The Adult Cardiothoracic Anesthesiology (ACTA) Fellowship is a one-year clinical training program designed to prepare graduates for leadership positions in the subspecialty practice of cardiothoracic anesthesiology. This fellowship provides state-of-the-art training and experience in a multidisciplinary academic environment in the field of cardiothoracic anesthesiology, aiming to develop competence in:
- Patient care
- Medical knowledge
- Procedural skills (invasive monitoring and transesophageal echocardiography)
- Practice-based learning and quality improvement
- Interpersonal and communication skills
- Professionalism
- Systems-based practice
The fellowship program offers six Accreditation Council for Graduate Medical Education (ACGME) accredited positions each year to qualified applicants. Completion of the fellowship program curriculum fulfills the minimum program requirements specified by the ACGME.
Graduates will also meet the eligibility requirements for:
The majority of the year is spent with clinical instruction in the cardiothoracic operating rooms at one of our two clinical sites, the Pavilion (primary clinical site) or Penn Presbyterian Medical Center (PPMC). The same group of Cardiac Anesthesia faculty care for patients at both sites, which are ~1 mile apart. Fellows are exposed to the comprehensive perioperative anesthetic care including pre-operative planning, intraoperative care and postoperative management in the intensive care unit. Intraoperatively, the fellows are exposed to all facets of anesthetic management, including training in perioperative transesophageal echocardiography. Echocardiography training includes didactic instruction and direct experience in the performance, interpretation, and reporting of comprehensive transesophageal echocardiographic examinations. In addition, fellows will work with faculty in supervising and educating Anesthesiology residents during their cardiothoracic anesthesiology rotation. At PPMC, fellows have exposure to working within an anesthesia-care team model consisting of physicians and CRNAs.
The intraoperative experience is supplemented with a one-month clinical rotation in the Cardiothoracic Surgical Intensive Care Unit at the Pavilion, which is staffed by Cardiac and Critical Care faculty from our department of Anesthesiology and Critical Care. The CT-SICU is a multidisciplinary unit where fellows will work with Penn surgical residents, critical care medicine fellows, cardiology fellows, and nurse practitioners in the postoperative management of the cardiothoracic surgical patients. Fellows will also be exposed to the use of bedside trans-thoracic and trans-esophageal echocardiography for diagnostic and rescue purposes.
Fellows also receive eight weeks of elective time in which they can pursue any number of electives including, but not limited to cardiac surgery, perfusion, trans-thoracic echocardiography, interventional cardiology, electrophysiology, pediatric cardiac surgery, blood bank, and research. Fellows can tailor their education and exposure, as there are no required electives.
Penn ACTA Fellowship Timeline:
| Rotation |
Duration |
| Cardiac Anesthesia ORs |
7 Months |
| Thoracic Anesthesia |
1 Month |
| CT-ICU |
1 Month |
| Elective Time |
2 Months |
| Vacation |
4 Weeks |
Clinical Caseload and Case Variety
Clinical Caseload:
Division of Cardiovascular Surgery
- Approximate Cardiac Procedures per Year: 3,000 (Pavilion and PPMC)
- Non-cardiac Thoracic cases per year: 1,400 (Pavilion and PPMC)
- Heart or Lung Transplants per year: >100
- Thoracic Aortic Operations with Deep Hypothermic Circulatory Arrest per year: >250
- Est. Distribution of Cardiac Cases: 25% CABG, 50% Valves, 5% Congenital, 20% Thoracic aorta and other
- TEE examinations per fellow per year: ~350-400
Case Variety:
- Coronary Revascularization – On Pump, Off Pump, Minimally Invasive/Robotic
- Cardiac Valve Repair and Replacement including Minimally Invasive, Robotic
- Thoracic Aortic Operations
- Heart and/or Lung Transplantation
- Heart Failure – mechanical ventricular assist (durable and temporary)
- Hypertrophic Cardiomyopathy Treatment – septal myectomy
- ECMO – VA, VV, VAV, etc
- Endovascular Aortic Repair
- Adult Congenital Heart Disease
- Pediatric Congenital Heart Disease (CHOP elective)
- Non-Cardiac Thoracic Surgery
- Electrophysiology – cardiac implantable electric devices, atrial and/or ventricular ablations
- Surgical Ablation – MAZE, Convergent, Robotic/Minimally invasive ablation
- Interventional Cardiology – complex coronary, transcatheter structural heart interventions
- Transcatheter Valve Implantation – aortic, mitral, pulmonary or tricuspid
Education and Scholarly Activities
Didactics and Conferences
- Summer Echo Boot Camp – 2 month, intense intro to echocardiography
- Weekly Lectures Series
- Monday –non-echo based topics critical to cardiac anesthesia, follows ACGME content outline and ABA Adult Cardiac Anesthesia syllabus
- Wednesday – Echocardiography-based lecture series, hands-on workshops
- Spring Echo Board Review Course – April-June
- Weekly Anesthesia and Critical Care Departmental Grand Rounds
- Weekly Cardiac Surgery Morbidity & Mortality Conference
- Weekly CVCT Conference – cardiology/cardiac surgery/cardiac anesthesia conference
- Monthly Cardiac Anesthesia QI Conference
Investigation is an important element of the fellowship experience for those planning careers in academic practice. Participation in clinical or laboratory research is encouraged. Academic time and support is provided to fellows based on their individual career pathway and area of investigation. For those dedicated to pursuing an academic career, the department offers several subspecialty academic career development training tracks (see below). For more details, visit the faculty page and research section.
