Thoracic Surgery Residency Program
The Division of Thoracic Cardiovascular Surgery is one of five divisions of the Department of Surgery (the others being General Surgery, Oncology, Transplant, and Pediatric Surgery. The Division of Thoracic Cardiovascular Surgery is also aligned with the Heart Center.
The physical facilities for cardiothoracic patients in the Division of Thoracic Cardiovascular Surgery include: 1) a 25 bed acute care nursing unit for adult cardiothoracic patients (additional beds on other nursing units are available when needed); 2) a 4 bed Thoracic Intermediate care unit, 3) a 10 bed TCV Post-Operative Unit under the sole direction the thoracic faculty; 4) as many pediatric beds as may be needed; 5) three operating rooms equipped specifically for open heart surgery with a fourth operating room for major thoracic operations; and 6) an Endoscopy suite with laser support, staffed by a full-time R.N.
Additional support facilities include: 1) three cardiac catheterization laboratories which perform approx. 3800 cardiac catheterizations/year; 2) a modern pulmonary function laboratory; 3) a stat laboratory for the immediate performance of blood gas analysis and electrolyte studies; 4) a pediatric intensive care unit; 5) a newborn intensive care unit; 6) a non-invasive vascular laboratory; 7) a coronary care unit; and 8) three fully-equipped and active cardiovascular research laboratories, 9) a Heart Center Clinic designed to provide outpatient care for cardiothoracic patients along with other Heart Center patients, 10) a Division of Pediatric Cardiology performing 200 pediatric cardiac catheterization per year and operating 8 field clinics each month in rural areas of Virginia; 11) the Division of Pulmonary Medicine in the Department of Internal Medicine, which is active in clinical and laboratory research;12) the Division of Cardiac Anesthesia in the Department of Anesthesiology, which manages all open heart surgery; 13) a team of certified clinical perfusionists who conduct all clinical cardiac perfusions; and 14) full-time cardiologists and pulmonologists dedicated to thoracic transplantation.
Thoracic Cardiovascular Surgery Division
The Division of Thoracic Cardiovascular Surgery is under the direction of Irving L. Kron, MD. As program director, Dr. Kron is responsible for the coordination and direction of the training program and the overall administration of the service. The Division participates in the National Residency Match Program for cardiothoracic residency applicants. After candidate interviews and consultation with other faculty members, Dr. Kron ranks the thoracic residency applicants for the National Residency Matching Program. Dr. Kron recommends to the Medical Policy Committee the appointment of the matched applicants to the UVA medical housestaff.
Thoracic Cardiovascular Surgery Faculty
There are six faculty members including Dr. Kron who perform cardiothoracic surgery and are the primary teachers for the residency program. Each faculty member is delegated a major role and responsibility.
Dr. Thomas Daniel coordinates and supervises the training of the thoracic residents in non-cardiac thoracic surgery. His focus includes laser-assisted endoscopic resection of tumors, video-assisted thoracoscopic surgery, diagnostic rigid and flexible bronchoscopy and esophagoscopy, and esophageal dilatation.
Dr. Curtis Tribble has a special interest in surgical education and educational techniques and assists in the coordination of the thoracic training program with the general surgery training program. He has a certificate of special competence in critical care and directs the heart and lung transplantation service.
Dr. Bradley Rodgers, Chief of Pediatric Surgery, is fully trained and certified in thoracic surgery and also had a certificate of special competence in critical care. Since the beginning of 1992 he supervises and works with the thoracic residents in the performance of pediatric non-cardiac thoracic surgery.
Dr. John Kern's interests involve both adult cardiac and peripheral vascular disease with associated surgical interventions. Dr. Kern is lead investigator in clinical trials focused on application of endovascular stents for the treatment of aortic aneurysms. Dr. Kern is board certified in general surgery, cardiothoracic, and vascular surgery and oversees the Vascular Surgery Service.
Dr. David Jones is a General Thoracic Surgeon whose clinical interests involve patients with thoracic malignancies and benign esophageal diseases. In addition, he has a particular interest in graduate medical education. Dr. Jones is the medical director of the TCV Post Operative Unit. He is Board certified in general and cardiothoracic surgery.
