About the Program

Our goal is to be the one of the top academic cardiothoracic surgical training programs in the region and among the top programs in the nation. In order to accomplish this goal, we have assembled a highly skilled and committed faculty to support the three key areas of the educational mission at The Ohio State University — patient care, education and research.

Dr. Robert Merritt, has assumed responsibility for the fellowship training program. In partnership with the outstanding faculty at The Ohio State University Wexner Medical Center, including Dr. Mark Galantowicz, Chairman of the Department of Cardiothoracic Surgery at the Nationwide Children’s Hospital, this program is positioned to take a leadership role in cardiothoracic surgical education of the future.

Program Specifics

The program accepts two fellows each year in categorical positions for a two year fellowship training program. Fellows rotate on the thoracic surgical service, the adult cardiac surgery service at the Ross Heart Hospital and the congenital heart service at Nationwide Children’s Hospital.

Fellows enter the program in July and will spend six months on thoracic surgery rotations and six months on adult and congenital heart surgery rotations in the first year. During the second year, each fellow will serve as a leader of the cardiothoracic surgery service and be responsible for directing the service and delegating responsibilities for patient care and operative coverage. This includes the responsibility for directing multi-disciplinary rounds with physician assistants, nurse practitioners, surgical associates, fellows and medical students.

At the completion of the second year it is our expectation that fellows will be competent to perform both routine and complex surgical procedures including adult coronary revascularization, routine and complex valve procedures, complex aortic reconstruction, open and minimally invasive thoracic lung resections, esophageal surgery for benign and malignant disease, chest wall resections and reconstruction and have exposure to minimally invasive percutaneous valve procedures, mechanical circulatory support and heart transplantation.

Goals and Objectives


The goal of this training program is to prepare physicians to function as well-qualified, independent specialists in cardiothoracic (CT) surgery. The faculty is committed to the education of the CT fellow in basic science and clinical surgery as it relates to cardiothoracic surgery. We hope to instill in our trainees with the essential elements of success for a career in cardiothoracic surgery including honesty and integrity, objectivity, self-motivation, curiosity, timeliness and a sense of responsibility.

The cardiothoracic surgery fellowship encompasses adult and pediatric cardiothoracic surgery. Objectives of this surgical specialty include the mastery of cardiac and thoracic procedures such as bronchoscopy, thoracotomy, pulmonary resection, pericardiocentesis, coronary bypass, valve repair and replacement, thoracic transplantation and pediatric cardiac surgery. The fellow is expected to demonstrate competent surgical skills to the faculty. Through graded progression over the course of training, the CT fellow will assume more responsibility for critical portions of operative procedures. He or she will be exposed to diagnostic tests appropriate to each condition and will develop an appreciation for the interpretation of these tests including echocardiography, nuclear scans and pulmonary function tests.

Through repetitive exposure to the decision-making process regarding critical care and operative therapy versus medical therapy, it is expected that the CT fellow will develop an understanding of clinical situations to create therapeutic plans and management strategies for his or her own patients. He or she should display a facility in oral and written communication, and will be responsible for maintaining a smoothly functioning service with attendings, general surgery fellows, nursing staff and secretarial staff.

Goals and objectives for each year and rotation

Goals and objectives for each year and rotation

The training program will follow the Thoracic Surgery Directors Association (TSDA) core curriculum guidelines and didactic education will occur on a scheduled weekly basis. The specific year objectives to implement the curriculum goals for the adult cardiac surgery rotation, the adult thoracic surgery rotation and the pediatric cardiothoracic surgery rotation are described in the sections below.

Curriculum Goals

To achieve the stated program goals, the following curriculum goals have been established:
  • Provide learning experiences based on measurable objectives for education of cardiothoracic surgeons during the fellowship
  • Integrate principles of basic sciences with clinical experiences
  • Promote a broad understanding of the role of surgery and its interaction with other medical disciplines such as general medicine, cardiology and pediatrics
  • Provide progressive responsibility from initial patient care to complete patient management
  • Foster effective interdisciplinary collaborative relationships
  • Provide CT fellows with the ability to function as teachers and consultants
  • Foster continuing education to promote lifelong individual initiative and creative scholarship
  • Prepare CT fellows to use research technology and skills in conducting studies that assist in solving surgical problems
  • Develop professional leadership and management skills
  • Promote understanding of the economic, legal and social challenges of contemporary and future surgery

Skills Acquired

At the completion of the program, the CT fellow will be expected to demonstrate competence in:

