Thoracic & Cardiovascular Surgical Fellowship

Mission Statement

Our mission is to produce well-rounded, clinically excellent and technically skilled cardiac and thoracic surgeons through commitment to education, scholarship, diversity, inclusion, and safe, high quality patient care. We will improve the health and well-being of Gainesville, Florida and referral area patients and their families by producing physicians who continue to learn and/or lead in whatever setting they choose for their career. 

Surgeon operating on a patient

Program Aims

Prepare residents for American Board of Thoracic Surgery Certification, achieving and maintaining a first time pass rate of 95% or better over.
Develop surgeons who are able to serve as the leader of a multidisciplinary care team to provide cost conscious care of the highest quality.
Provide residents with academic skills that will make them competitive for careers in academic surgery as well as private practice.
Equip residents with the life skills to navigate professional stressors, including the recognition of symptoms of burnout and the development of healthy coping skills.
Produce well-rounded, clinically excellent and technically skilled cardiac and thoracic surgeons via a structured curriculum that provides training in all facets of our specialty:

  • Adult cardiac surgery, including surgery for ischemic heart disease, valvular disease, adult congenital heart disease and re-do operations.
  • Major resections for cancer of the lungs, chest wall and esophagus utilizing all current platforms for open and minimal invasive surgery including VATS and Robotic surgery.
  • Complex aortic surgery, including thoracic aortic aneurysms and aortic dissection using both open and endovascular techniques.
  • Valvular heart surgery including open techniques, MitraClip, minimally invasive mitral valve repair and replacement as well as transcatheter aortic, mitral and tricuspid valve replacement.
  • Surgical treatment of end stage respiratory failure with advanced mechanical ventilator support, extracorporeal membrane oxygenation (ECMO) and orthotopic lung transplantation.
  • Surgical treatment of end stage heart failure with ventricular-assist devices, extracorporeal membrane oxygenation (ECMO) and orthotopic heart transplantation.

Traditional Three-Year Training Pathway

The thoracic and cardiovascular surgical fellowship program at the University of Florida in Gainesville has successfully trained generations of highly skilled surgeons for many decades. Our program has enjoyed uninterrupted American Council of Graduate Medical Education accreditation since September 11, 1961. Alumni from our program have chosen career pathways in academic surgery as well as private practice.

This is a three-year program in which candidates who have completed five years of general surgery training (many with two additional years of dedicated research), receive specialized surgical instruction in the management and treatment of conditions of the cardiovascular and pulmonary systems as well as the foregut.
Our fellows are closely involved in the pre-operative assessment, operation, and post-operative care of all patients on the services to which they are assigned. The operative experience is designed to allow graduated technical responsibility commensurate with increasing skills, judgment and surgical maturity. All residents graduate with an average operative experience of seven hundred cases.

The University of Florida is a high volume, tertiary center that offers a rich academic environment that consists of various teams of specialists committed to the care of routine, complex and end-stage pathology involving adult cardiac, pulmonary and foregut disease as well congenital cardiopulmonary disease. Our affiliate Veterans Affairs Medical Center is the second largest adult cardiac program and highest volume robotic thoracic surgery program in the national VA health system. This intimate and collegial partnership of medical and surgical specialists, combined with high volume, generates a fantastic milieu in which to train fellows in the latest technical advances and most up to date surgical interventions to ensure completeness in training and success in independent practice.

Our program is not designed to commit trainees to a particular pathway (cardiac or thoracic), from the start of the first year. Instead fellows are trained equally in adult cardiac and thoracic in the first two years and allowed to tailor their experience in the third year to master techniques appropriate for their desired career pathway. Our fourteen faculty members, with varied interests in individual areas of expertise are committed to mentoring and academically engaging the fellows throughout the training experience and into independent practice.

Finishing residents have been eligible for UNOS certification in Cardiac Transplantation since 1984 and Pulmonary Transplantation since 1994. The depth and breadth of the complex aortic surgery performed has been a boon to graduating residents as a distinction in the competitive job market.


Integrated Six-Year Training Pathway

The Integrated six-year program offers all of the advantages of the traditional three-year fellowship (please read the description), with the addition of many unique training opportunities. Medical students apply directly to the integrated cardiothoracic surgery residency program, similar to standard applications for other residency programs. The overarching objective of this training program is to provide a more comprehensive and rational total immersion in the diagnosis and management of all aspects of cardiovascular and thoracic diseases through multidisciplinary training, including rotations in interventional radiology, interventional cardiology, endovascular surgery, oncology, and pulmonary disease.

