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Adult Cardiothoracic Anesthesia Fellowship

two physicians review patient vitals on a monitor

The Adult Cardiothoracic Anesthesia Fellowship program at Indiana University School of Medicine offers trainees a robust clinical and academic experience unmatched in the state. With clinical exposure to a medically complex patient population, innovative surgical techniques and the latest technology in minimally invasive and percutaneous interventions, fellows can expect to become expert consultants in the subspecialty. With over 500 cardiac surgical cases per year, IU School of Medicine provides a rich learning environment for the budding cardiothoracic anesthesiologist.

In addition to more routine cardiac cases, fellows will learn the nuances of management of advanced procedures including robotic-assisted mitral valve surgery, aortic reconstructive surgery and adult congenital cardiac surgery, to name a few. Fellows can also expect to become familiar with heart and lung transplantation, temporary and durable ventricular assist devices and extracorporeal membrane oxygen. In the cath lab, fellows will provide care for patients undergoing transcatheter aortic valve implantation, transcatheter mitral valve repair and left atrial appendage occlusion, among others.

The educational curriculum is designed to prepare fellows for the ABA Adult Cardiac Anesthesiology Exam and the NBE Advanced Perioperative Transesophageal Echocardiography Exam. With the mix of protected lecture time, multi-disciplinary conferences, one-on-one intraoperative teaching and time for independent study, fellows can feel confident that their training has set them on a path to board certification.

Curriculum

  • Fellows will have protected didactic time on Wednesday mornings and Thursday afternoons to attend the cardiothoracic anesthesia lecture series, Department of Anesthesia Grand Rounds, and echocardiography rounds with the Division of Cardiovascular Medicine.

  • The lecture series includes speakers from cardiothoracic surgery, cardiology, critical care, and pediatric anesthesiology.

  • Fellows will be asked to present several times throughout the year to the cardiothoracic anesthesia group on a current topic or journal article.

  • The Department of Anesthesia abides by the duty hour policy set forth by the IU School of Medicine Office of GME, which is compliant with ACGME requirements.

  • Cardiac operating rooms start at 6:45 a.m. In general, fellows will be expected to be present until the cases in their room finish with exceptions made for other academic pursuits or education.

  • Fellows will take home call, and if utilized over night, will be post-call the following day.

  • Fellows will be free of clinical duties on any weekend they are not on home call.

  • Moonlighting opportunities will include staffing IU Health Methodist Hospital “overflow” rooms on weekend days. Fellows will be asked supervise one to two general operating rooms with residents or anesthesiologist assistants when working this shift.

  • Moonlighting shifts cannot be taken when on cardiothoracic call or when doing the shift would result in a duty hour violation.

  • Fellows will be required to submit an abstract or project for presentation at the Society of Cardiovascular Anesthesiologists (SCA) Annual Meeting. Fellows will be given a CME stipend (see benefits information below) and time off from clinical responsibilities to attend the meeting.

  • Fellows will also spearhead a quality improvement project with the help of a faculty mentor.

  • Fellows will have the opportunity to participate in research by starting or joining an ongoing project during the year. Up to two months of elective time may be utilized to work on a project.

Rotation Schedule

Fellows will spend the majority of the year in the cardiac operating rooms at IU Health Methodist Hospital with one-to-one supervision by our cardiothoracic anesthesia faculty. Fellows can expect to care for patients undergoing coronary revascularization, valve repair/replacement, aortic surgery involving deep hypothermic circulatory arrest, temporary and durable left ventricular assist device placement and heart and lung transplantation. Additionally, fellows will be exposed to cases in our hybrid operating rooms, including laser lead extractions and transcatheter aortic valve implantation. Fellows will also manage patients undergoing aspiration thrombectomy with interventional radiology, as well as interventional cardiology procedures including left atrial appendage occlusion. Fellows can expect to be working in a supervisory role with an anesthesiology resident about 70% of the time and solo with the attending about 30% of the time.

Understanding the perspective of the heart failure cardiologist can be critical to the cardiothoracic anesthesiologist when their patients arrive in the operating room. The goal of this two-week elective rotation is to give fellows a glimpse into the management of patients in the cardiac medical critical care unit at Methodist Hospital, where they will round on heart failure patients with the cardiology team, assist with procedures, and get increased exposure to temporary assist devices such as intra-aortic balloon pumps.

