University of California (San Diego) Medical Center Program

The ACGME-accredited Cardiothoracic Anesthesia Fellowship at the University of California, San Diego Medical Center is designed to provide comprehensive clinical training and academic expertise in the field of cardiothoracic anesthesiology. This one-year fellowship is well-structured to equip fellows with the technical skills and knowledge necessary to excel in this highly specialized area of anesthesia.

The primary training component consists of a diverse case mix that includes core cardiac procedures such as off-pump coronary artery bypass grafting (CABG), robotic valve replacements, transcatheter aortic valve replacements (TAVR), mitral clips, left ventricular assist devices (LVADs), and heart transplants. Additionally, the program offers specialized training in the perioperative evaluation of chronic thromboembolic pulmonary hypertension and pulmonary thromboendarterectomy, ensuring that fellows gain substantial expertise in complex surgical cases1.

Curriculum Overview

The fellowship involves an extensive curriculum, emphasizing clinical cardiac anesthesia during the first year. To ensure a well-rounded educational experience, rotations include at least six months in the main cardiac operating room, a month in thoracic anesthesia, a month in the cardiac intensive care unit (CICU), and two months focused on transesophageal echocardiography (TEE). Additionally, fellows engage in elective rotations at various institutions, including Children's Hospital, Scripps Memorial Hospital, and the VA San Diego, enabling exposure to different clinical environments while sharing common educational goals2.

Research Opportunities

Fellows are encouraged to participate in both basic science and translational research projects under the mentorship of NIH-funded faculty. A scholarly project is required before graduation, and this often results in publications tailored to the fellow's career aspirations. The research conducted at the cardiovascular physiology laboratory explores various mechanisms related to myocardial ischemia-reperfusion, cardiac remodeling, and the effects of anesthetic agents, presenting fellows with meaningful opportunities for academic contribution1.

Training in Echocardiography

The cardiothoracic anesthesia program emphasizes the importance of echocardiography, offering monthly didactic sessions on TEE and hands-on training with state-of-the-art simulators. This experience is bolstered by a robust transtracheal echocardiography component, vital for mastering both image acquisition and interpretation. The program's faculty consists of board-certified anesthesiologists with formal training in TEE, ensuring that fellows receive instruction from experts in the field2.

Competitiveness and Application Requirements

The fellowship is highly competitive, welcoming applicants from both U.S. and international medical schools. Candidates must have graduated from a four-year ACGME-accredited core anesthesiology residency program and should demonstrate satisfactory residency performance through reference letters and evaluations. Applicants must possess a full and unrestricted medical license in California and should ideally hold ABA board certification. For international medical graduates, a valid ECFMG certificate and proof of permanent residency in the U.S. are required. The program adheres to a non-discrimination policy in the selection process2.

Visa Support

The program offers visa sponsorship for qualified international medical graduates. Candidates seeking a fellowship position while on a visa must ensure they meet all licensing regulations established by the Medical Board of California and comply with federal immigration laws. The specific visa types supported will typically include J-1 and H-1B visas, depending on individual qualifications and departmental requirements.

Unique Aspects of the Program

The fellowship's affiliation with UC San Diego's Sulpizio Cardiovascular Center, which handles over 1,300 cardiothoracic cases annually, enhances the training experience, providing ample exposure to a wide spectrum of cardiac and thoracic surgical procedures. Furthermore, dedicated non-clinical time for scholarly activities such as a quarterly journal club allows fellows to engage in critical discussions with faculty, enriching their learning experience and fostering an academic mindset1.

Overall, the UC San Diego Cardiothoracic Anesthesia Fellowship is committed to developing skilled anesthesiologists through rigorous training, comprehensive research opportunities, and a strong emphasis on echocardiography and procedural competencies.