Advanced Cardiothoracic and Vascular Anesthesia Fellowship positions are offered for 2 (two) years. Fellowship programme includes cardiac anesthesia, cardiac postoperative Intensive care, perioperative echocardiography and major thoracic and vascular surgical procedures at the Leipzig Heart Center,Leipzig,Germany. Leipzig Heart Center is a speciality clinic of the University of Leipzig, and is one of the major referral centers in the country. The center is
specialised for Cardiac, Vascular and Thoracic surgeries for Adult, Pediatric and the Newborn population. There will be exposure to wide variety of cases which includes adult major valvular repairs(Minimal Invasive and Conventional), Surgery for the Newborn and Pediatric age group, Heart and Lung transplantation, Implantation of the latest ventricular assist devices (Uni and Bi) , and Aortocoronary bypass procedures. The Fellow will assist in looking after complex and rare,as well as prevalent, congenital cardiac cases. There is a highly active programme for Perioperative TEE which includes over 2500 intra-operative examinations per year. Leipzig Heart Center experienced a inpatient occupancy of 96.33% during the year 2008. 16,201 patients were treated as inpatients, 10,761 patients were treated on an ambulatory basis and 3121 received a day care.
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Leipzig Heart Center is an equal opportunity employer encouraging applications from all over the world and less economic countries and thereby encouraging applicants and considering applications without regard to, race, color, religion, sex, national origin, sexual orientation, disability or veteran status. The Fellowship programme is an internationally acclaimed programme and applications are invited from Doctors around the world. Every year 3 Fellows will be accepted, upon successful completion of the supervised assessment, lasting for a period of 1 (one)month from the date of joining. |
The Fellow will be completely trained as to work independently after the completion of the Programme. This programme offers excellent opportunities for the Fellow to become profiient in Cardiothoracic and Vascular anesthesia, both in a clinical and research setting. The Candidate will have extensive exposure not only to conventional modes of Cardiac surgery but also to the pioneering techniques in Cardiac surgery, including surgeries for Heart Failure, Surgical modalities for treatment of Rhythm disturbances and catheter based valve implantation. Robotic Surgical procedures (DaVinci Robotics).
The Fellow will have experience with surgeries with complete circulatory arrest using deep hypothermic techniques and will be acquainted with the different models of Ventricular Assist Devices and Artificial Hearts. It is designed to meet the Fellows individual needs as well as maximal exposure to the clinical caseload available within our center.
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Clinical Programme
Statistics from our center in 2008:
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Cardiac cases: |
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| Operation with Heart Lung Machine | 2971 |
| Operation without Heart Lung Machine | 3218 |
| Valve surgeries | 1340 |
| Combined CABG with Valves | 1041 |
| Beating Heart Surgeries | 413 |
| Surgeries of the Aorta | 344 |
| Congenital Surgeries | 332 |
| Pacemaker Insertion | 823 |
| ICD Insertion | 547 |
| Thoracic cases: | |
| One lung ventilation for MIDCAB and minimallyinvasive mitral valve repair | 140 |
| High frequency jet ventilation | 5 |
| Lung transplant |
13 |
| Pulmonary resection | 43 |
| Pleurectomy/decotrtication | 61 |
| Resection of mediastinal mass | 317 |
| Partical resection of chest wall | 154 |
| Other operation on chest wall | 91 |
| Vascular cases: | |
| Peripheral vascular procedures | 103 |
| Embolectomy | 23 |
| Thrombectomy | 34 |
| Pulmonaryembolektomy | 13 |
| Axillo femoral bypass | 2 |
| Infrarenal Y prosthesis | 1 |
| Thoracoabdominal replacement beating heart | 10 |
| Other aortic procedures without CPB | 35 |
They will be exposed to extensive TEE training and will be prepared for TEE accreditation examination from the European Society of Cardiology ESC and EACTA conducted twice a year. Leipzig Heart Center is a certified training center for TEE from DGAI. (Deutsche Gesellschaft für Anaesthesiologie und Intensivmedizin e.V.)
Fellows will have a proper training both for basic and advanced TEE, including 2D and 3D modes The TEE training will be divided into understanding the basic principles of echocardiography (physics, standard views for examination, Doppler principles and quantification etc.) to advanced mode (3D, AQ for assessment of ventricular function, Stress and Strain, Tissue Doppler) as they master the basic skills of TEE. Twice a year 2 day courses are conducted for TEE training and participants are given an intensive training in TEE. This course is recognized and accredited by DGAI.