This one-month rotation will take place in the cardiovascular critical care unit at Methodist Hospital with the goal of providing fellows an important perspective on the ways cardiac surgery impacts patients post-operatively. Fellows will become active participants in the care of post-operative cardiothoracic surgery patients and patients with mechanical circulatory support, including temporary ventricular assist devices and extracorporeal membrane oxygenation. Fellows will develop an appreciation of the multi-disciplinary decision-making that goes into the care of these patients.

This two-week elective rotation serves to help the fellow gain a better understanding of the role of the perfusionist and the important details of the cardiopulmonary bypass machine. Fellows will be paired each day with a perfusionist and assist in setting up the pump and conducting the cardiopulmonary bypass run.

Fellows will spend one month at IU Health University Hospital (approximately 10 minutes away from Methodist Hospital) for the thoracic anesthesia rotation. Fellows will be exposed to the management of patients undergoing open and thoracoscopic surgery, including lung resection and esophagectomy. Fellows will also practice regional and neuraxial pain management techniques appropriate for these cases.

This two-week elective will give fellows the opportunity to both perform and interpret transthoracic echo under the supervision and guidance of professional sonographers and the adult echocardiography cardiologists. The goal of the rotation will be to improve fellows’ ability to obtain high quality transthoracic images for diagnosis of cardiac pathology.

Benefits

  • Continuing medical education fund of $2,000 to be used on educational programs, textbooks and conferences

  • Society of Cardiovascular Anesthesiologists annual membership

  • Quiet, locked office space and computer

  • Weekend moonlighting opportunities staffing general operating rooms at Methodist Hospital

Find details about employment terms and benefits through the Office of Graduate Medical Education

Life in Indianapolis

monument circle and indianapolis downtown at twilight

The anesthesia programs are in the heart of downtown Indianapolis. Indianapolis is a fantastic city in which to live, offering our fellows and their families much to explore and enjoy. The city itself is well-ranked as a great place to live and the Indianapolis suburbs frequently hold spots in the top ten best places to live in the US with low cost-of-living, superb public education and many parks and recreation activities available.

Whatever your interest, Indianapolis has something for you. If you are a sports fan, you can experience one of the largest single-day sporting events in the world at the Indy 500 or cheer on one of the professional sports teams including the Indianapolis Colts NFL team, Indiana Pacers NBA team, Indiana Fever WNBA team, Indy Eleven soccer team, Indianapolis Indians minor league baseball team or Indy Fuel hockey team.

The city is proud to have the largest children's museum in the world and have other fantastic museums and activities including the Indianapolis Zoo, NCAA Hall of Champions, Conner Prairie interactive history park and Newfields art museum and nature park.

If you are a music fan the city has everything from national headliners to free concerts. Indianapolis also offers outdoor recreation including many parks, running and biking trails and kayaking. Learn more about our city from Visit Indy.

Application Information

The Adult Cardiothoracic Anesthesiology Fellowship program will accept applications and extend interview invitations through the San Francisco Match. Please see sfmatch.org for details.

Candidates must be board-eligible or board-certified by the American Board of Anesthesiology prior to the start of fellowship.

Program Leadership

Fellowship Program Director
40161-Becher, Edwin

Edwin L. Becher, MD

Assistant Professor of Clinical Anesthesia

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Fellowship Program Coordinator

Serena Mahoney

Department of Anesthesia
Indiana University School of Medicine
1130 West Michigan Street
Fesler Hall Room 204
Indianapolis, Indiana 46202
317-274-4343 Phone
317-274-0256 Fax
semmitch@iu.edu

Program Faculty

Fellowship Assistant Program Director
50462-Cohen, Zachary

Zachary R. Cohen, MD

Assistant Professor of Clinical Anesthesia

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Megan E. Carmony, MD

Assistant Professor of Clinical Anesthesia

Makoto Kataoka, MD

Assistant Professor of Clinical Anesthesia

Alex Service, MD

Assistant Professor of Clinical Anesthesia

Brian C. Shin, MD

Assistant Professor of Clinical Anesthesia

Nuo Yang, MD, PhD

Assistant Professor of Clinical Anesthesia