New York Presbyterian Hospital

The Cardiothoracic Surgery residency program at New York Presbyterian Hospital/Columbia is a high volume program committed to establishing resident independence by progressive responsibility in an environment of collegiality and innovation. The program, ACGME accredited since 1967 and led by Dr. Craig Smith since 1996, distinguishes itself by cutting edge innovation, with an entire program dedicated to minimally-invasive, robotic, and arrhythmia surgery headed by Dr. Michael Argenziano, who also acts as the program’s associate director.

Columbia offers a 2-year ACGME accredited cardiothoracic training fellowship. Two positions are open each year and residents are brought in at 6 month staggered intervals (one starting on July 1st and the other on January 1st). This unique format allows the option for 6 months of research or clinical training in a field adjunct to cardiothoracic surgery before the 2 years of clinical training. Many residents also choose an additional 6 month “superfellowship” at the conclusion of their training, resulting in a total training time of 3 years. These additional periods of specialization are instrumental in providing supplemental training that makes Columbia’s graduates extremely attractive as job applicants. During these 6 month intervals, residents are paid, provided with malpractice insurance, and have privileges at Columbia’s hospitals. This allows residents to operate, although these procedures will not count toward American Board of Thoracic Surgery (ABTS) requirements. Options for these 6-month intervals are diverse and include training in transplant and LVADs, minimally-invasive surgery, and interventional cardiology. However, residents are provided with the flexibility to pursue other professional interests such as additional aortic surgery training.

The first year of training consists of 3 months of pediatric cardiac surgery, 3 months of adult cardiac surgery, and 6 months of thoracic surgery. The second year consists of 3 months of pediatric cardiac surgery, 3 months of adult cardiac surgery, followed by 6 months as a chief resident on the adult cardiac surgery service. For adult cardiac training, residents become proficient in performing coronary artery bypass surgery, routine and complex valve replacement and repair, aortic surgery, as well as surgery for heart failure. Columbia has one of the busiest transplant and mechanical assist device practices in the country, performing 80-100 heart transplants and 30-40 ventricular assist device insertions per year. Columbia also has one of the largest minimally-i--- -innvasive and robotic surgery programs in the country, performing over 150 procedures per year. The General Thoracic service does a high volume and wide variety of procedures for benign and malignant lung, esophageal, and mediastinal diseases, and is one of the nation’s highest volume centers for lung transplantation and lung volume reduction surgery. The pediatric cardiac portion of the program is one of the busiest on the East Coast, providing exposure to diverse, technically challenging cases. Residents benefit from an extremely large volume of cases, with chief residents completing the program with over 500 cases as the operating surgeon. The program also encourages research by their residents. Residents are provided with funding to attend one national or international cardiothoracic surgical conference a year, as well as any meeting in which they are presenting an abstract.

Approximately 50% of graduates from Columbia’s program go into academic practice, while the remaining 50% go into private practice. Overall, approximately 70% of graduates pursue careers in adult cardiac surgery, with almost all of these graduates using the extra fellowship time described above. Approximately 20% of Columbia’s graduates pursue careers in thoracic surgery while 10% pursue additional training in congenital heart surgery.

The Columbia program is looking for potential residents who are academically accomplished. The program is looking for innovative thinkers who will ultimately push the field of cardiothoracic surgery forward. In 2008, the program received 67 applications. Each year, Columbia interviews 10-15 applicants for the two positions.

Located in the heart of New York City, residents will find opportunities for all types of personal enrichment. The program is also very aware of the steep cost of living in New York City and provides a housing subsidy to defray some of the cost of housing in the area. Ms. Jennifer Quill, the Program Coordinator, is actively involved in maximizing the residents’ experience by facilitating many of their administrative duties and other day-to-day issues.

In conclusion, Columbia provides its graduates with the necessary training to succeed as the field of cardiothoracic surgery evolves by emphasizing technical excellence, surgical independence, and an interdisciplinary approach. It accomplishes this by providing high volume training in the full spectrum of cardiothoracic procedures, while incorporating technical innovations such as mechanical assist devices, catheter-based interventions, and minimally-invasive techniques. According to Dr. Argenziano, Columbia’s associate director, the future looks bright for the graduates of Columbia’s program.

Acknowledgements

Special thanks to Dr. Michael Argenziano, Dr. Craig Smith, and Jennifer Quill for their contributions to this article.

Additional Resources

Program link: http://www.columbiasurgery.org/ctfellowship/

Program Contact Information

Director: Dr. Craig R. Smith
Associate Director: Dr. Michael Argenziano
Coordinator: Jennifer Quill
Coordinator e-mail: quillje@nyp.org
Address: 177 Fort Washington Ave, MHB 7GN-435, New York, NY 10032
Phone: (212) 305-0423