the opportunity to work with both adult and pediatric patients. They participate in the pediatric and adult heart transplant program, the heart/lung transplant program, and the lung transplant program. There is a major forum on minimally invasive cardiac valve repair and replacement often with robotic assistance. In addition, the residents perform implantation of circulatory assist devices.

Core Training

Training in cardiac surgery focuses on mastering accurate assessment of cardiac performance and effective medical management of myocardial dysfunction. Management methodologies considered include pacing, drugs, and application of intra-aortic balloons and left ventricular assist devices. Pathology staff provide histologic reviews of surgical specimens to help residents correlate pathologic findings with intra-operative observations.

Basic Surgical Training Programs for residents in the PGY-1 and PGY-2 years provide ample opportunity to perform thoracentesis and pericardiocentesis. During their rotation in Cardiothoracic Surgery, they place chest tubes, central venous catheters, and intra-arterial lines. The resident will assist in the operating room, and will be trained to appropriately handle tissues, repair arteriotomies, open and close thoracotomy incisions, perform lung biopsies, tracheostomies and bronchoscopies, and insert pacemakers. The resident assists the senior surgeon on major operations.

Constant emphasis is placed on the principles involved in making patient management decisions. Under supervision, the resident is responsible for postoperative patient care. Residents are expected to acquire skill in diagnosing and treating patients with hypovolemia, depressed cardiac performance, arrhythmias, pericardial tamponade, oliguria, arterial hypertension, and respiratory insufficiency.

Residents are involved in the education and mentorship of PGY1 and 2 general surgery residents as well as medical students from UCLA and other institutions. Academic and scholarly pursuits are encouraged to prepare residents for an academic career.

Surgical responsibility is increased based upon experience and ability. Surgical goals and objectives are established for each rotation leading to independence in the conduct of a cardiac operation both on and off cardiopulmonary bypass for coronary artery surgery, valve repair and replacement, aortic dissection, arrhythmia surgery, congenital cardiac and long transplantation. Our residents surpass all case residents of the American Board of Thoracic Surgery and receive excellent job or fellowship offers. The faculty at West Los Angeles VA Hospital is the same at the Ronald Reagan UCLA Medical Center, providing continuity of training and mentorship.

General Thoracic Surgery
The UCLA Division of Cardiothoracic Surgery has a rich tradition of dedicated Thoracic Surgeons that provide expert surgical services to patients with all types of benign and malignant diseases of the chest. Thoracic Surgery is an integral part of the Division of Cardiothoracic Surgery and to the educational program of residents and fellows. It provides a broad and diversified experience in benign and malignant non-cardiac thoracic pathology with over 900 surgical procedures performed annually at UCLA and its affiliated hospitals.
This includes, but is not limited to, the following conditions and operations:

• Lung volume reduction surgery for emphysema
• Thoracic sympathectomy for hyperhidrosis
• First rib resection for thoracic outlet syndrome
• Surgical removal of benign and malignant tumors
  • Airway Tumor
  • Barrett's Esophagus
  • Chest Wall Tumor
  • Esophageal Cancer
  • Germ cell tumor
  • Lung nodule, lung cancer, and lung metastasis
  • Mediastinal tumor
  • Mesothelioma
  • Neurogenic tumor
  • Sarcoma
• Surgical repair of chest wall deformity: pectus excavatum, pectus carinatum
• Surgery for benign esophageal diseases: achalasia, gastroesophageal reflux disease
       There are two weekly clinics that provide an invaluable exposure of these thoracic pathologies to Cardiothoracic Surgery and General Surgery Residents. The residents learn to carefully evaluate patients as potential surgical candidates. They learn the roles played by thoracoscopy, bronchoscopy, pulmonary function studies, and other invasive and non-invasive procedures in making that determination. The program emphasizes multimodality and multidisciplinary protocols involving radiation therapy, chemotherapy, surgery, and biologic therapy. The proper use of these modalities alone and in combination is discussed and illustrated.
• There are several conferences hosted by Thoracic Surgery that provide a unique educational outlet. The “Thoracic Teaching Conference” is held weekly and led by an attending surgeon. This is a formal didactic teaching session. The “Thoracic Oncology Program Tumor Board” occurs weekly where new and established patients with complex thoracic malignancies are presented. From these discussions, our multidisciplinary team comprised of thoracic surgeons, radiation oncologists, medical oncologists, pathologists, pulmonologists, and radiologists, makes a treatment recommendation specific for each patient situation. The residents actively participate in this conference and present patients for discussion. The “Gastrointestinal Tumor Board” provides a forum where patients with esophageal cancer from the Center for Esophageal Diseases are presented. Residents are encouraged to attend this conference. The "Thoracic Morbidity and Mortality" Conference is held monthly and residents present cases for discussion with a didactic focus.
  
  For more information, please contact: Thoracic Surgery (310) 794-7333 or Cardiac Surgery (310) 206-8232.