Drs. Daniel and Kern are active in clinical research; Drs. Kron, Tribble, Kern, and Jones have active research laboratories with grant funding and research fellows. Please see Research in the Department of Surgery
Surgical Volume
The volume in the program continues to grow. The thoracic volume has increased due to the new programs in lung transplantation, thoracoscopy, and most recently, lung shaving for emphysema. The cardiac volume has continued to increase due to close allegiance with two new cath labs in neighboring institutions, the development of a busy cardiac transplant program, and introduction of minimally invasive cardiac surgery.
| Procedures | 1st year | 2nd Year |
|---|---|---|
| Major General Thoracic Procedures: Lungs, Pleura, Chest Wall Pneumonectomy, Lobectomy, Segmentectomy Esophagus, Mediastinal, Diaphragm |
130 | 15 |
| Major Cardiovascular Procedures: Congenital Heart, Acquired Valvular, Myocardial Revascularization, Transplantation |
100 | 325 |
Overview Thoracic Surgery Residency
The Thoracic Surgery residency program provides two continuous years of clinical training in cardiothoracic surgery. There are three half-day and one full-day outpatient cardiothoracic clinics each week, in which the thoracic residents see the ward and private patients with the attending staff. The thoracic residents have primary responsibility in diagnosing and planning the treatment of all thoracic patients. The thoracic residents perform the majority of the operations after appropriate planning with the attending staff. A member of the attending staff is scrubbed during the critical part of the operation.
Every patient admitted to the TCV Service is assigned to a member of the attending staff who is responsible for supervising and guiding the resident. If, in the opinion of the attending, the complexity of an operation is beyond the experience and ability of the resident, the attending will perform the operation; however, the resident always has the option of serving as first assistant. The thoracic residents are responsible at all times for the patients under their care, unless they are on vacation or administrative leave. They rotate night call for new, emergency admissions.
There are several hours of conferences each week, (see the Conference schedule) some of which are planned and conducted by the resident staff with the collaboration and participation of the faculty. All of the major thoracic and cardiovascular surgical journals and many of the important monographs are available to thoracic residents in the TCV Library, located adjacent to their offices. In addition, the Health Sciences Library, physically integrated with the Medical Center and open 7 days a week, subscribes to over 2880 journals and provides on-line computer searches with other libraries.
Each three months one of the two senior thoracic residents, under the supervision of the program director, is responsible for the administration of the clinical service and the supervision of the general surgery housestaff assigned to the division. He or she coordinates admissions, plans the operative schedule, and assigns housestaff duties. He or she assigns specific patients to the junior thoracic residents, who then become responsible for these cases and report directly to the responsible attending. Each thoracic resident attends at least one national scientific meeting and one or two national continuing educational courses annually, such as the postgraduate courses in thoracic and cardiac surgery of The American College of Surgeons.
The thoracic faculty meets weekly to discuss the resident staff and the overall clinical service. Any problems or deficiencies are discussed with the individual resident. Each faculty member provides a quarterly written evaluation of each thoracic resident. All thoracic residents complete the annual In-Service exam, and the results are reviewed with each resident. Each thoracic resident submits a quarterly evaluation of the program to the Program Director. The Program Director meets separately with the residents weekly to discuss the service, patient care, and educational needs.
Department of Surgery Connections
The Division of Thoracic Cardiovascular Surgery has a major role in the educational efforts of the Department. The thoracic surgical staff and residents participate regularly in departmental conferences and meetings. General surgery residents rotate on the thoracic service in their PG-1, PG-2, and PG-3 years to receive instruction, guidance, experience, and progressive responsibility commensurate with their skills and knowledge in the management of patients and cardiothoracic diseases. PG-4 general surgery residents rotate for 3 months each to oversee the vascular patients on the TCV Service.
Applications for the Thoracic Surgery residency can be obtained from:
National Residency Match Program
2501 M Street, NW Suite 1
Washington, DC 20037-1307
(202) 828-0676