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Cardiothoracic Surgery (2015)

Overview Key Topics Professional/Leadership Skills Intermediate (I) Intermediate (II) Final Sub-specialty
LEVELS ST1 ST2 ST3 ST4 ST5 ST6 ST7 ST8

Final

Final Phase of training (ST7 & ST8)

The final phase of training will consist of an indicative period of two years. These two years should in turn consist of four modules, each of 6 months. By the end of this phase trainees will have been successful in the intercollegiate examination. Trainees will have developed sufficient experience and competence in the generality of cardiothoracic surgery to be eligible for the award of a CCT. They may be provided with the opportunity to develop an area of special interest during this period through the selection of appropriate modules.

The curriculum for each of the modules is defined (see syllabus). Aims and levels of competence to be attained within each module by the end of this stage are identified.

The list of specialist index conditions is detailed below. This list defines the requirements for the award of a CCT and in cardiothoracic surgery. All trainees (including those who are developing additional special interests and those who are taking academic pathway) will be required to meet these standards.

  • The management of critically ill cardiothoracic surgical patients in the pre and post operative periods.
  • The management of a patient undergoing cardiopulmonary bypass
  • The management of myocardial protection during cardiac surgery
  • The management of a patient requiring circulatory support
  • The assessment and management of patients with coronary heart disease, including elective and emergency presentations. To include competence in both primary and secondary procedures, and where appropriate to include off pump and on pump strategies and arterial revascularisation
  • The preliminary assessment and initial management of patients with complications of myocardial infarction, including mitral regurgitation, aneurysm and septal defects. To include operative management in appropriate situations. Full competence in operative management of complex cases to be developed in the post CCT period
  • The assessment and management of patients with valvular heart disease; including both isolated and combined aortic and mitral valve disease.
  • The assessment and management of patients with combined coronary and valvular heart disease, including operative management.
  • Full competence in operative management of complex cases including mitral valve repair and secondary procedures to be developed in the post CCT period.
  • The preliminary assessment and initial management of patients with acute dissection of the ascending aorta. To include operative management in appropriate situations.
  • Full competence in operative management of complex cases to be developed in the post CCT period
  • The assessment and management of patients with minor and major cardiothoracic trauma. To include operative management in appropriate situations.
  • Full competence in the operative management of complex cases including great vessel injury to be developed in the post CCT period
  • Patient selection and determination of suitability for major thoracic surgery and the pre and postoperative management of a thoracic surgical patient.
  • The assessment and management of a patient by bronchoscopy including foreign body retrieval
  • The assessment and management of a patient by mediastinal exploration
  • Competence in performing appropriate thoracic incisions
  • The assessment and management of lung cancer, including the scientific basis of staging systems and techniques used in the determination of stage and fitness for surgery
  • An understanding of the role of surgical treatment in the multidisciplinary management of lung cancer and other intrathoracic malignant diseases, including an appreciation of the principles of other treatment modalities and their outcomes
  • The assessment and management of patients with pleural disease; including pneumothorax and empyema, and including both VATS and open strategies
  • The assessment and management of patients with chest wall abnormalities, infections and tumours
  • The assessment and management of patients disorders of the diaphragm, including trauma to the diaphragm
  • The assessment and management of patients with emphysematous and bullous lung disease; including surgical management if appropriate and utilising both VATS and open strategies.
  • Full competence in operative management of complex cases, including lung reduction surgery, to be developed in the post CCT period
  • The assessment and management of patients with disorders of the pericardium and pericardial cavity; including surgical management if appropriate and utilising both VATS and open strategies
  • The assessment and management of patients with mediastinal tumours and masses; including surgical management if appropriate and utilising both VATS and open strategies
  • The assessment and management of patients with disorders of the major airways. Including operative management in suitable cases.
  • Full competence in operative management of complex cases, including tracheal resection, to be developed in the post CCT period

The curriculum is flexible and can accommodate the needs of trainees following an academic pathway. This is achieved by having individualised learning agreements. Academic trainees will be expected to demonstrate that they have achieved all the essential requirements of the CCT, but may choose not to undertake any optional additional training in the final stage. It is however acknowledged that academic trainees will need longer training pathways to achieve the essential competencies.

Click on Workplace Based Assessments to view the assessment forms including DOPS and PBAs

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