The training pathway to becoming a Cardiothoracic Surgeon in Ireland commences at Core Surgical Training ST1 and completes at Specialty Training ST8.
Within these 8 years of training a trainee will undergo Core Surgical Training in ST1 & ST2 . Core Training is a common trunk of training which is undertaken by all surgical trainees, irrespective of their future specialty aspiration. It is intended to introduce trainees to the principles of surgery in general and give them the knowledge, skills and attitudes which are required by all surgical specialities in preparation for Specialty Training (ST3- ST8) .
There is only one entry point into Surgical Training at ST1. There is no direct entry into the Cardiothoracic Surgery Higher Specialist Training Programme (ST3-ST8).
Those trainees on core training will compete to progress to ST3 in their selected specialty towards the end of ST2.
ST3 is entry level into Specialty Training in Cardiothoracic surgery which completes at ST8 . This based on continuous assessment during ST1 & ST2 through the CAPA (Competency Assessment Performance Appraisal) process, successful completion of the MRCS exam and Specialty interview.
Duration & Organisation of Training
Cardiothoracic training is undertaken in a 6 year Specialty Training Programme (ST3 – ST8).
During the 6 years of training an appointed trainee will be expected to spend some time in each of the approved public cardiothoracic surgical units to acquire a rounded knowledge of the specialty. At a minimum Specialist trainee’s will spend three years doing adult cardiac surgery, six months doing thoracic surgery and six months in Paediatric cardiothoracic surgery.
The cardiothoracic training programme has a defined curriculum that trainees need to complete. Biannual assessments, training courses, wet labs and modalities such as the Intercollegiate Surgical Curriculum (www.iscp.ac.uk) are used to track progression throughout ST3 – ST8.
Specialty trainees then have the option of focusing their training on a sub-specialty in cardiothoracic surgery i.e. adult cardiac, adult thoracic, transplantation or congenital cardiothoracic surgery. At the current time there are no sub-specialty divisions on the Irish Medical Council cardiothoracic register, however in other jurisdictions such as the United Kingdom trainees can train towards sub-specialist recognition i.e. congenital or thoracic. In Ireland at present most consultant cardiothoracic surgeons have a specialist interest (adult cardiac, adult thoracic, congenital or transplantation) and they may practice across the sub-specialties. However in recent years some consultants have been appointed into single sub-specialty clinical practice i.e. thoracic surgery.
Cardiothoracic sub-specialty training: –
- Adult cardiac specialist are expected to do a minimum of 4 years of adult cardiac surgery training and will frequently undertake specialist training in areas such as mitral repair, aortic root surgery, minimal invasive surgery or hybrid procedures (TAVI, TEVR).
- Thoracic specialist is expected to do a minimum of 2 years of adult thoracic training, which may include oesophageal surgery. They will frequently do specialist training in thoracic oncology, VATS surgery or robotics.
- Transplantation specialist is expected to do a minimum of one year in thoracic organ transplantation and they may focus on heart or lung transplantation depending on their other area of interest (thoracic or cardiac surgery).
- Congenital cardiothoracic trainees are expected to spend a minimum of three years doing congenital cardiothoracic training. Often 1-2 of these years is done post Higher Surgical Training as a fellow.
Adult cardiothoracic surgery is performed at the Mater Misericordiae University Hospital, St James’s Hospital, St Vincent’s Hospital (Thoracic), Cork University Hospital and Galway University Hospital. The Heart and Lung transplantation Program and the ventricular assist program are delivered in the Mater Misericordiae University Hospital. All Paediatric cardiothoracic surgery is performed in Our Lady’s Children’s Hospital, Crumlin. The various programmes report their results to the society of cardiothoracic surgery of Great Britain and Ireland and NICOR, which allows the results to be compared with international units. The results are published annually and online.
Biannual assessments, training courses, wet labs and modalities such as the Intercollegiate Surgical Training Programme (www.iscp.ac.uk) are used to track progression throughout ST3 – ST8.
Trainees need to complete the curriculum and the FRCS C-Th examination in order to achieve a Certificate of Completion of Surgical Training (CCST). Awarding of CCST deems eligibility for registration with Irish Medical Council.
For more information on the training programme click here