University of Colorado

The University of Colorado has a rich history in cardiothoracic surgery beginning in the 1950’s with Dr. Henry Swan performing open heart operations under deep hypothermia. In fact the tub used to cool these patients now resides in the Smithsonian Institute. The current faculty has followed Dr. Swan’s pioneering example serving in a wide array of important medical, surgical, and thoracic leadership positions. These positions include serving on the Thoracic Board, the STS executive Committee, the Western Thoracic executive committee, and the National Quality Forum, among others. The faculty led by David Fullerton, a cardiac surgeon and chief of the division, is very academically oriented with ongoing clinical and basic science research that is directly translatable to the care of cardiothoracic surgical patients. Each of the cardiac faculty has particular clinical interests including David Fullerton’s interests in aortic stenosis pathogenesis and myocardial ischemia/reperfusion injury, Frederick Grover’s interest in outcomes research, Joseph Cleveland’s interests in mechanical assist devices, heart transplantation, and geriatric patient care, and Brett Reece’s interest in aortic pathology. On the thoracic side, John Mitchell has particular interests in tracheal surgery and lung operations for mycobacterial disease, while Michael Weyant is specifically interested in lung transplantation, esophageal surgery, and chest wall resections. The Children’s Hospital faculty, currently made up of David Campbell and Max Mitchell, are nationally known for their training program in congenital heart surgery. The congenital heart surgery program is one of the first to acquire certification by the American Board of Thoracic Surgery.

The mantra of the overall cardiothoracic training program across all the attendings is that the fellows do every case from the surgeon side of the table. With this attitude, the fellows are given early responsibility and control in the operating room and in the postoperative care of the patients. Moreover, aspiring academicians have free reign and complete divisional support regarding the pursuit of research during fellowship.

The University of Colorado offers a three year ACGME-approved program with the flexibility of allowing fellows in their last year to choose an area of concentration to bolster their training and credentials. These electives have been pursued both within and outside of the University of Colorado Health System. Although it is not a track program, this elective time allows fellows to refine skills in their particular interest. Overall, the training is very well balanced among cutting edge experience in adult cardiac, congenital cardiac, and thoracic surgery. Despite not being a traditional high volume center, the cardiac service provides a broad experience in heart and thoracic vascular surgery. Trainees consistently accrue adequate numbers for UNOS certification with 15-20 heart transplants and at least that many VADS by the completion of the fellowship. Furthermore, the fellows are deft with root replacements, thoracic aorta and arch procedures, aortic dissections, and thoracic endovascular procedures. The thoracic surgery service benefits greatly from the strength of the pulmonary services both at the University of Colorado, particularly for transplant, and at National Jewish Hospital, specifically for mycobacterial disease, interstitial lung disease, and COPD. The fellows finish training with 100 or more lobectomies, with the majority being VATS, as well as performing more than 30 lung transplants.

The program is based out of two newly built hospitals, the University of Colorado Hospital and The Childrens Hospital, both on the campus of the former Fitzsimmons Army Hospital Base. The Veterans hospital remains near the former campus, but is set to move to Fitzsimmons with another new facility to be occupied in 2013.

The program’s objective is to train the complete cardiothoracic surgeon. As Dr Fullerton states,” The University of Colorado Thoracic Surgery residency program does not track residents into a particular sub-specialty of Thoracic Surgery. Instead, the mission of the program is to provide a well-rounded education in all facets of Thoracic Surgery. Graduates of the program are well-qualified to enter any Thoracic Surgical subspecialty. In recent years, the graduates of the program have been equally divided in choosing careers adult cardiac surgery, congenital cardiac surgery and general thoracic surgery.” With this preparation graduates are not limited to any specific job type upon completion of their fellowship. Dr. Fullerton adds,” Although most graduates of the program have chosen careers in academic surgery, resident applicants are selected without regard to ultimate career goals. Instead, the most competitive applicants are chosen. The faculty is committed to preparing a resident for any chosen career, whether in an academic or private setting and regardless of the specific sub-specialty interest of the resident.”

Graduates of the program have been competitive for a wide array of jobs, but 12 of the last 15 have obtained jobs in academic surgery. As suggested by the balance of the training program, graduates have taken jobs in thoracic, adult cardiac, and congenital heart surgery. Graduates are well prepared for their transition from training to their first job. “Upon completion of the program, graduates have traditionally been highly sought-after in the job market. This reflects their excellent clinical training and ability to immediately function independently in the management of all cardiac and thoracic surgical diseases upon completion of the program,” according to Dr Fullerton.

In conclusion, the University of Colorado Cardiothoracic Surgery training program gives fellows a broad based experience in all avenues of cardiothoracic surgery. Graduates leave the program prepared to pursue careers specific to their interests, no matter what they may be.  

Acknowledgements

Special thanks to Dr. Fullerton for his contribution to this article.

Additional Resources

Program link: http://www.ucdenver.edu/academics/colleges/medicalschool/departments/surgery/divisions/ CardiothoracicSurgery/Pages/Residency.aspx

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