Last Update: 30/01/2013 18:12
Criteria for Minimum Operative Experience
The Board of Cardiothoracic Surgery considers the following to
be the minimum requirement for adequate operative experience during
the six years of Cardiothoracic Surgery training. The total
operative experience must be recorded in the Trainee logbook which
will be assessed every six months by the Board of Cardiothoracic
Surgery. It is emphasised that these numbers are to be taken as a
general guide and that discretion is left with the Board of
Cardiothoracic Surgery. Should operative experience be deemed
sub-optimal at any stage of training, additional training time may
be required to rectify the situation.
Set 1
No minimal operative experience.
Set 2
Perform the following under supervision:
| 1. |
Conduit Harvests - Level A |
30 |
| 2. |
Soft Tissue Closures - Level A |
100 |
| 3. |
Sternotomies - Level A or B |
25 |
| 4. |
Thoracotomies or Thoracostomies - Level A or B |
5 |
| 5. |
Major Cases at Level C or above |
100 |
Set 3
First assistant at 150 cases (coronary/valve/aortic).
Perform the following under supervision:
| 1. |
Sternotomy |
50 |
| 2. |
Closure of Sternotomy |
50 |
| 3. |
Vein harvest |
50 |
| 4. |
Radial artery harvest |
20 |
| 5. |
IMA harvest |
10 |
| 6. |
Cannulation for cardiopulmonary bypass |
5 |
Set 4
First assistant at 150 cases (coronary/valve/aortic) and this
should include repeat sternotomy (10).
Perform the following under supervision:
| 1. |
Cannulation for cardiopulmonary bypass |
20 |
| 2. |
Aorto coronary anastomosis |
20 |
| 3. |
Sternotomy |
50 |
| 4. |
Closure of Sternotomy |
50 |
| 5. |
Vein harvest |
50 |
| 6. |
Radial artery harvest |
30 |
| 7. |
IMA harvests |
30 |
Thoracic surgery requirements for the SET 3 and SET 4
would be:
| 1. |
First assistant at major cases (lobectomy/pneumonectomy) |
20 |
| 2. |
First assistant at VATS/open biopsy/pericardial resections |
50 |
| 3. |
Perform under supervision the following
- Thoracotomy
- VATS/open biopsies/pericardial resections |
10
20 |
| 4. |
Bronchoscopy
- rigid
- flexible fibreoptic |
20
20 |
Set 5
First assistant at 150 cases to include at least 25 aortic valve
replacements, 10 mitral valve procedures, 5 aortic procedures and
assistance at 10 reoperative sternotomy procedures.
Perform the following under supervision:
| 1. |
Aorto coronary anastomoses |
50 |
| 2. |
IMA harvest |
50 |
| 3. |
Radial artery harvest |
20 |
| 4. |
Sternotomy |
75 |
| 5. |
Coronary artery bypass graft (assisted) |
25 |
| 6. |
Aortic valve replacement (assisted) |
5 |
Set 6
First assistant at 150 cases to include at least 25 aortic valve
replacements, 10 mitral valve procedures and 10 aortic
procedures.
Perform the following under supervision:
| 1. |
Coronary artery bypass (assisted)
(supervised but supervising surgeon not scrubbed) |
40
10 |
| 2. |
Off pump coronary artery bypass (OPCAB) procedures (assistant
or surgeon assisted) |
20 |
| 3. |
Aortic valve procedures (assisted) |
5 |
| 4. |
Mitral valve operations (assisted) |
5 |
| 5. |
Repeat sternotomies (assisted) |
10 |
| 6. |
Atrial septal defect closure |
10 |
Thoracic surgery requirements for the SET 5 and SET
6 would be:
| 1. |
Major procedures (30 as first assistant and 20 assisted) |
50 |
| 2. |
Lobectomy/Pneumonectomy (supervised but supervising surgeon not
scrubbed) |
5 |
| 3. |
Minor Procedures (30 assisted; 20 supervised but supervising
surgeon not scrubbed) |
50 |
| 4. |
Bronchoscopy
- rigid
- flexible fibreoptic |
20
20 |
| 5. |
Pacemaker and defibrillator exposure during training |
20 |
A curriculum in Cardiac or Thoracic Surgery may be obtained upon
application to the Royal Australasian College of Surgeons.