  • Evaluation of surgical patients including appropriate and cost-effective use of diagnostic examination
  • Definition and documentation of an optimal therapeutic plan and implementation of appropriate therapy
  • Knowledge of current surgical literature and progress, and appropriate application to patient care
  • Facility in written and oral communication in case presentations, medical records, orders and manuscripts
  • Up-to-date completion of all duties related to medical records
  • A humane and considerate approach to patients and family members
  • Establishment of good interpersonal relationships with medical and paramedical professionals

Special Competencies

Since July, 2001, the ACGME requires that all surgical specialties include instruction and assessment of CT fellows in six “ACGME Competencies.” CT fellows must demonstrate and be evaluated on the following competencies:

  • Patient care that is compassionate, appropriate and effective for the treatment of health problems and the promotion of health
  • Medical knowledge about established and evolving biomedical, clinical and cognitive (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care
  • Practice-based learning and improvement that involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence and improvements in patient care
  • Interpersonal and communication skills that result in effective information exchange and teaming with patients, their families and other health professionals
  • Professionalism as manifested through a commitment to carry out professional responsibilities, adherence to ethical principles and sensitivity to a diverse patient population
  • Systems-based practice as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value

All programs reviewed by the RRC will have to demonstrate that they are teaching the six competencies and that they are also assessing fellow achievement of these competencies.

Adult cardiac surgery rotation

Adult cardiac surgery rotation

The adult cardiac service component of the CT Surgery Fellowship program comprises the bulk of the time spent in the training program (one full year). The fellowship program starts a fellow every six months and the first rotation for the starting fellow is the adult cardiac service. The fellow who is finishing the program is also on the adult cardiac service and is the chief fellow of the service. The six-month stagger start for the program allows every Fellow to have this valuable experience.

The chief fellow is responsible for organizing the fellow component of teaching conference as well as creating the on-call schedule. He or she is also responsible for leading rounds both in the morning and evening and assigning residents for the operating room, outpatient clinics and coverage for transplantation.

All fellows participate in twice-daily rounds on the service. They will coordinate the care of the patient from admission to discharge with the attending physician, consulting physicians, physician assistants and nurses.

Competency-based performance objectives:

Junior Level Performance Objectives

1. Perform preoperative evaluation, history and physical examination of cardiac surgery patients

2. Obtain and interpret indicated diagnostic studies

3. Discuss diagnostic and therapeutic approaches to specific acquired and adult congenital cardiac diseases with the attending physicians

4. Perform and assist with selected cardiac cases, such as:

  • Pacemaker and defibrillator insertions
  • Saphenous vein harvest and wound closure for coronary bypass operations
  • Valve and coronary operations
  • Pericardial drainage operations
  • Tracheostomy
  • Minor vascular repairs
  • Cardiectomy for donor heart procurement

5. Provide postoperative cardiac surgery follow-up care for the following cases:

  • Coronary surgery
  • Valve surgery
  • Thoracic aortic surgery
  • Pacemaker and defibrillator placement
  • Congestive heart failure surgery

6. Perform percutaneous insertion of chest tubes and intravenous, intra-arterial and pulmonary artery catheters with supervision

Senior Level Performance Objectives

1. Serve as first assistant or surgeon on selected major cardiothoracic cases, including:

  • Coronary artery bypass surgery, minimally invasive off-pump and direct coronary artery bypass
  • Valvular replacements and repairs, including minimally invasive procedures
  • Thoracic aortic surgery
  • Adult congenital cardiac surgery
  • Complex defibrillators
  • Emergency thoracotomies
  • Congestive heart failure surgery, including surgical ventricular restoration, myoblast transplant and heart transplantation

2. Perform cardiac procedures under supervision, including:

  • Insert intra-aortic balloon pump
  • Pacemaker implantation
  • Median sternotomy incision
  • Aortic cannulation for cardiopulmonary bypass
  • Saphenous vein and internal thoracic artery harvest
  • Perform proximal and distal coronary anastomoses
  • Repair of vascular trauma
  • Graft replacement of aorta

3. Coordinate the work-up of emergency cardiac surgery cases with:

  • Emergency room or trauma team
  • Cardiac catheterization laboratory
  • Diagnostic imaging services
  • Laboratory (including blood bank)
  • Anesthesia
  • Operating room
  • Perfusion services

4. Perform and assist, under supervision, with emergency cardiac surgery including trauma cases

5. Recognize and prescribe treatment for complications of cardiac surgery such as:

  • Gastrointestinal bleeding
  • Cerebrovascular accident
  • Endocrine abnormalities
  • Pulmonary complications
  • Renal dysfunction
  • Coagulopathy
  • Dysrhythmias
  • Low cardiac output status
Adult thoracic surgery rotation

Adult thoracic surgery rotation

The general thoracic surgery component of the two-year CT surgery fellowship at The Ohio State University is concentrated in a six-month block. The fellow functions as the senior fellow on the thoracic surgery service during the rotations and has full responsibility for postoperative care and consultative services. The fellow participates in preoperative evaluation with the attending faculty and is involved with operative planning.

