Candidates after their MCh/DNB in cardiothoracic surgery and desirous of pursuing this subspecialty, are at sea in acquiring the right form of structured training. Candidates who find a place to train and hone their skills after their post-doctoral degree are expected to learn the skill in a measure of time and wait to garner experience through a waiting list in measure of time rather than quantifiable experience and confidence.
To help our aspiring graduates get the necessary exposure, skills, and a mindset in handling patients with Thoracic Oncology disease, a peer reviewed fellowship program under the aegis of a respected professional body such as IACTS is being proposed to be commenced from 2016.
In the light of new knowledge and advancing technologies, IACTS through its academic council and the respective subcommittees, desires to conduct and oversee specialized courses of study in the subspecialties of CTVS, having a peer reviewed and a structured training program with uniformity, with an emphasis on providing one on one mentoring needed to build up the confidence and develop the practical skills of the candidate to go and practice the subspecialty, certified primarily by the mentor and then by the IACTS.
Also, we have various universities conducting fellowship programs adding to the many “qualifications” that could be secured by a candidate, the thrust being on securing another qualification rather than a structured training under a specified mentor, with finite end points. It is earnestly hoped that this is one point that will differentiate the IACTS fellowship from other programs.
There are many peer respected and skilled surgeons of good standing achieving excellent outcomes and conducting many outstanding programs in this subspecialty in many private hospitals across India who could be great mentors. However, these individuals' talents are not harnessed in our training schedules.
Hence, IACTS as a peer body could help to bridge this gap.
Many professional associations have adopted this practice. It is in vogue in many countries such as America (AATS) and Europe (EACTS). There exists no accredited or in-vogue training paradigms for Thoracic surgery in Asia. It is an ardent effort of the IACTS to establish a program that serves the need of the society and the interests of trainees in credence.
1. SUBSPECIALTY TRAINING IS ESSENTIAL:
- 1. Given the skills to be acquired.
- 2. The paucity of exposure to complex subspecialty cases in their training institutions.
- 3. Giving the candidate an opportunity to work under the tutelage of senior and skilled surgeons in the teaching and non-teaching sector in a structured training program.
- 4. Providing a platform of training encompassing all aspects of the subspecialty in an accredited centre of excellence of the respective subspecialty.
- 5. Recognizing that peer certificate by an accredited mentor is perhaps the most balanced assessment and certification of a surgeon’s training and skills in the concerned subspecialty after a recognized post doctoral qualification.
It also gives an opportunity for the senior surgeons interested in mentoring to provide this platform for our junior colleagues in helping them become well trained surgeons in future in their chosen subspecialty.
It is hoped that the Fellowship in Thoracic Oncology Surgery (TOS) will be a “Fellowship” in the true sense of the word—more emphasis on transmission of concepts, thoughts and surgical skills needed for practice of the subspecialty and creating a platform and environment for the candidate to acquire and develop the same. Unlike the training programs prevalent in India, where acquisition of theory plays a dominant role, it is hoped that a “Fellowship” after a post doctoral degree is more for getting exposed to the practice and nuances of the subspecialty, and learn the practical ways to handle problems working shoulder to shoulder with a peer recognized expert, The Mentor. More emphasis and opportunity is to be given for the mentee to acquire the fine surgical skills needed in a supervised environment and build the confidence of the young surgeon.
The goal of this fellowship is to provide recently-graduated Cardiovascular Surgeons with a skill-based educational opportunity to enhance their understanding & upkeep proficiency in the surgical treatment of Thoracic Oncology disease.
The purpose of initiating this educational program is clearly delineated in the mission & vision of the league of thoracic surgery in the Indian subcontinent.
Mission
- Provide an advanced foundation in the understanding of the metamorphic lesion & its management.
- Engage surgeons in the multimodal management of TOS.
- Establish a formal teaching program dedicated towards the training of Thoracic Oncology Surgery, after the candidate obtains formal qualifications & is board certified.
- Enable trainees in acquiring skills to manage complex arterial lessons of the heart & great vessels.