The program is equally divided into three-year portions. This allows an opportunity for an elective academic enrichment period of two years, if the resident wishes.

The first two years are focused on the basic surgical skills and surgical principles with dedicated rotations on core general and vascular surgery services as well as general cardiology and heart failure.

During the second year more experience will be obtained in critical care as well as increased exposure to vascular and cardiac physiology.

During the third year residents become exposed to the cardiothoracic surgery rotations as well as gaining experience with interventional cardiology and endovascular techniques.

During the second three-year period candidates will rotate on adult cardiac, congenital cardiac, and adult thoracic surgical services. The final three years of the residency program are dedicated to mastering the skills and knowledge required to become a well-trained and competent cardiothoracic surgeon.

In the sixth year it is expected that the resident will be able to assume major patient care and intraoperative responsibility in the full range of etiologies and procedures, including the latest techniques, therapies and devices. All finishing residents will have received the necessary training in minimally invasive, transcatheter, endovascular and interventional procedures to advance the specialty into the future.

Throughout the training period a rigorous core curriculum along with a didactic teaching, clinical and academic conferences is woven as an integral part of the training program.


Application Process

Applications are accepted electronically through the Electronic Residency Application Service (ERAS). You must also complete the Association of American Medical Colleges – National Residency Matching Program (AAMC-NRMP) application for residency.

  • Applications are complete when the following information is received through ERAS:
  • Common Application Form (CAF)
  • Personal Statement
  • Medical School Transcript
  • Dean’s Letter
  • Three letters of recommendation.
  • An official copy of your USMLE scores

In addition to the above, students and graduates of foreign medical schools must provide the following verifications:

  • ECFMG Certification
  • J-1 Visa status
  • United States residency status (permanent resident, naturalized citizen, etc)
  • Proof of successful completion of USMLE step I, II, and III
  • In general, international applicants beyond three (3) years from medical school are unlikely to be granted an interview.

Interviews

After careful review by the Selection Committee, applicants will be invited for an interview. If you are offered an interview, you will be contacted by e-mail to select a date for your interview. Please be sure to include your e-mail address as part of your ERAS application. At the earliest decisions related to the offer of an interview will not be made until the first week of November for the I-6 program and the first week of January for the traditional program. Please do not contact the office with inquiries related to application status.

Interviews are typically scheduled in November and December for the for the Integrated Residency and January to March for the Traditional Fellowship.
Interviews are by invitation only.


Conferences

Recurring conferences frequency (weekly, monthly, etc.)
TAVR Conference Weekly
Thoracic and Cardiovascular (TCV) Didactic Training Weekly
Aortic Conference Biweekly
Thoracic – Thoracic Surgery Directors Association (TSDA) Case Conference Biweekly
TCV Morbidity & Mortality Biweekly
TCV Quality Conference Monthly
Cardiac TSDA Monthly
General Surgery SCORE Weekly
General Surgery Skills Laboratory – Simulation Laboratory Weekly
Department of Surgery Grand Rounds Weekly
Department of Surgery Morbidity & Mortality Weekly
Wellness Conference Monthly
TCV Journal Club Monthly
Mock Oral Examinations Biannually

Conferences for our integrated residency and independent fellowship program participants:

TSDA / STS BOOT CAMP

Houston Methodist Cardiovascular Fellow’s Boot Camp

Intermountain Healthcare Cardiovascular and Thoracic Surgery Core Curriculum Review

Local, National and International Society Meetings:

Society of Thoracic Surgeons

American Association of Thoracic Surgeons

International Society for Heart and Lung Transplantation

Southern Thoracic Surgical Association

Florida Society of Thoracic and Cardiovascular Surgeons


Alumni Over the Last Decade

year name employer
2020 Kirsten Freeman, MD UF Health Shands & Gainesville VA Hospital, FL
2019 Juan Gallegos, MD Tallahassee Memorial Hospital, FL
2018 Eric Jeng., MD UF Health Shands, Gainesville, FL
2016 Erol Belli, MD Mayo Clinic Jacksonville, Tampa General
2016 Gio Piovesana, MD Private Practice, GA
2015 Thomas Zeyl, MD Private Practice, TN
2014 Tommy Caranasos, MD University of North Carolina, NC
2014 Ryan Mellor, MD Private Practice Tampa, FL
2013 Junewai Reoma, MD Naval Appointment Bethesda, MD
2012 Paul Tessmann, MD University of Kentucky, KY
2011 Omeni Osian, MD Private Practice, FL
2010 Michael Shillingford, MD UF Health Congenital Heart Center, FL
2010 Chadwick Stouffer, MD Private Practice, GA

