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 Valve surgery 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 Cardiac disease.
The purpose of initiating this educational program is clearly delineated in the mission & vision of the league of Minimal Access 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 advanced valve surgery with special emphasis on repairs and reconstruction.
- Establish a formal teaching program dedicated towards the training of advanced valve surgery, after the candidate obtains formal qualifications & is board certified.
- Enable trainees in acquiring skills to manage complex valvular heart disease
- Establish a credible teaching program.
- Develop a base of dedicated surgeons who are proficient in the treatment of advanced valve surgery
- Establish a marriage of academics & clinical practice dedicated towards advanced valve surgery & its treatment.
- Establish India as a global leader in the treatment of valve surgery through a teaching program.
2. AT THE END OF THE FELLOWSHIP, THE CANDIDATE OR THE MENTEE SHOULD HAVE:
1. Developed concepts and been exposed to the surgical management, of most varieties of simple and complex presentations of valvular heart 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 valve cases including special emphasis on TEE
4. Be able to manage and guide the ICU teams to help recovery of patients after valve surgery.
5. Be familiar with all ICU practices in delivering post-operative care including resuscitation, 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 valve surgery.
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 Cardiac disease before and after surgery for best outcomes.
8. Be trained in auditing outcomes after surgery
9.. Developed the ability to plan and execute a research project, publish, and contribute to the literature in his/her tenure.
3. ASSESSMENT:
1. At the completion of the “Fellowship” tenure of Two years, the candidate would be required to appear for an exit examination.
2. An “exit” examination (written and oral) is to be conducted along with evaluation of log book to assess the candidates in depth knowledge.
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, fulfilment 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 Valvular heart Surgery Certificate given under the seal & aegis of the IACTS.
Fellowship Curricula
Pathophysiology/ genesis of Valvular heart disease (VHD)
Imaging and other relevant investigations required for management of VHD
Key anatomy, physiology ,biochemistry, pathology pharmacology, microbiology and other basic sciences associated with VHD and surgical treatment for the same.
Collaborating with the Heart-Team in VHD treatment
Contemporary referenced & peer-reviewed literature on lesion & management.
Established guidelines for multimodal and surgical treatment.
Approaches & considerations for sole & concomitant- procedures.
Modalities of surgery associated with valve replacement. repair and reconstruction.
Decision making & surgical planning
Strategizing use of cardiopulmonary bypass,
Teaching sessions
Intensive care & management.
Analysis on outcomes.
Post-surgical care & follow-up of patients.
Activities
Participating in post-operative intensive care
Outpatient and preoperative planning of cases
Case discussion with radiology, and cardiology departments for diagnostic imaging for VHD
Initial operative work shall include valve replacement and special emphasis on valve repairs and reconstruction with specific emphasis on performing mitral valve repairs.
Staged training shall enable the trainee to observe & assist and finally perform valve replacements and valve repairs of increasing complexity and also to assess the quality of surgery done.
The fellow is expected to conduct himself/ herself in the order of a junior consultant, who shall take responsibility of patients in post-operative care, while on-call.
The fellow may enable the facility of an experimental-skills to further habituate/ develop skills, in non-clinical hours that shall be made available.
The fellow shall undertake a small research topic as part of the academic teaching program, in consultation with the mentor; in addition to any additional research work.
The fellow shall participate & present their research work at 2 teaching IACTS conclaves (Annual conference, either IACTS cardiac CME).