Cardiothoracic Surgery

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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.