Have you ever wondered what it's like to see a beating human heart, or how if feels to hold one in your hand? Have you ever been inclined to examine the mitral and aortic valves, which up to now have represented themselves only as nonmusical sounds through your stethoscope? Did you know that cardiothoracic surgeons spend their careers concentrating on the diagnosis and management of both the number one non-cancer killer of adult Americans (cardiovascular disease), as well as the number one cancer killer of American and women (lung cancer)? Regardless of your answers to the above questions or which way your career plans may take you, we promise a fascinating and rewarding three weeks on our cardiothoracic services.

Under the direction of Robbin G. Cohen, M.D., the medical student rotation is part of the 3rd year Surgical Subspecialties Rotation. Students in each 3 week rotation are divided into two groups of 3 students each. One group is based at LAC+USC Medical Center, and the other at Huntington Memorial Hospital. In addition, each student spends 1 day observing congenital heart surgery at the Childrens Hospital Los Angeles, 1 day in the Cardiac Catheterization Laboratory at Huntington Memorial Hospital, and 1/2 day in the clinic with one of the cardiothoracic faculty members. There is also an opportunity to observe heart or lung transplants at USC University Hospital as they occur.

Objectives

During the Cardiothoracic Surgery Rotation, each student will accomplish the following:

Cardiac Surgery

• To develop a working knowledge of the pathophysiology and clinical presentation of coronary artery disease. This includes the evaluation of patients with coronary artery disease including acute myocardial infarction, and the indications and rationale for coronary artery bypass surgery.
• To understand the pathophysiology, clinical presentation, and indications for surgery in acquired aortic and mitral valvular disease.
• To be familiar with the basic principles of cardiopulmonary bypass.
• To be familiar with the indications for heart transplantation.
• To develop competence with basic surgical suturing techniques.

Thoracic Surgery

• To be able to describe the appropriate evaluation of a patient with a lung nodule on a chest X-ray.
• To be able to clinically stage a patient with lung cancer, and to recommend therapy based on the clinical and surgical evaluation. This includes evaluation of the chest X-ray and CT scan, and to know the indications for needle biopsy, bronchoscopy, and mediastinoscopy.
• To observe and be able to describe the surgical therapy of lung cancer.
• To know the differential diagnosis and evaluation of a patient with a mediastinal mass.
• To describe the diseases of the pleural space including pneumothorax, hemothorax, and empyema. To know the indications for thoracostomy tube drainage. To understand the mechanics and daily maintenance of chest tube drainage including the threechamber drainage system, and to be able to determine when a chest tube can be removed.
• To have a basic knowledge of the indications for lung transplantation.