Our Current Fellows

SURGERY FELLOW

Tyler Wallace, DO

Tyler Wallen Headshot

SURGERY FELLOW

John Spratt, MD

SURGERY FELLOW

Kristen Walker, MD


Rotation Schedule

Integrated Six-Year Pathway – Year One

Year One
Block 1 2 3 4 5 6 7 8 9 10 11 12
Site UF/Shands UF/Shands UF/Shands UF/Shands UF/Shands UF/Shands UF/Shands UF/Shands UF/Shands UF/Shands UF/Shands UF/Shands
Rotation General Surgery General Surgery Adult SICU Pediatric Surgery Thoracic Surgery Trauma & Acute Care Surgery Trauma & Acute Care Surgery Surgical Oncology Surgical Oncology Burns Transplant Cardiovascular Surgery
%Outpatient 20% 20% 0% 20% 20% 20% 20% 20% 20% 0% 20% 20%
% Research 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%

Integrated Six-Year Pathway – Year Two

YEAR TWO
Block 1 2 3 4 5 6 7 8 9 10 11 12
Site UF/Shands UF/Shands UF/Shands UF/Shands UF/Shands UF/Shands VA VA UF/Shands UF/Shands UF/Shands UF/Shands
Rotation General Surgery General Surgery Flexible Endoscopy Adult SICU Adult SICU Vascular Surgery Vascular Surgery General Surgery General Surgery Thoracic Surgery Thoracic Surgery Cardiovascular Surgery Cardiovascular Surgery
%Outpatient 20% 20% 0% 0% 20% 20% 20% 20% 20% 20% 20% 20%
% Research 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%

Integrated Six-Year Pathway – Year Three

Year Three
Block 1 2 3 4 5 6 7 8 9 10 11 12
Site UF/Shands UF/Shands UF/Shands UF/Shands UF/Shands UF/Shands UF/Shands UF/Shands UF/Shands UF/Shands UF/Shands UF/Shands
Rotation General Surgery MIS Laparoscopy Pediatric Surgery Interventional Cardiology Congenital Cardiac Surgery Endo-Vascular Surgery Endo-Vascular Surgery General Surgery General Thoracic Surgery Thoracic Surgery Cardiovascular Surgery Cardiovascular Surgery
%Outpatient 20% 20% 20% 20% 20% 20% 20% 20% 20% 20% 20% 20%
% Research 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%

Integrated Six-Year Pathway – Year Four

Year Four
Block 1 2 3 4 5 6 7 8 9 10 11 12
Site UF/Shands UF/Shands UF/Shands UF/Shands VA VA UF/Shands UF/Shands UF/Shands UF/Shands UF/Shands UF/Shands
Rotation Congenital Cardiac Surgery Congenital Cardiac Surgery Cardiovascular Surgery Cardiovascular Surgery Thoracic & Cardiac Surgery Thoracic & Cardiac Surgery Adult Cardiac ICU Adult Cardiac ICU Thoracic Surgery Thoracic Surgery Cardiovascular Surgery Cardiovascular Surgery
%Outpatient 20% 20% 20% 20% 20% 20% 0% 0% 20% 20% 20% 20%
% Research 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%

Integrated Six-Year Pathway – Year Five

Year Five
Block 1 2 3 4 5 6 7 8 9 10 11 12
Site UF/Shands UF/Shands VA VA UF/Shands UF/Shands UF/Shands UF/Shands VA UF/Shands UF/Shands UF/Shands
Rotation Congenital Cardiac Surgery Elective Thoracic & Cardiac Surgery Thoracic & Cardiac Surgery Elective Thoracic Surgery Thoracic Surgery Thoracic Surgery Thoracic & Cardiac Surgery Cardiovascular Surgery Cardiovascular Surgery Cardiovascular Surgery
%Outpatient 20% 0% 20% 20% 0% 20% 20% 20% 20% 20% 20% 20%
% Research 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%

