SCA Fellowship Template

Institution Name:
Website:
Chair:		Email:
Cardiothoracic/Cardiovascular Anesthesia Fellowship Director:		Email:
Mailing Address:
City:
*State/Province:	-- Select State or Province -- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territory Nova Scotia Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory
Postal Code:
* Country:	Canada USA
Phone:
Fax:
Application Process:
General Program Information
Number of Positions:
Number of Positions Available
CA-4:
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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