Fellows will be rotating in Adult and Pediatric Operating Rooms as well as the post anesthetic care unit (PACU). This implementation of PACU is an unique concept started from November 2005 in Leipzig Heart Center for selected patients undertaking the principles of Fast Track Anesthesia. With the expertise from our team of surgeons Fellows can have a good mix of conventional and advanced techniques in cardiac surgery. Such an active and highly successful minimal invasive surgical programme is an active and successful programme which is performed in very few centers in Europe and North America. It also has an active programme for ventricular assist device (VAD) insertions (both Bi and Univentricular Assist Device) and fellows will reach an understanding of basic principles of ECMO, Intraaortic Balloon Pumps IABP and advanced Cardiac Monitoring. The Heart and Lung Transplant programme is a busy programme in our institute. Fellows will have an additional value of exposure for post-operative pain management of cardiac surgical cases. Our Intensive Care station with 36 beds for Adults is managed by Anesthesiologists as well as by Cardiac Surgeons. There is also an added Step-Down unit with 24 beds, providing facilities of Invasive monitoring but without facilities for invasive Ventilatory support.
Operating Room Equipment Available
Fellows will be rotating during their 2 year tenure in state of the art Operating rooms (Adult and Pediatric),Hybrid ORs for Transapical valve as well as percutaneous valve implantation procedures and insertion of Endovascular stents and also in the Intensive station. They will gain sufficient exposure with vascular cases including carotid endarterectomies, thoraco-abdominal aneurysms, and stent procedures from abdominal and descending aorta. Transesophageal echocardiography with 2D and Live3D and 4D modes with Philips 7500, and Philips IE 33 Real Time 3D machines for regular use in the ORs with multiplane probes for both adult and pediatric patients, Hybrid ORs for transapical and percutaneous aortic valve implantation procedures, Pacemaker and ICD insertions, ECG ST segment analysis, Narcotrend monitor for assessing "Awareness and Depth of Anesthesia", mixed venous oximetry, continuous cardiac output monitoring, evoked potentials, cerebral blood flow/transcranial Doppler, large accessible patient outcome database. There is an addition of a new hybrid OR with state of the art Artis Zeego multi axis system for advanced cardiac imaging. There is also facility for post processing imaging workstation, a new dimension and future of cardiac surgery.
Academic Programme
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The Department of Anesthesia and Intensive Medicine is academically very active. The fellowship program also offers a strong, diverse academic program that include conferences at least two times a week-lectures on diverse topics relating to cardiothoracic and vascular anesthesia, TEE review, and case conferences. In addition, fellows should participate in a monthly journal club. The weekly rounds should include didactic session of TEE and topics related to principles of cardiothoracic and vascular anesthesia. These sessions will be supervised by the Staff and the Fellow will be given assistance in preparing for the presentation. |
Fellows are expected to have 80% attendance for the teaching sessions which will be assessed at the end of the year through an attendance sheet maintained during the teaching sessions. Fellows who have a special interest in clinical research will be encouraged in academic writing. They will be given extra time within the work schedule for pursuing their academic interests, starting from the second year of their fellowship. No research time will be allocated during the first year of the fellowship. They will be given incentive for carrying out their original work after confirmation from the programme director, and they may participate in the on-going research projects. Fellows will be given 100% financial assistance for presenting their original work in international and national meetings and conferences. The fellow will have an access to the central library which has an adequate collection of all the major journals subscribed through the department. The Fellow is also entitled to use the electronic library of the University of Leipzig. Reading material could be lent out on request to a maximum period of two months. There is also an extensive collection of books and DVDs on TEEs which could be borrowed on a periodical basis.
The Fellows will individually be assigned to a topic of clinical investigation by the Programme Director, which may include any of the following:
- Blood saving techniques
- Congenital heart disease
- Neuroprotection in cardiac surgery
The greatest strength of the academic programme lies on the experienced faculty,who have diverse interests and broad expertise in their region of interest.