Integrated Six-Year Pathway – Year Six

Year six
Block 1 2 3 4 5 6 7 8 9 10 11 12
Site UF/Shands UF/Shands VA VA UF/Shands UF/Shands UF/Shands UF/Shands VA UF/Shands UF/Shands UF/Shands
Rotation Congenital Cardiac Surgery Elective Thoracic & Cardiac Surgery Thoracic & Cardiac Surgery Elective Thoracic Surgery Thoracic Surgery Thoracic Surgery Thoracic & Cardiac Surgery Cardiovascular Surgery Cardiovascular Surgery Cardiovascular Surgery
%Outpatient 20% 0% 20% 20% 0% 20% 20% 20% 20% 20% 20% 20%
% Research 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%

Possible Electives:

  1. Endovascular / Interventional
  2. Minimally invasive adult cardiac
  3. Minimally invasive thoracic
  4. Advanced adult aortic
  5. Adult Esophageal (Gen Surgery & Thoracic Surgery)
  6. Chest / Cardiac Imaging
  7. Research (100%)

Traditional Three-Year Pathway

AUG-19 SEPT-19 OCT-19 NOV-19 DEC-19 JAN-20 FEB-20 MAR-20 APR-20 MAY-20 JUN-20 jul-20
VA Cardiac/Thoracic (VA) 2nd Year 1st Year 3rd Year 3rd Year 3rd Year 1st Year 1st Year 2nd Year 2nd Year 2nd Year 1st Year 1st Year
Shands Cardiac (SC) 3rd Year 3rd Year 2nd Year 2nd Year 1st Year 2nd Year 2nd Year 3rd Year 1st/3rd Year 1st/3rd Year 3rd Year 3rd Year
Shands Thoracic (ST) PGY3 GS PGY3 GS PGY3 GS PGY3 GS PGY3 GS 3rd Year 3rd Year PGY3 GS PGY3 GS PGY3 GS PGY3 GS PGY3 GS
CTICU (ICU) 1st Year –– –– –– –– –– –– –– –– –– –– ––
Congential (CO) –– –– –– –– 2nd Year –– –– 1st Year –– –– –– ––
Elective –– –– –– –– –– –– –– –– 3rd Year (TAVR) 3rd Year (TAVR) 2nd Year 2nd Year
–– –– –– –– –– –– –– –– –– –– –– ––
TCV Fellows Aug-17 Sept-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 Apr-18 May-18 Jun-18 Jul-18
3rd Year (PGY 8) SC SC VA VA VA ST ST SC Elective Elective SC SC
2nd Year (PGY 7) VA ST SC SC CO SC SC VA VA VA Elective Elective
1st Year (PGY 6) ICU VA ST ST SC VA VA CO SC SC VA VA
–– –– –– –– –– –– –– –– –– –– –– ––
Rotation 3rd Year 2nd Year 1st Year PGY3 GS –– –– –– –– –– –– –– ––
VA Cardiac/Thoracic (VA) 3 4 5 0 –– –– –– –– –– –– ––
Shands Cardiac (SC) 5 4 3 0 –– –– –– –– –– –– ––
Shands Thoracic (ST) 2 1 2 10 –– –– –– –– –– –– –– ––
CTICU (ICU) 0 0 1 0 –– –– –– –– –– –– –– ––
Congenital (CO) 0 1 1 0 –– –– –– –– –– –– –– ––
Elective 2 2 0 0 –– –– –– –– –– –– –– ––

Case Log Example

Required cases class 2016 class 2019 class 2020
Congenital Heart 29 22 38
Adult Cardiac 479 398 458
Lungs, Pluera, Chest Wall, Diaphragm, Tracheobronchial 110 107 148
Mediastinum 8 22 10
Esophagus 19 17 14
Video-Assisted Thorascopic Procedure 11 51 56
Bronchoscopy 33 34 34
Endoscopy 21 17 14
Mediastinal Assessment 24 22 23
Total Operative Experience 734 650 748
Other Experience –– ––
Consultative Experience 114 101 85
Multidisciplinary Patient Management Conference 21 26 33
Critical Care Management 79 75 75
Simulation 21 24 24