SCA Fellowship Template

Institution Name:
Website:
Chair / Email:
Cardiothoracic/Cardiovascular Anesthesia Fellowship Director / Email:
Mailing Address:
City:
State/Country:
Zip Code:
Phone:
Fax:
Application Process:
General Program Information Number of Positions Available:
CA-4:
CA-5:
Total CA-4 and CA-5:
Type of Fellowship Training Available:
Clinical only:
Clinical / Basic Research:
Clinical / Clinical Research:
Clinical Research only:
Basic Research only:
Comments: (optional)
Clinical Responsibility: (e.g. Clinical 80% Non-Clinical 20%)
Annual Salary:
Minimum Length of Training:
Number of CA-4/CA-5 Fellows Completing 12-24 Months Cardiothorcic / Cardiovascular Training in Previous 5 Years:
Faculty
	Cardiac Anesthesia Faculty - Research Interest and/or Clinical Expertise
Name 1 / Email:
Expertise:
Name 2 / Email:
Expertise:
Name 3 / Email:
Expertise:
Name 4 / Email:
Expertise:
Name 5 / Email:
Expertise:
Name 6 / Email:
Expertise:
Name 7 / Email:
Expertise:
Name 8 / Email:
Expertise:
Name 9 / Email:
Expertise:
Name 10 / Email:
Expertise:
Name 11 / Email:
Expertise:
Name 12 / Email:
Expertise:
Name 13 / Email:
Expertise:
Name 14 / Email:
Expertise:
Name 15 / Email:
Expertise:
Percent of Cardiac Anesthesia Faculty with NBE Perioperative TEE Certification:		%
Academic Program Fellow Conferences
Frequency:
Type:
Extra-Institutional Educational Conference Support:
In the Previous 5 Years, Fellows were 1st or 2nd Author On:
Abstracts:
Peer-Reviewed Journal Articles:
Book Chapters:
Other Publications:
Other Comments:
Funding:
Dedicated Research Time:
Echocardiography Instruction:
Critical Care Rotation:
Formal Course Work Available in:
Maximum Time in Non-OR Activities:
Clinical Program
Number of Cardiac Procedures with CPB Per Year:
Distribution of cases (e.g. 50% CABG, 20% Valves, 10% Thoracic Aneurysm, 20% Congenital):
Average Number of CPB Procedures Per Trainee Per Year:
Number of Cardiac Procedures off-CPB Per Year:
Distribution of cases (e.g. 65% off-pump CABG, 30% thoracic aneurysm, 5% AICD):
Average Number of off-CPB Procedures Per Trainee Per Year:
Number of Non-Cardiac Thoracic Cases Per Year:
Number of Heart, Lung, and Heart/Lung Transplants Per Year:
Number of Major Vascular Cases Per Year:
Operating Equipment Available:

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