During the first months of the programme there will be supervised assessment of the fellow, where the fellow will be assessed for both theoretical, practical and communication skills. This will also enable the fellow to get acquainted with the OR set up and be familiar with the different monitors and TEE machines. Upon successful completion of the assessment they will be responsible for handling their own ORs, although Staff coverage will always be available. At the start of the fellowship every fellow will be provided with a manual from the Programme Director which enables them to get acquainted with the existing clinical practice prevalent in the department, and the fellows are expected to abide by the same. Encouragement will be given to share their adopted clinical practice, provided it does not hamper the quality and safety of patient care management.
The call schedules will be as per the EU guidelines with a stipulated time not exceeding 40 hours per week, which will be equally distributed into day and night calls. Weekend calls will be maximum of one per month.
Evaluation for Fellows
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The Fellows will be assessed by the Staff on a one to one basis during the first month of the fellowship. Upon successful completion of their assessment fellows will be subjected to a quarterly evaluation by a Staff anesthesiologist. The means of evaluation will depend on the Fellows performance in the OR, clinical and theoretical knowledge of the subject in proper and the ability to apply in practical set-up, quality of presentation during seminar presentations, their ability to communicate in the OR with the Colleagues, Surgeons and the Nursing staff. |
The Chairman can ask the Fellow to upgrade his communication skills if there is need. The Fellow can communicate directly with the Programme Director anytime during the tenure, if there are any queries regarding the Fellowship Programme. Additionally the Fellows will assess the Staff individually at the end of the Fellowship Programme, through an anonymous form and can express their views regarding the programme.
Upon successful completion of the Fellowship Programme the Candidate will be issued a Certificate for the Fellowship Programme from HEART CENTER LEIPZIG, Germany and from EACTA (European Association of Cardiothoracic Anaesthsiologist).
Criteria for Application
Although the Final selection lies at the discretion of the Chairman and Programme Director, the Fellows should have the following requirements before they can apply for the Programme:
1. The Candidate should have a Medical Degree from a Recognised University.(Certified translated German copy required).
2. Certification of a Specialist In Anesthesia from the Medical Council of the candidate’s country of Education, with German translation. Candidate should have completed the Residency Programme in Anesthesia and should be German Board eligible.
3. Upto date Curriculum Vitae with German Translation.
4. Three letters of reference with German translation.
5. Basic knowledge of German for communication. This should be at B2 level and should be certified from Goethe Institute or their equivalent from the candidates country of origin or presently residing.
6. Experience in Cardiac Anesthesia for a minimum period of one year. Experience with TEE is an added advantage although it is not mandatory.
Although these are the basic requirements, the Candidates Papers will be assessed by the Regierungspraesidium Leipzig (Licensing body to practice Medicine).The Candidate will have to furnish the additional documents, as and when required, for licensure to practise medicine in Heart Center Leipzig. Upon successful assessment, the Candidate will be registered with Saechsische Landesaerztekammer (Chamber of Physicians for state of Sachsen) and then can commence with their work.
7. German qualified candidates (Facharzt fuer Anesthesie) can communicate directly with the Chairman for entry into the Fellowship Programme.
General Information
The Fellowship programme will start from March every year.
Medium of Instruction for the Fellowship Programme is German and English.
The renumeration for the programme will be 51,000 Euros per year. During the second year of the Fellowship the Candidate will be paid 54,000 Euro. The above renumeration will be paid equally on a monthly basis. There is a provision for an additional 7200 Euros per annum subject to additional working hours, within stipulation of EU working guidelines.
Health Insurance needs to be purchased for a month before leaving their home country. After arrival German health Insurance needs to be purchased, which can be paid on a monthly basis. Assistance and Information in details will be provided upon arrival.
ON –LINE APPLICATION FORM
If you are interested in our Advanced Cardiac Fellowship Programme, please feel free to contact:
Dr. Joerg Ender
CHAIRMAN
Department of Anesthesia and Intensive Medicine,
Leipzig Heart Center, University Clinic
Struempellstrasse 39
04289 Leipzig
Germany
Tel No: 0049-341-8651438/39
E-Mail: ender.an@herzzentrum-leipzig.de
Dr. Chirojit Mukherjee
PROGRAMME DIRECTOR
Staff Anesthesiologist,
Department of Anesthesia and Intensive Medicine,
Leipzig Heart Center, University Clinic
Struempellstrasse 39
04289 Leipzig
Germany
Tel No: 0049-341-8651441
E-Mail: chirojit.mukherjee@herzzentrum-leipzig.de