Vision
- Establish a credible teaching program.
- Develop a base of dedicated surgeons who are proficient in the treatment of TOS.
- Establish a marriage of academics & clinical practice dedicated towards TOS & its treatment.
- Establish India as a global leader in the treatment of TOS through a teaching program.
- 1. Developed concepts and been exposed to the surgical management, of most varieties of simple and complex presentations of Thoracic Oncology disease, as an assistant and later as a Supervised Operating Surgeon.
- 2. At least operated the stipulated number and types of cases.
- 3. Be familiar with echocardiography and other contemporary imaging modalities in managing TOC cases
- 4. Be able to manage and guide the ICU teams to help recovery of patients after TOC.
- 5. Be familiar with all ICU practices in delivering post operative care including resuscitation by ECMO, ECPR, IABP, fundamentals of intensive care, and ventilation management.
- 6. Exposed to the process of assuming leadership in a Heart Team and be able to recognize the “Team Concept” of Adult Heart Care in a team comprising of experts from many disciplines needed for adult Thoracic Oncology heart care.
- 7. Appreciated and learnt the ability of the mentor to develop cordial interpersonal professional and soft communication skills with all other stakeholders caring for the patient with Thoracic Oncology disease before and after surgery for best outcomes.
- 8. Developed the ability to plan and execute a research project, publish, and contribute to the literature in his/her tenure.
- 1. At the completion of the “Fellowship” tenure of one years, the candidate would be required to appear for an exit examination.
- 2. An “exit” examination (written and oral) is more of a formality than a true test of knowledge in the traditional sense.
- 3. Once certified by the mentor, it is assumed that the candidate is well trained to go forth and practice the subspecialty. Hence it places great onus on the mentor in the selection, training and certification of the candidate or mentee.
- 4. On successful completion of the fellowship training of two calendar years at the accredited centre, a pass at the exit examination, fulfillment of all the norms of the fellowship, and a certificate of competence signed by the accredited mentor under whom the candidate has worked, he/she would be eligible for the Fellowship in Thoracic Oncology Surgery Certificate given under the seal & aegis of the IACTS.
1. Ex Officio (IACTS):
- a. The President
- b. The Senior Vice President
- c. The Junior Vice President
- d. The Secretary
- e. The Treasurer
- f. The Editor
2. Program Coordinator, TOS Fellowship Program
The Steering Committee will meet twice a year at the annual conference and another midterm EC meeting of IACTS.
2. Subcommittee members:
a. Dr. Ali Zamir Khan Accreditation of Centres (Mentee issues)
b. Dr. L. M Durlong Accreditation of Centres (Mentee issues)
c. Dr. C.S Hiremath: Accreditation of Centres (Mentee issues, curriculum, course requirements)
- a. He/she would select three committee members from IACTS members/Academic Council members—who are senior practitioners of the subspecialty and are at least 15 years in practice after completing MCh/DNB.
- b. Tenure of the subcommittee would be three years.
- c. Subcommittee proceedings would be reported twice a year to the Steering Committee by the Program Coordinator with regard to the functioning of the fellowship program, and update the latter about all aspects of the program, including funding needs, budgets etc.
- a. THE COMMITTEE WILL:
- 1. Decide on the course curriculum
- 2. Conduct examinations, identify centres, schedules, etc.
- 3. Monitor the fellowship program through site visits to the accredited centres by one member at least once a year, interviewing the candidate and the mentor and submitting a report to the CASE & A Subcommittee.
- 4. Accredit centres and mentors meeting the norms of accreditation through site visits and inspection of the centre and facilities. One E & A committee member would be deputed by the Program Coordinator.
- 5. The E & A committee members would communicate with each other and meet at least twice a year at the national meeting before the Executive and Steering Committee meeting during the annual conference and IACTS Midterm CME and at the Examinations.
- 6. The Program Coordinator and the committee members would prepare the annual budget for the expenses of that year as regards travel, and other anticipated expenses and secure the approval for the same from the steering committee.