The structure of the six-month rotations includes participation in the outpatient setting as well as the operating room.

Competency-based performance objectives:

Junior Level Performance Objectives

1. Evaluation, diagnostic planning and assessment for operative approach of the patient with pulmonary, esophageal or mediastinal pathology

2. Develop necessary endoscopic skills, including flexible and rigid endoscopy for diagnostic esophagoscopy and bronchoscopy

3. Manage routine postoperative management of the thoracotomy, pulmonary resection and esophageal resection patient

4. Perform thoracotomy from multiple approaches and with different techniques

5. Perform minor procedures such as:

  • Lung biopsy
  • Wedge resection
  • Pleural biopsy
  • Decortications
  • Pleurodesis
  • Thymectomy

Senior Level Performance Objectives

1. Demonstrate proficiency in:

  • Fiber optic endoscopy
  • Rigid endoscopy
  • Mediastinoscopy
  • Endoscopic intervention with photodynamic therapy and stent placement

2. Demonstrate expertise with thoracoscopy and approaches to the mediastinum and pleural spaces

3. Manage lung volume reduction and lung transplant patients

4. Conduct a full range of major thoracic procedures including:

  • Lobectomy
  • Pneumonectomy
  • Sleeve resection
  • Tracheal resection
  • Pulmonary resection
  • Esophageal resection
  • Mediastinal resection
  • Lung volume reduction
  • Lung transplantation

5. Conduct surgeries for esophageal reflux and achalasia. Most of these procedures are minimally invasive surgeries. Some procedures are conducted as a collaborative effort between the Division of Cardiothoracic Surgery and the Division of General Surgery. The collaborative procedures include surgery for reflux disease requiring thoracotomy, paraesophageal hernia and achalasia.

OSU pediatric cardiothoracic surgery: children’s hospital rotation

OSU pediatric cardiothoracic surgery: children’s hospital rotation

During the two, three-month rotations at Nationwide Children’s Hospital, the CT surgery fellow is the senior house officer involved in the multidisciplinary approach to patient management. There are two weekly management conferences: a two-hour surgical conference on Wednesdays and a two-hour catheterization conference held on Fridays. Attendance is mandatory.

Both the CT surgery fellow and cardiology fellow will have a more significant level of responsibility for patient management under supervision from the attending CT surgeons and cardiac intensivists.

Competency-based performance objectives:

Junior Level Performance Objectives

1. Discuss the following conditions, then choose and justify the appropriate diagnostic and therapeutic modalities:

  • Pectus excavatum
  • Congenital lobar emphysema
  • Esophageal or bronchial duplication cyst
  • Post pneumonic emphysema

2. Identify indications for the following therapeutic modalities, and then justify/critique their use:

  • Extracorporeal membrane oxygenation
  • High frequency jet ventilation

3. Discuss postoperative management including the monitoring, prevention and therapeutic intervention of:

  • Low cardiac output
    • Hypovolemia
    • Myocardial depression
    • Common postoperative arrhythmias
  •  Postoperative bleeding
  •  Postoperative hypertension

4. Manage general thoracic perioperative procedures

5. Use, set and regulate mechanical ventilators

6. Observe and:

  • Insert chest tubes and pig tail catheters
  • Perform thoracentesis
  • Insert central venous access lines

7. Perform selected cardiac and general surgery cases, such as:

  • Pacemaker and defibrillator insertions
  • Straightforward cardiac repairs
    • Atrial septal defect
    • Ventricular septal defect
    • Coarctation of aorta
    • Patent ductus arteriosus
    • Minor vascular repairs

Senior Level Performance Objectives

1. Discuss the pathophysiology and surgical management of congenital cardiac disease, including:

  • Coarctation of the aorta
  • Patent ductus arteriosus
  • Atrial septal defects
  • Ventricular septal defects
  • Complex cyanotic cardiac disease
    • Transportation of great vessels
    • Tetralogy of Fallot
    • Pulmonary atresia
    • Atrioventricular septal defect
    • Total anomalous venous return
    • Hypoplastic left heart syndrome

2. Demonstrate working knowledge and use of the following:

  • Temporary and permanent pacemakers
  • Dialysis and ultrafiltration
  • Cardiopulmonary bypass and extracorporeal membrane oxygenation

3. Perform and/or supervise pacemaker/defibrillator selection and placement

4. Serve as first assistant and surgeon on selected major cardiothoracic cases, including:

  • Valvular replacements and repairs, including minimally invasive procedures
  • All types of congenital cardiac surgery

