Welcome to the Cardiothoracic Surgery section of the Health Education England working across the north east and north Cumbria.
The Training Programme Director - Mr Jonathan Ferguson
Specialty Co-ordinator - Trudie Heron
Why choose Cardiothoracic Surgery?
For the last 50 years Cardiothoracic Surgery has always been at the cutting edge of technology and innovation. The demand for operations is huge, as Coronary Artery Disease, Heart Failure and Lung Cancer are amongst the commonest causes of death.
As surgeons we work closely with our Cardiology and Thoracic Medicine colleagues. Care is increasingly delivered by multi-disciplinary teams, with surgeons a vital part of this. Collaboration with Cardiology has brought innovations such as Suture less Valves and Percutaneous Valves – something thought almost impossible 10 years ago. The trend has been to develop minimally invasive operations over the past 5 years or so – and this will undoubtedly increase.
Thoracic surgery is increasingly delivered minimally invasively – with Video assisted (VATS) and robotic surgery becoming common place. The North East has led the UK with the first 2 robotic thoracic teams – at both the Freeman and James Cook.
Cardiothoracic Surgery tends to be high volume, high complexity surgery. There are very few “small” operations. A large amount of time is spent in theatre (at least 2 days per week), rather than in clinics (although typically a half day a week is spent in out-patients). Not surprisingly, team work is vital – MDTs, large theatre teams and intensive care units.
As a trainee what can I expect from my training programme?
Training in Cardiothoracic Surgery is based across 2 sites in the North East – the Freeman Hospital in Newcastle and James Cook in Middleborough. It is possible to join the rotation both at ST1 or ST3 level, as the programme is designated one of the pilot regions for run through training. ST1 is spent on core surgical topics and ST2 is then a year attachment in Cardiothoracic at the Freeman. For ST3-8 trainees around 4 years are spent at the Freeman and 2 years at James Cook – although this is flexible to suit trainees’ needs.
The programme is one of the most highly sought after in the UK and is regularly in the top choices of candidates applying through national selection. Cardiothoracic Surgery is increasingly splitting into the sub-specialties of Cardiac and Thoracic Surgery. It is important, however, that trainees are taught both aspects of the specialty in the early years. The training in both Cardiac and Thoracic Surgery is excellent in the region, with many struggling trainees from other regions asking to come to the North East for help. A particular strength has been the nurturing of left handed trainees at James Cook.
The Freeman Hospital is unique in the UK in offering the complete range of sub-specialties – Cardiac, Thoracic, Transplant and Congenital Surgery. This allows trainees to experience a taste of everything before making a final career choice.
There are a wide range of research activities at both hospitals. The North East is one of 2 regions supporting academic trainees (ACFs) in cardiothoracic surgery.
What our trainees say:
Every day starts with a quick ward round of the patient who you have operated on previously. This includes going regularly into our own Intensive Care unit. You are either seeing patients for assessment for heart or lung surgery or seeing the results of your surgery. We rarely follow people up for long periods and we virtually never get GP referrals so all the patients are well worked up already for us and we do not have thousands of patients being followed up years after their surgery. Thus our outpatients are great and not too busy as a rule.
You are on call for emergency heart or lung surgery or ward problems which can be busy or quiet. You also need to be resident on call as a Registrar as patients post Cardiac Surgery can get very ill “in a heartbeat”. Cardiac Surgery is the most technically difficult surgical specialty (apart from pediatric heart surgery which knocks the spots off everything!) so it takes a long time to master and therefore is satisfying once you get to operate on your own.
The thing I find most enjoyable about my job is that we don’t do many operations that are not lifesaving or life prolonging. The operations are very satisfying and usually the patients get better quite quickly. Stopping someone’s heart twice per day isn’t a bad way to earn a living!