- 1. List of accredited mentors and accredited centres will be displayed on the IACTS website by 15th June each Year.
- 2. Candidates who wish to apply for the IACTS Thoracic Oncology Surgery Fellowship Program should have passed the examination and undergone training leading to MCh (CTVS)/DNB (CTS) or equivalent overseas qualifications with MCI registration, and should have worked for a year in a CTVS unit after their qualification.
- 3. Candidates who wish to apply must be a Life Member (or Overseas Life Member) of the IACTS.
- 4. Those candidates who have been working in an accredited congenital heart centre after their qualifying examinations under an accredited mentor, are also eligible to apply for the fellowship. The E & A subcommittee would scrutinize their credentials and inform them of their eligibility, and decide on credits to be given for periods of training already undergone, provided other norms of the fellowship requirements are met and fulfilled.
- 5. Interested candidates should write to the mentor with all details mentioned in the application process.
- 6. Mentor will scrutinize the applicants and their credentials and inform the Secretary, IACTS and Program Coordinator of the TOS Fellowship program about his/her choice by email with all submitted attachments.
- 7. Secretary IACTS and CASE & A subcommittee will register the candidate for fellowship.
- 8. All fellowships commence on 1st August each year.
- 9. A candidate is permitted 15 days leave for each year of the fellowship tenure. This includes attendance of conferences, teaching sessions, etc. Any leave granted more than this specified period will need to be compensated by working in the parent unit for the excess leave period, before the fellowship certificate and mentor’s competence certificate is awarded.
- 10. If a candidate leaves the course after one or more month of commencing the fellowship, then the succeeding candidate could be registered only from 1st August of the subsequent year(or otherwise). The latest a candidate can commence the fellowship is 16th August of the year of commencement.
- 11. If the candidate who is selected leaves the fellowship course midway, then he/she forfeits their right to apply for any of the IACTS Fellowships in other subspecialties currently in force or proposed in future.
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Centre Rajiv Gandhi Cancer Institute and Research Centre, Delhi
Sir Chotu Ram Marg, Sector – 5
Rohini Institutional Area, Rohini, New Delhi
Delhi – 110085,INDIA
Phone: +91-11-47022222
Website: https://www.rgcirc.orgMentor Dr. L.M Darlong
Head of Thoracic Oncology surgery
Department of Cardiothoracic & Vascular Surgery
Rajiv Gandhi Cancer Institute and Research Centre, Delhi
Sir Chotu Ram Marg, Sector – 5
Rohini Institutional Area, Rohini, New Delhi
Delhi – 110085, INDIA
Email: drthoracoscopy@gmail.comDuration Candidates admitted/year One calendar year One (RGCIRC)
- 1. An exit examination (written (MCQ & short answers) & oral) needs to be taken and passed by all candidates at the completion of the fellowship tenure to obtain their Fellowship Certificate at a centre announced by 30th June of each year.
- 2. Examination Centre: (an accredited training centre) would be decided by the E & A Subcommittee.
- 3. Examination fee will be included in the admission fees.
- 4. Submission of attested logbook of training, signed certificate of competence from the mentor, and copies of the mandatory publications/research project conducted to be submitted to the CHS Program Coordinator by 15th June each year.
- 5. Examination would be held in the last weekend of July each year. All formalities regarding the examination and fellowship needs to be completed by July 15th of each year.
- 6. Program Coordinator and the Mentor whose centre the examination is being conducted would oversee the examination conduct and ensure that all facilities are provided for conduct of the examination.
- 7. Two Thoracic and TOS Subcommittee Members, Mentor who is hosting the Examination and Program Coordinator would constitute the Examiner Team who would examine the candidates.
- 8. The marking and results declared by the Examiners would be final and will be forwarded by the Program Coordinator to the members of the Fellowship Steering Committee for information and action by the Secretary, IACTS. As this examination is a peer certified test of competency to pursue a very skilled surgical subspecialty, any canvassing would be frowned upon, and may go against the concerned candidate.
