Background
The Advanced Cardiac Surgery Fellowship at the University of British Columbia is a 1-year fellowship for a cardiac surgeon who has successfully completed cardiac surgical training recognized by the Royal College of Physicians and Surgeons of Canada.
The fellowship will take place at Vancouver General Hospital (VGH), which is a quaternary care hospital in Vancouver, BC. VGH performs ~ 700 open heart procedures annually, including: coronary artery bypass grafting (CABG); aortic, mitral, and tricuspid valve surgery, including transcatheter aortic valve replacement (TAVR); major aortic surgery, including thoracic endovascular aortic repair (TEVAR); robotically-assisted cardiac surgery; and mini-thoracotomy valve repair/replacement and atrial septal defect (ASD) repair.
Supervising Surgeons
Dr. Richard Cook’s primary areas of interest are in minimally-invasive valve surgery and robotically assisted MIDCAB. He has completed ~ 350 robotically-assisted MIDCAB operations, and ~ 350 right mini-thoracotomy valve operations since he started his clinical practice at VGH in 2005. He currently performs ~ 30 – 50 mini-thoracotomy cases/year, and 20 – 30 robotically-assisted MIDCAB operations/year. He will be starting a randomized trial of CABG vs hybrid revascularization (robotically-assisted MIDCAB + PCI) in moderate-risk patients later in 2023.
Dr. Steve Kim underwent an advanced fellowship focusing on surgery for hypertrophic cardiomyopathy at Mayo Clinic. His clinic interests include septal reduction surgery and aortic surgery. Dr. Joel Price’s clinical interests include valve reconstruction and aortic and endovascular surgery. This includes general aortic surgery, aortic valve reconstruction, endovascular aortic surgery, and minimally invasive and transcatheter valve therapies. Dr. Price has a special interest in the repair of bicuspid aortic valve, including aortic valve-sparing root replacement and leaflet repair. With a background in epidemiology, Dr. Price focuses his research on outcomes in aortic and valvular heart surgery, clinical trials and simulation in surgical education.
Objectives of Training
The objectives of the fellowship are to provide the fellow with the opportunity to be involved in all types of adult cardiac surgical procedures occurring at VGH. The skills that may be acquired include:
- CABG techniques, including harvesting of conduits
- Aortic valve replacement
- Use of the robot to harvest the internal mammary arteries
- Right and left mini-thoracotomy access to the cardiac structures
- Mitral valve repair techniques, including: neochordae, resection, sliding plasty, ring annuloplasty, commissural closure, cleft closure
- Tricuspid valve repair techniques including ring annuloplasty, neochordae, patch enlargement of leaflets, cleft closure
- Off-pump minimally-invasive direct coronary artery bypass (MIDCAB)
- Off-pump CABG
- Left atrial appendage ligation
- Aortic valve repair techniques
- Aortic root enlargement techniques
- Aortic root replacement and aortic valve-sparing root replacement surgery
- Aortic arch surgery
- Descending aortic and thoracoabdominal aortic surgery
- Thoracic endovascular aortic repair (TEVAR)
- Management of acute type A and type B dissections
- Surgery for hypertrophic cardiomyopathy
- Pacemaker placement and management
- V-A ECMO
- TAVI
Responsibilities
The fellows will be responsible for the following:
- Pre-operative assessment of patients, including in-hospital consults
- Preparation of patients for surgery, including obtaining consent and writing orders
- Post-operative management of patients
- Intra-operative responsibilities will be assigned according to the ability of the fellow and will be expected to increase with experience and time
- To take call (from home) on a 1 in 3 basis with either Dr. Cook, Dr. Kim or Dr. Price
- Attendance at clinical and teaching rounds
- Weekly mitral and tricuspid valve clinic rounds (Friday AM)
- Weekly cardiac surgery triage rounds (Wednesday AM)
- Weekly combined cardiac surgery/cardiology clinical and academic rounds (Thursday AM)
- Monthly TEVAR rounds (Tuesday AM)
- Intra-operative teaching of learners, including medical students and residents
- Participation in clinical and teaching rounds
- Didactic teaching of cardiac surgical residents
- Performing clinical research
Research
The fellow will be expected to lead and complete at least one, and preferably 2 clinical research projects for the year that he/she is in the program. The proposal for the research projects will be expected within the first month of the fellowship to allow enough time to complete the project. Activities related to research projects may include preparation of a study protocol, including study design; submission of ethics applications, submission of grant applications, collection and interpretation of data, preparation and submission of abstracts and manuscripts, presentation of study results at local and international meetings.
Opportunities will also exist to participate in other research projects as time allows.
Fellowship application will only be considered if it meets the CPSBC requirements for a medical license:
https://www.cpsbc.ca/registrants/current-registrants/registration-and-licensing/student-and-graduates/postgraduate-fellow
Salary will be commensurate with the guideline set by PGME.
Interested applicants should forward their CV and a cover letter to:
Maryam Milani
Senior Administrative Assistant
UBC Division of Cardiac surgery
Email: maryam.milani@ubc.ca