Minimally Invasive Thoracic Surgical Fellowship Curriculum

The goal of the minimally invasive thoracic surgical fellowship program would be to expose the fellow to the various aspects of the evaluation, multi-disciplinary treatment, surgical techniques and post-operative care of patients with thoracic malignancies including lung cancer, esophageal cancer, mesothelioma and thymoma. There will be an emphasis on minimally invasive surgical techniques: robotic surgery, advanced thoracoscopy, endobronchial ultrasound, navigational bronchoscopy and laser ablations. 

To achieve this goal, the fellow will have the following rotations:

• Thoracic Surgery (9 months)
• Radiation Oncology (1 month)
• Medical Oncology (1 month)
• Clinical Research (1 month) 

The objectives of the rotations are as follows:

• Thoracic Surgery: During the nine-month rotation with the four surgeons, the fellow will gain gradual autonomy and must be able to demonstrate to faculty his/her ability to perform independently and safely the following procedures: robotic lung and esophageal resections, advanced thoracoscopy, tracheal resections, extra-pleural pneumonectomies, chest wall resections and reconstructions, various approaches to a Pancoast tumor, navigational bronchoscopy, endobronchial ultrasound and laser ablations. Furthermore, the fellow must be able to teach and lead a junior surgical resident safely through basic cases.
• Radiation oncology: The rotation would be spent with the thoracic and GI radiation oncologists to gain familiarity with indications, contour planning, and management of side effects of radiation therapy for both lung and esophageal cancer. In particular, there would be exposure to the technique of stereotactic body radiation (SBRT) for early-stage lung cancer.
• Medical oncology: The rotation would be split between outpatient thoracic and GI (esophagus) medical oncology clinics to allow the fellow to learn indications for chemotherapy, rationale for choice of agents, the importance of genetic-based treatments, immune-therapies and a better understanding of clinical trials.  
• Clinical research: The fellow will have as an objective to have completed a minimum of two publications in peer-reviewed journals
• Overall, by the end of the 12 months, aside from technical skills, the fellow is expected to demonstrate the following abilities: to work-up appropriately and cost-effectively patients presenting with complex thoracic malignancies; to lead effectively all the members of the thoracic team including colleagues and staff; to master the intricacies of building a loyal referral base and managing a profitable practice; to understand basic hospital/departmental administration.   

Didactic sessions will include on a weekly basis:

Wednesday: Multi-disciplinary Thoracic Tumor Board (2h)

Friday: Thoracic Conference (1h) 

• Week 1: Morbidity and mortality
• Week 2: Journal club
• Week 3: Invited speaker - various specialties
• Week 4: Clinical research project update

Furthermore, the fellow will be integrated into our existing annual thoracic surgery visiting professor and our quarterly Tampa Bay Thoracic Club meetings.