Robotic Cardiac Surgery Fellowship

The Robotic Cardiac Surgery unaccredited fellowship is a 12 month* training program focused on advanced minimally invasive and robotic cardiac surgical techniques. The fellow will have direct management of patients on the Cardiovascular Surgery Service under the supervision of the attending cardiac surgeons. Duty hours will include weekday nights and weekend days and nights for the Cardiovascular Surgery Service. The fellow must hold a current, unrestricted, or institutional Pennsylvania medical license and have experience in cardiology, cardiac surgery, and/or critical care medicine. The fellow will not maintain independent surgical practice or perform independent elective cardiovascular surgical procedures without direct supervision by the Chief of Cardiovascular Surgery or their designee.

Duration: 12 months (*with an option for a 6-month abbreviated program)

Educational Goals and Objectives:

• Develop skills in the preoperative assessment of patients requiring minimally invasive and robotic cardiac surgical procedures.
• Gain expertise in patient selection and surgical planning specific to robotic cardiac surgery.
• Develop proficiency in the medical management of patients undergoing minimally invasive and robotic cardiac surgical interventions.
• Acquire advanced intraoperative skills and techniques for robotic-assisted cardiac procedures, including mitral valve repair and coronary revascularization.
• Understand the integration of robotic technology into complex adult cardiac surgical cases and hybrid approaches.
• Be responsible for post-operative management of patients who have undergone robotic cardiac surgery, including managing unique recovery pathways associated with minimally invasive techniques.
• Participate in original research related to robotic cardiac surgery, including surgical outcomes and technological advancements.
• Gain exposure to outpatient follow-up and participate in the Robotic Cardiac Surgery Clinic under the supervision of the attending surgeons.
• Participate in the teaching activities of the Department of Surgery and the Division of Cardiothoracic Surgery, including case presentations at the Wednesday Combined Cardiac Surgery/Cardiology Conference when involved in cases.
• Deliver one Professor Rounds talk to junior residents and medical students every two months. These may be didactic sessions in 5 Founders SICU or bedside teaching rounds focused on robotic cardiac surgical patients.

Optional Abbreviated Program - 6 months

The Robotic Cardiac Surgery unaccredited fellowship can be completed as either a 6 month or 12-month training program. Both options maintain the same balance between clinical surgery and clinical research, with the 6-month program structured as follows:

• 60% Clinical Robotic Cardiac Surgery
• 30% Clinical Research (focused on robotic cardiac surgical techniques and outcomes)
• 10% Outpatient Robotic Cardiac Surgery Clinics

The Robotic Cardiac Surgery fellowship’s educational goals and objectives remain the same for both the 6 month and 12-month programs.

On-Call Responsibilities

1. The Robotic Cardiac Surgery Fellow will have weekday nights and weekend days and nights as assigned.
2. The Fellow will make rounds on all patients on the cardiovascular surgery step-down unit under the supervision of the attending surgeons.
3. The Fellow will be available for consultation regarding patients who are candidates for or have undergone robotic cardiac surgery.
4. The Fellow will be immediately available to respond to all calls for assistance from other healthcare providers at the hospital.
5. The Fellow will promptly involve the attending surgeon in any evaluation or management issue requiring attending-level attention.
6. The Fellow will assume a position within the regular in-house on-call schedule for cardiac surgery residents when coverage is needed.

Educational Service

1. The Robotic Cardiac Surgery Fellow will be responsible for attending all 7 am–8 am conferences, including Monday Case Conferences, Tuesday Cardiac Transplant, Wednesday Cardiac Service and Cardiovascular Conferences, Thursday Lung Transplant, and Friday Cardiac Grand Rounds.
2. The Fellow will also be responsible for presenting cases at the Wednesday Combined Cardiac Surgery/Cardiology Conference when involved in robotic cardiac surgical cases.

Outpatient Activity

1. The Robotic Cardiac Surgery Fellow will be expected to gain broad outpatient exposure related to minimally invasive and robotic cardiac procedures.
2. They will attend the Robotic Cardiac Surgery Clinic with the attending surgeons to participate in preoperative evaluations and postoperative follow-up care.
3. They may also attend other outpatient cardiac surgery initiatives as requested by the program director or supervising faculty to gain comprehensive exposure to patient care across the continuum.

Facilities

The majority of the Robotic Cardiac Surgery Fellowship training will take place at Penn Presbyterian Medical Center, with additional clinic and inpatient care occurring within the University of Pennsylvania Health System at the Hospital of the University of Pennsylvania as needed.