- 9. Fellowship certificates would be given to the successful candidates by the President of IACTS after their presentation about the TOS Fellowship Program at the GB meeting at the next annual conference of IACTS.
- a. The stipend to be paid and the accommodation to be provided will be as per the norms of the accredited institution where the candidate applies for the fellowship.
- a. The annual fee of INR 24000.00 should be paid by the candidate to the IACTS, after the selection procedure. It includes the examination fee as well.
- b. Payment can be made only online, to that candidate who is selected under IACTS guidelines, and the link will be shared through the mail.
10. TIMELINES:
a. Admissions
b. Fellowship Exit Examination:
The latest dates for admissions & examinations will be announced accordingly.
11. CURRICULUM:
Fellowship Curriculum
Details will be updated shortly.
Activities
Details will be updated shortly.
12. ACCREDITATION:
a. Centre: Teaching hospital or a major private hospital with all supportive super specialities, pathology, blood banking and imaging facilities.
b. Facilities For Thoracic Oncology Surgery:
1. Staffing:
- a. Should have dedicated Thoracic Oncology surgeon(s)(performing>400-600 cases a year), adult cardiologists, qualified cardiac anesthesiologists, intensivists, and perfusionists. A dedicated cardiac ICU and operating room and cath labs with all acceptable facilities for performing on pump and off pump surgery and cardiological interventions.
- b. The principal mentor should be a qualified (MCh (CTVS)/DNB (CTS)) and a trained Thoracic surgeon(either by fellowship or experience) with at least 15 years of experience exclusively in Thoracic Oncology and a peer recognized expert in this field.
- c. Centre should be performing at least 400-600 simple and complex Thoracic surgeries per year with good outcomes complimented with a robust cardiac interventional program.
- d. Preference for accreditation would be given to a centre with an active teaching (residency) program.
- 1. Combined cath meetings between cardiologists, surgeons and other members of the team, case planning, discussion etc.
- 2. Journal clubs, topic presentations, seminars and teaching rounds.
- 3. Monthly mortality and morbidity audit meetings.
- 4. Attendance of at least one national (IACTS, INSHLT, SfHFT)/international meeting during the tenure by the mentee with a paper presentation.
- 5. At least one original study or two case reports in a peer reviewed cardiology or CTS journal should be done by the Mentee. Extra credits could be accrued for publishing these in the Indian Journal of Thoracic and Cardiovascular Surgery (IJTCVS), the official publication of the IACTS.
- 6. Presentation of the final report of the Fellowship (for five minutes) at the IACTS annual conference in the year the fellowship is being awarded or subsequent year.
- 7. The mentee’s travel, registration and lodging expenses to participate in the conference when he/she presents the fellowship report shall be borne by the mentee himself.
- 8. Minimum mandatory cases to be performed by the Trainee as a primary surgeon and supervised by the Mentor: 50
Index cases as the operating surgeon assisted by the Mentor: - The trainee must accomplish a case-work load and maintain a documented Proforma for the same. The fellow is expected to index participation in 50 cases as a primary surgeon, and the remaining with the mentor as lead surgeon, that may encompass;
Feedback & Analysis
The teaching program has been formulated in lieu of training needs and shall incorporate constant feedback from the fellow, for the mentor and the former may accommodate the needs of the beneficiary from time to time.
The program committee shall review the program from time to time, to improvise & make necessary provisions that are of need.
Candidates with a genuine passion to ensure quality-oriented Thoracic healthcare and academics are encouraged to apply.
HOW TO APPLY
Applications must contain the following as attachments in the email indicating interest:1. Curriculum vitae of the applicant (with the photograph)
2. 2 letters of recommendation (preferably from the Chief of CT Surgery & a senior CT surgeon) with their IACTS Membership number.
3. Marks cards of degrees earned
4. A google form is enclosed below and also shared through e-mail to submit all your details and the above documents.
Letter of intent indicating interest for this subspecialty of TO(indicating the centre of choice, with a minimum of 1000 words is encouraged) Copies of these documents must be attached to the form.