The Department of Cardiothoracic Surgery has developed a mandatory weekly Educational Day. This includes:
- Thoracic Surgery Educational Conferences: every first and third Wednesday of the month from 6:30-10:30 AM. The Thoracic Educational Day includes Thoracic Grand Rounds, Thoracic Oncology Tumor Board, Thoracic Morbidity and Mortality Conference, TSRA Mock Oral Boards and Esophageal Case Conference.
- Cardiac Surgery Educational Conferences: every second and fourth Wednesday of the month from 6:30– 10:00 AM. Cardiac Educational Day includes Cardiac Grand Rounds, Cardiac Morbidity and Mortality Conference, and Cardiac Case Conference.
- Monthly cardiac and thoracic journal club.
Residents are excused from all clinical responsibilities to participate to the fullest extent in these educational conferences. Advanced Fellows are strongly encouraged to attend and are provided time away from clinical responsibilities to do so.
The primary didactic educational component of the training program is the Cardiothoracic Surgery Grand Rounds which take place on Wednesday mornings with faculty, residents and mid-level providers. Topics are chosen following the Thoracic Surgery Directors Association (TSDA) Core curriculum, a web-based series of lectures covering the basics of cardiothoracic surgical anatomy, physiology, diagnosis and surgical therapy.
Conference topics are assigned to Department of Cardiothoracic Surgery faculty members, faculty from related specialties (pulmonologists; oncology; electrocardiology; perfusion; echocardiology; cardiothoracic transplantation),invited Visiting Professorships, as well as our own resident and fellow trainees.
In conjunction with each Visiting Professorship is an afternoon of clinical case and research presentations by the residents. The visiting professor questions, interprets and directs discussion, providing an excellent opportunity for comparative perspective and analysis. The Grand Rounds Schedule is organized by assigned Thoracic and Cardiac Faculty members chosen by the Program Director and rotates on an annual basis.
Several other teaching conferences are devoted to the clinical and research education of the residents and fellows. Residents are excused from their clinical duties to attend teaching conferences and faculty members are also encouraged to postpone the start of their clinical activities to facilitate resident education. The teaching conferences are as follows:
Esophageal Case Conference
The conference is entirely devoted to complex benign esophageal disorders. Coordinated by thoracic surgery faculty, the conference is a multidisciplinary endeavor that includes members of the Gastroenterology Division and the General Surgery Divisions. The focus of the Esophageal Conference is the clinical evaluation, management, and decision making that is essential for thoracic surgical management of complex esophageal pathology. The spectrum and presentation of esophageal disorders during the conference encompasses everything from esophgaeal malignancies, gastroesophageal reflux disease, esophageal motor disorders, and paraesophageal hernia.
Increasingly, there are a multitude of treatment options such as endoscopic therapy or surgery for patients with such disorders. Diagnostic evaluation, interpretation of radiographic and esophageal physiology testing, and operative options and techniques are emphasized. Moreover, common operative pitfalls and peri-operative complications are also a critical discussion point. The conference serves as an invaluable resource for residents and fellows preparing for their thoracic boards.
Thoracic Oncology Tumor Board
This conference includes members of the thoracic surgery Division, medical oncology, radiation oncology, gastroenterology, surgical oncology, pulmonology, radiology, and pathology. Cases are presented by thoracic surgery faculty and trainees to representatives of these specialties for discussion. This format allows for a multidisciplinary discussion of the evaluation, staging/diagnosis and management options using patients with whom the resident has already interacted.
Pathologists are present for this conference monthly and review the pathologic findings in a slide presentation, providing important learning opportunities in thoracic pathology and facilitating discussions regarding differential diagnosis and optimal strategies for tissue sampling. The thoracic tumor board is an ideal opportunity for the residents to understand the current limitations of therapy and the current status of clinical trials for various thoracic malignancies.
Residents are also exposed to the complexity and challenges of protocol development and implementation, and clinical research. They are exposed to, and encouraged to participate in, the ensuing discussions regarding cutting-edge, multidisciplinary treatment of thoracic malignancies.
Thoracic Morbidity and Mortality Conference
At the thoracic morbidity and mortality conference, thoracic faculty members and residents from both thoracic and general surgery review the previous week’s adverse outcomes, including mortalities, and discuss management issues. At this conference, opportunities for quality improvement are identified. Faculty members are present and encouraged to raise important evidence-based considerations for the adverse outcomes, including issues of appropriate management (including preoperative decision-making, intra-operative technical issues and post-operative care).
Thoracic Surgery Journal Club
The second Tuesday of each month the Thoracic Surgery Journal Club takes place from 5 pm to 6 pm at UPMC Presbyterian campus. Faculty members from the Division of Thoracic Surgery oversee the journal club to ensure relevance, guide the discussion and provide expert opinion and insight. Core topics in lung, esophageal and mediastinal disease processes are selected.
Each journal club involves an in-depth review of landmark scientific papers to impart historical context. In addition, important new published findings are reviewed. Approximately 8-9 papers are identified by faculty and distributed prior to the journal club for discussion with the residents.
The papers discussed at each journal club are placed on a password protected intranet site for future review should the residents want to obtain articles on a prior topic. Papers are assigned to one resident, who then provides a summary review of the hypothesis, aims, methods, results and conclusions.
Faculty members then moderate a group discussion of the paper, encouraging and guiding residents in the development of critical thinking and skills in evaluating study design, statistical testing and interpretation of findings. Residents are encouraged to think critically and important skills in evaluation of scientific literature are emphasized, including the appropriateness of statistical tests and study design.
Cardiac Morbidity and Mortality Conference
The cardiac surgery division oversees the cardiac morbidity and mortality conference during the cardiac educational days. Cardiac faculty members, residents, and fellows review the previous week’s adverse outcomes, including mortalities, and discuss management issues. At this conference, opportunities for quality improvement are identified.
Faculty members are present and encouraged to raise important evidence-based considerations for the adverse outcomes, including issues of appropriate management (including preoperative decision-making, intra-operative technical issues and post-operative care).
Cardiac Case Conference
Directed by the cardiac surgical faculty, this is a case-based interactive conference. The topic for the week is often selected in advance on the basis of recent interesting or difficult cases which occurred during the prior week. Core cardiac surgical topics and problems are addressed each week with focus on diagnosis, work-up, echocardiogram/coronary angiography/ct scan review, and technical aspects of the conduct of the operation. Often an oral board exam style is utilized.
Cardiac Cath Conference
This is a multidisciplinary conference on Thursday afternoons held in conjunction with the Division of Cardiology. It is a case presentation based conference with discussion among surgeons and cardiologists regarding diagnosis and management of cardiovascular pathology. CT residents on adult cardiac services have rotating responsibility for case presentation at Cath Conference.
Congential Case Conference
This conference is held weekly at Children’s Hospital of Pittsburgh and is attended by the residents on the congenital heart service. It is a multidisciplinary case conference of pediatric cardiologists, interventionalists, radiologists, and congenital heart surgeons. Patient physiologic data, echocardiography, angiography, and MRI/CT images are reviewed by the group as part of the decision making for current and future cases.
To address resident learning in the specific competencies, whenever possible, discussions in these conferences include the larger context of patient care, medical knowledge, interpersonal and communication skills, systems-based practice, professionalism, and practice-based learning and improvement.