5. Perform cardiac procedures under supervision, including the following:

  • Median sternotomy incision
  • Aortic cannulation for cardiopulmonary bypass
  • Patent ductus arteriosus

Fellow Roles and Responsibilities

Surgical conference

The CT surgery fellow runs the surgical conference. In the surgical conference:

1. All cases performed in the prior seven days are reviewed for surgical correlation and management issues
2. All cases scheduled for surgery in the next seven days are presented

The CT surgery fellow presents the history and physical findings as well as the EKG and ECHO findings. The latter are done in conjunction with the cardiology fellow. The CT surgery fellow presents the catheterization physiologic data and the cardiology fellow presents the cineangiography. Thus the CT surgery fellow always has intimate prior knowledge of every case operated with the possible exception of emergencies, almost all of which will have been presented as add-ons at one or the other conference. Since the fellow is present in virtually every procedure, this gives excellent continuity of experience from first presentation through the surgical procedure.

The monthly Heart Center Mortality and Morbidity Conference at Nationwide Children’s Hospital is a multidisciplinary quality assurance conference that includes extensive pathology input and compliments the monthly Mortality and Morbidity Conference held at Ohio State in the Division of Cardiothoracic Surgery.

Experience in the operating room

In the operating room, graded responsibility is afforded to the fellow based on his or her level of training and ability. Because more than 25 percent of our patients are under 30 days of age and greater than 50 percent are less than one year of age, actual operative experience as the primary surgeon is limited compared to the adult rotation. Also, the Heart Center at Nationwide Children’s Hospital has a comprehensive interventional catherization laboratory where many of the simpler congenital heart lesions are managed with nonoperative stents or devices, e.g. atrial septal defect device closure. However, there remains enough other operative volume to meet the requirements as outlined by the ABTS. The fellow is the first assistant on nearly all other cases. From this vantage point, attention is paid to his or her exposure to the anatomy, physiology and conduct of the operation for all forms of complex congenital heart disease. Special attention is paid to common anatomic variations, which might confront an adult cardiac surgeon with instruction in the necessary cannulation options and perfusion strategies.

Experience in the intensive care unit

In the intensive care unit, the patient is managed by a team that includes surgery attendings and residents, intensive care cardiologists and pediatric intensive care specialists. The CT surgery fellow is expected to be at the bedside of any unstable patient, along with the attending physicians. Discussion is frequently vigorous, and in any given rotation there will be considerable exposure to almost every normal and abnormal form of cardiovascular physiology and pathophysiology. The fellow presents a summary of the post-operative course of all patients each week at the surgical conference.


Current Cardiothoracic Surgery Fellows

Current Cardiothoracic Surgery Fellows

Ronald Figura, MD

MD: St. George's University School of Medicine, Grenada, West Indies, 2011
Specialty training: General Surgery Residency, Spartanburg Regional Medical Center, Spartanburg, NC, 2016
Appointment: 2016

Tariq Lescouflair, MD

MD: University of Connecticut, Farmington, CT, 2011
Specialty training: General Surgery Residency, University of Connecticut, Farmington, CT, 2016
Appointment: 2016

Vincent Nardy, DO

DO: Lake Erie College of Osteopathic Medicine, Erie, PA, 2011
Specialty training: General Surgery Residency, OhioHealth Doctors Hospital and Grant Medical Center, 2016
Appointment: 2016

Madonna Lee, MD

MD: Michigan State University College of Medicine
Surgery Residency: Rutgers- Robert Wood Johnson Medical School
Appointment: 2017

Daniel Mansour, MD

MD: Howard University College of Medicine
Surgery Residency: University of Maryland
Appointment: 2017

Application Process

The Ohio State Cardiothoracic Surgery training program accepts online applications through the Electronic Residency Application Service (ERAS) of the Association for American Medical Colleges (AAMC). When applying online, please include our 10-digit program code for FREIDA: 460-38-21-077.

For standard application forms, contact:

National Resident Matching Program
2450 N Street NW
Washington, DC 20037-1127
Phone: 202-828-0566
Fax: 202-828-4797

For more information about the program contact:

Juan A. Crestanello, MD
Program Director
Juan.crestanello@osumc.edu

Corey Ferguson
Program Coordinator
Corey.ferguson@osumc.edu 

Address:
Cardiothoracic Surgery
c/o Corey Ferguson
N846 Doan Hall
410 W. 10th Ave.
Columbus, OH 43210
Phone: 614-293-0333

Resident candidate interview information

Please utilize ERAS/MATCH system to apply for the program year beginning July 2018.

More details coming soon.

Interview location:
The Ohio State University Wexner Medical Center
N846 Doan Hall
410 W. 10th Ave.
Columbus, OH 43210

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