Subspecialty Academic Development Tracks
In addition to the traditional one-year clinical fellowship, candidates have the option of entering one of several academic development tracks offered by the Department of Anesthesiology and Critical Care.
- The combined Critical Care Medicine and Cardiothoracic Anesthesiology track is a two-year program for achieving board certification in both Adult Cardiothoracic Anesthesiology and Critical Care Medicine with an emphasis in Cardiothoracic Surgical Critical Care. Elective time is provided in order to pursue collaborative research with division faculty members.
- There are additional pathways available for those interested in making clinical or basic science research a significant portion of their future career, including an NIH-funded T32 position. If one of these options interests you, please reach out to the program director for more information.
Cardiac Anesthesia/Critical Care Faculty
| Name |
Clinical Areas* |
| Lourdes Al Ghofaily, MD |
Cardiac Anesthesia
|
| John Augoustides, MD, FASE, FAHA |
Cardiac Anesthesia, Critical Care |
| Alessandra Ilaria Cardi, MD |
Cardiac Anesthesia, Critical Care |
| Navdeep K. Chahal, MD |
Cardiac Anesthesia |
| Joseph Anthony Colao, MD |
Cardiac Anesthesia |
| Holly Elizabeth Corkill, MD |
Cardiac Anesthesia |
| Jared Feinman, MD |
Cardiac Anesthesia |
| Emily Gordon, MD |
Cardiac Anesthesia, Critical Care |
| Jacob Gutsche, MD |
Cardiac Anesthesia, Critical Care |
| C. William Hanson, MD |
Cardiac Anesthesia, Critical Care |
| Jiri Horak, MD |
Cardiac Anesthesia, Critical Care |
| Zev Noah Kornfield, MD |
Cardiac Anesthesia, Critical Care |
| Jeremy Kukafka, MD |
Cardiac Anesthesia |
| Regina E. Linganna, MD |
Cardiac Anesthesia |
| Tal Mandelbaum, MD |
Cardiac Anesthesia, Critical Care |
| Bonnie Milas, MD |
Cardiac Anesthesia, Critical Care |
| E. Andrew Ochroch, MD |
Thoracic Anesthesia |
| Saumil Patel, MD |
Cardiac Anesthesia |
| Stuart M. Sacks, MD |
Cardiac Anesthesia |
| Joseph S. Savino, MD |
Cardiac Anesthesia, Critical Care |
| Ronak Shah, MD |
Cardiac Anesthesia |
| Audrey Spelde, MD |
Cardiac Anesthesia, Critical Care |
| Sherry Y. Tang, MD |
Cardiac Anesthesia, Critical Care |
| Nabil K. Thalji, MD, PhD |
Cardiac Anesthesia |
| Asad Usman, MD |
Cardiac Anesthesia, Critical Care |
| William J Vernick, MD |
Cardiac Anesthesia |
| Kelvin Wang, MD |
Cardiac Anesthesia |
| Stuart J. Weiss, MD, PhD |
Cardiac Anesthesia, Critical Care |
| Elizabeth Zhou, MD |
Cardiac Anesthesia |
*A: Adult cardiac; P: Pediatric cardiac (at CHOP); T: Thoracic; ICU: Cardiothoracic intensive care; TEE: Transesophageal echocardiography
Fellowship Application Process
The fellowship program begins on July 1 of each year. Fellow candidates are selected in June to start the following July. Applications are accepted for the following year starting on January 1st with an application deadline of March 31st of the year before the fellowship start date. Interviews are required and conducted from January through May each year.
Our fellowship participates in the SF Matching program. The match takes place in early June and will be used to process all applicants. To be considered for a position in our fellowship, you must register and submit your application through the SF Match, sfmatch.org.
If applying for the Combined Critical Care Medicine and Adult Cardiothoracic Anesthesiology track (2-year program), please register for both Critical Care Medicine and ACTA and indicate that your interest in the combined program in the SF Match website.
Eligibility Requirements
Application
In order to be considered, please submit:
- Registration with SF Match
- Copy of Dean's letter and medical school transcript (supplemental documents)
- In-Training Examination scores (supplemental documents)
Note: For CCM and CT dual fellowship candidates when registering for the SF Match, please register both CT or CCM. Indicate on your application that you are interested in the dual fellowship.
Scan all documents into one PDF and email it to anesadmission@pennmedicine.upenn.edu.
For questions concerning your application or the program, please contact:
Jemilla Slaffey
Fellowship Program Coordinator
Department of Anesthesiology and Critical Care
3400 Spruce Street, 6th Floor Dulles
Philadelphia, PA 19104
Phone: 215-662-7832
Email: anesadmission@pennmedicine.upenn.edu
Program Director
Saumil J. Patel, MD
Program Director, Adult Cardiothoracic Anesthesiology
Associate Professor, Department of Anesthesiology and Critical Care
3400 Spruce Street, 680 Dulles
Philadelphia, PA 19104
Email: Saumil.Patel@Pennmedicine.upenn.edu