Core Competencies

Patient Care

The fellow must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of cardiovascular disease and the promotion of overall cardiac health. The fellow is expected to:

• Communicate effectively and demonstrate caring, respectful behaviors when interacting with patients and their families.
• Gather essential and accurate information about patients undergoing minimally invasive and robotic cardiac surgical procedures.
• Make informed decisions about diagnostic and therapeutic interventions based on patient information, preferences, current scientific evidence, and sound clinical judgment.
• Develop and carry out patient management plans specific to robotic cardiac surgical care.
• Counsel and educate patients and their families regarding robotic surgical options, risks, benefits, and postoperative expectations.
• Use information technology and imaging platforms to support surgical planning, patient care decisions, and education.
• Perform competently all medical and invasive procedures considered essential for robotic cardiac surgery under supervision.
• Provide health care services aimed at preventing cardiac health problems and optimizing outcomes for patients undergoing robotic procedures.
• Collaborate effectively with multidisciplinary teams, including anesthesia, cardiology, nursing, and perfusion staff, to provide patient-focused care.

Medical Knowledge
The fellow must demonstrate a strong understanding of established and evolving biomedical, clinical, and technical sciences, as well as their application to robotic cardiac surgical care. The fellow is expected to:

• Demonstrate an investigatory and analytical approach to clinical situations, particularly those involving minimally invasive and robotic techniques.
• Know and apply the basic sciences, surgical anatomy, and clinically supportive sciences that are essential to robotic cardiac surgery.
• Understand the principles of robotic system operation, instrumentation, and technology integration into cardiac surgical procedures.

Practice-Based Learning and Improvement

The fellow must be able to investigate and evaluate their patient care practices, integrate scientific evidence, and continuously improve outcomes in robotic cardiac surgery. The fellow is expected to:

• Analyze practice experience and perform practice-based improvement activities using a systematic methodology specific to robotic cardiac procedures.
• Locate, appraise, and assimilate evidence from scientific studies related to minimally invasive and robotic cardiac surgery.
• Obtain and use information about their own patient population and compare outcomes to the larger population undergoing robotic cardiac surgical interventions.
• Apply knowledge of study design and statistical methods to evaluate clinical studies and other data on the diagnostic and therapeutic effectiveness of robotic approaches.
• Use information technology, surgical simulation, and imaging systems to manage information, support surgical planning, and enhance education.
• Facilitate the learning of students, residents, and other healthcare professionals, including teaching principles of robotic cardiac surgery.

Interpersonal and Communication Skills

The fellow must demonstrate interpersonal and communication skills that support effective information exchange and collaboration with patients, their families, and the multidisciplinary cardiac surgical team. The fellow is expected to:

• Create and maintain a therapeutic and ethically sound relationship with patients, providing clear explanations of robotic surgical options and procedures.
• Use effective listening skills and communicate clearly using verbal, nonverbal, and written methods to ensure patients and their families understand treatment plans.
• Collaborate and work effectively with the entire robotic cardiac surgery team, including surgeons, anesthesiologists, nursing staff, and perfusionists, serving as a team member or leader as appropriate.

Professionalism

The fellow must demonstrate a commitment to professional responsibilities, ethical principles, and sensitivity to a diverse patient population in the context of robotic cardiac surgery. The fellow is expected to:

• Exhibit respect, compassion, and integrity; prioritize the needs of patients and society above self-interest; maintain accountability to patients, society, and the profession; and commit to excellence and ongoing professional development.
• Adhere to ethical principles in the provision of care, including confidentiality of patient information, informed consent, and appropriate disclosure regarding robotic surgical approaches and risks.
• Demonstrate sensitivity and responsiveness to each patient’s culture, age, gender, and disabilities while providing individualized care in a technologically advanced surgical setting.

Systems-Based Practice

The fellow must demonstrate an understanding of and responsiveness to the broader health care system and be able to effectively utilize system resources to deliver high-value, patient-centered robotic cardiac surgical care. The fellow is expected to:

• Understand how their patient care and professional practices impact other health care professionals, the surgical team, the organization, and the larger health care system, as well as how these elements influence their own practice.
• Recognize differences among medical practice and delivery systems, including approaches to managing health care costs and allocating resources specific to advanced robotic technology.
• Provide cost-effective care and resource utilization in robotic cardiac surgery without compromising quality or patient outcomes.
• Advocate for high-quality, patient-focused care and assist patients in navigating the complexities of the health care system, including access to specialized robotic procedures.
• Collaborate with health care managers, administrators, and multidisciplinary teams to assess, coordinate, and improve surgical care delivery and understand how these activities influence overall system performance.