Welcome to the Cardiothoracic Fellowship at Rutgers Robert Wood Johnson Medical School.

Medical School: UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey, 1989 Janelle Foroutan, MD Fellowship:UMDNJ-Robert Wood Johnson Medical School, Obstetrics and Gynecology, 2007–2011. This rheumatology fellowship program was reaccredited in 2007 by the Accreditation Council for Graduate Medical Education (ACGME) and was commended for its demonstrated substantial compliance with the ACGME's requirements for graduate medical education without citations. This fellowship has been reaccredited in all subsequent years.

We offer an ACGME accredited 1-year fellowship in Adult Cardiothoracic Anesthesia. The goal of the Rutgers Robert Wood Johnson Medical School Cardiac Anesthesia Fellowship is to provide an academic environment and enough clinical substrate to ensure that the fellow achieves a level of autonomy in delivering anesthetic care for complex cardiac surgery. The program features a flexible curriculum, which includes the following opportunities:

Extensive clinical training in adult cardiac anesthesia is achieved due to our high volume of complex and challenging cardiac cases. As a tertiary center we accept patients from all of NJ. We have an active VAD program where we regularly implant the Heartmate II as a bridge to transplant and as destination therapy. The fellow will also be exposed to the more traditional BIVAD and the Impella. Our surgeons perform minimally invasive aortic and mitral valve surgery utilizing Edwards ThruPort systems. This allows our fellows to learn placement of both coronary sinus and pulmonary artery vent catheters under the guidance of echocardiography. We routinely provide anesthesia for complex aortic repair as well. The fellow will also have ample opportunity to manage patients undergoing conventional open valve surgery and coronary artery bypass grafting. In 2011 we provided anesthesia for over 800 adult cardiac procedures.

Extensive clinical and formal didactic training in transesophageal echocardiography is provided via lectures and clinical training. In addition to performing TEE on all his/her cardiac cases throughout the year the fellow will have a dedicated rotation in echocardiography. This will involve intraoperative examinations and interpretation as well as examinations under the teaching of our cardiology service. Here the fellow will have the opportunity to learn transthoracic echocardiography as well as transesophageal echocardiography. The program is structured so that the fellow will have performed and interpreted the required number of exams to sit for the advanced PTEeXAM given by the National Board of Echocardiography. To date all of our fellows who have taken the exam have passed on the first attempt.

A two-week rotation with the Perfusion Service is offered during which the fellow will have the opportunity to learn basic perfusion techniques and physiology. The fellow will assemble the perfusion circuit and assist the perfusionist in maintaining the patient on cardiopulmonary bypass. This allows the fellow to gain the perspective necessary to collaborate with the perfusionist in order to plan for today’s increasingly complex cardiac surgeries. One day a week during this rotation the fellow will scrub with the surgeon for a case for some closer hands on experience.

The fellow will have a one-month rotation in the cardiac surgical intensive care unit. Here the fellow will participate in the care of the postoperative cardiac surgical patients. This allows the fellow to gain an understanding of potential complications and how our operating room management impacts the patient’s recovery. During this rotation they will also be given the opportunity to join one of our surgeons in his office and see patients coming for preoperative consultation and postoperative follow up.

A one-month rotation on the thoracic anesthesia service is also provided where the fellow will provide anesthesia for complex thoracic patients. The fellow will have ample exposure to double lumen tube placement utilizing fiberoptic bronchoscopy. They will manage one-lung ventilation and have the aopportunity to place thoracic epidurals. During this rotation they will also be given the opportunity to join one of our surgeons in his office and see patients in that area.

Throughout the year the fellow is given the opportunity to provide anesthesia for major vascular cases such as open thoracoabdominal aneurysm repair and thoracic endovascular aneurysm repair.

The fellow will have a two-week rotation with the cardiology service. During this time the fellow will round with the cardiology fellows and the attending cardiologist on the acute inpatient cardiology service. The fellow will have exposure to the management of various cardiac diagnoses including acute MI and post interventional catheterization patients. The fellow is encouraged to observe cardiac catheterization procedures during this time as well.

A total of 4 weeks in the electrophysiology/Cardiac Catheterization suite is also offered. Here the fellow will gain an appreciation for the increasingly complex nature of the procedures performed in this arena. The fellow will spend two weeks providing anesthesia for these procedures and two weeks with the Electrophysiologist.

The fellow will have the opportunity to mentor a resident for his/her case conference presentation at least once per year.

A fellow will also take part in Journal Club once a year.

The fellow will have the opportunity to participate in ongoing clinical research projects conducted within the department.

Antonio Chiricolo, MD

Program Director