Clinical Instructor---Cardiothoracic Surgery

Tulane University School of Medicine Department of Surgery is currently seeking a non-ACGME Cardiothoracic Fellow to join its Division of Cardiothoracic Surgery and its growing practice in New Orleans and the greater New Orleans area.

Summary --------

The Division of Cardiothoracic Surgery Department of Surgery is seeking a qualified cardiac-trained surgeon with prior experience for a clinical position at the East Jefferson General Hospital. This individual will be involved primarily as a first assist in surgery and clinical support as part of East Jefferson General Hospital Tulane. The candidate will be looking to further their knowledge of advanced cardiac surgery, mechanical circulatory support, heart and lung transplantation, and patient care management.

Requirements ------------

The ideal candidate will have a United States Medical License or have completed all the United States Medical License Exams prior to starting the position. The recruited individual will be a full-time faculty member at the clinical instructor rank in the Department of Surgery at Tulane School of Medicine. The individual should be able to apply for and be granted a Louisiana medical license.

Clinical and Research Components -----------------------------

There are no planned research components to this training experience. The entirety of the experience is clinically based. There are opportunities for trainees to participate in clinical research activities, but such participation is not a requirement for successful completion of training.

Educational Goals and Objectives --------------------------------

Fellow is expected to become proficient in the preoperative workup, indications, and postoperative care of common adult cardiac conditions. The fellow will review the case preoperatively with the attending and during the operative procedure will function as primary surgeon or first assistant depending on the complexity of the case and their ability to perform the case. Fellow will see patients preoperatively and postoperatively in the hospital as well as in the outpatient clinics. Fellow will interact with the cardiac surgery team consisting of cardiac surgery attendings, physician assistants, nurse practitioners, surgical assistants, medical students, and perfusionists.

Fellow will be required to attend all mandatory core curriculum conferences. In addition, they are encouraged to attend the Heart transplant, VAD conference, Lung transplant conference, Structural conference, and cardiology M&M.

Fellow will be responsible for occasional presentation of cases at the weekly educational conference, Cardiac Surgery M & M, and Department of Surgery M & M.

On-Call Responsibilities ------------------------

Fellow will have weekday nights and weekend days and nights. Fellow will make rounds on patients on the cardiovascular surgery step-down and intensive care units. Fellow will be available for consultation. Fellow will be immediately available to respond to all calls for assistance from other healthcare providers at the Hospital. Fellow will promptly involve the attending surgeon in any evaluation or management issue requiring attention.

Outpatient Activity ------------------

Fellow will be expected to experience a broad outpatient exposure. Fellow will be expected to attend the Cardiac Surgery Clinic with the Cardiac Surgery team.

Facilities ------------

All clinic and inpatient care will take place within the East Jefferson General Hospital system.

Core Competencies -----------------

### Patient Care

The fellow must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. The fellow is expected to:

• Communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and their families.
• Gather essential and accurate information about their patients.
• Make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment.
• Develop and carry out patient management plans.
• Counsel and educate patients and their families.
• Use information technology to support patient care decisions and patient education.
• Perform competently all medical and invasive procedures considered essential for the area of practice.
• Provide health care services aimed at preventing health problems or maintaining health.
• Work with health care professionals, including those from other disciplines, to provide patient-focused care.

### Assessment and Management

The fellow is expected to:

• Assess patients referred for adult cardiac surgery in the inpatient and outpatient settings and perform a history and physical exam concentrating on the areas relevant to adult cardiovascular disease.
• Arrive at an appropriate differential diagnosis.
• Order appropriate diagnostic tests and procedures, demonstrating knowledge in the interpretation of these investigations.
• Use the history, physical exam, and diagnostic tests to arrive at an acceptable patient assessment and management plan, demonstrating knowledge in the operative and nonoperative management of the disease process.
• Care for the adult cardiac surgery patient throughout the hospital stay, including management in an intensive care setting, demonstrating knowledge and ability to anticipate, recognize, and manage potential complications of the disease processes and operative procedures.
• Provide a plan for patient follow-up and care for the adult cardiac surgical patient in the outpatient clinic after hospital discharge.
• Demonstrate adequate technical skills, including the proper handling of tissues and surgical instruments in an appropriate manner and strict adherence to sterile technique.
• Demonstrate an operating room awareness, showing appropriate management of and interaction with first assistants, perfusionists, anesthetist, scrub technicians, and circulating nurses.
• Demonstrate the ability to act as first assistant in the procedures below and anticipate surgical maneuvers, give and take direction well, make reasonable suggestions, and contribute to a positive operating room atmosphere.
• Demonstrate the ability to perform a variety of procedures performed by the cardiac surgeon, including but not limited to:
• Cardiopulmonary bypass cannulation via various arterial and venous access
• Coronary revascularization
• Conduit harvest
• IMA saphenous vein radial artery
• Coronary artery bypass grafting
• Aortic surgery
• Aortic root ascending aorta aortic dissection
• Aortic valve surgery
• TAVR
• Tricuspid valve surgery
• TVR repair
• Mitral valve surgery
• MVR repair
• Pericardial surgery
• Pericardial window
• Pericardiectomy
• Arrhythmia surgery
• MAZE procedure

Qualifications and Application -----------------------------

To be eligible for this position, the candidate must:

• Have completed medical school
• Have completed the equivalent of an ACGME-approved residency in cardiothoracic surgery
• Provide appropriate letters of recommendation from their training program director and/or other mentors
• Be in good mental and physical health
• Have no criminal record
• Be able to work collaboratively with other physicians and staff associated with the cardiothoracic service

Licensure ----------

The fellow must be eligible to obtain a Louisiana medical license.

Medical Knowledge ----------------

The fellow must demonstrate knowledge about established and evolving biomedical, clinical, and cognate sciences, including epidemiological and social-behavioral sciences, and the application of this knowledge to patient care. The fellow is expected to:

• Demonstrate an investigative and analytical thinking approach to clinical situations
• Know and apply the basic and clinically supportive sciences that are appropriate to their discipline
• Describe the anatomy, physiology, and pathophysiology of the pericardium, heart, and great vessels
• Describe the natural history of treated and untreated cardiovascular surgical conditions, including ischemic heart disease, valvular heart disease, thoracic aortic disease, heart failure, transplant, and non-transplant options, conduction system disturbances, cardiac tumors, pericardial disease, and trauma
• Acquire the ability to interpret noninvasive diagnostic methods, including EKG, CXR, CT, MRI, ECHO, and viability studies
• Describe the procedure of and potential complications involved with invasive diagnostic methods, including coronary angiography and cardiac catheterization
• Describe the pharmacology, indications, and complications of the various drugs commonly used by the adult cardiac surgeon, including anti-arrhythmics, inotropes, diuretics, anti-lipid, anticoagulants, thrombolytics, and pain medications
• Describe the physiology, technology, indications, and complications of cardiac pacemakers and defibrillators
• Describe the physiology, technology, indications, and complications of mechanical assistance, including ECMO, ventricular assist devices, and artificial heart
• Describe the principles and techniques for myocardial and cerebral protection

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