Aortic Fellow

**Programme of learning**: Capabilities in Practice (CiPs) The Training Fellowship is designed to produce a person capable of safely and effectively performing Complex Aortic Surgery at the level of an independent clinician in addition to CCT/CESR requirements. Clinicians will become an independent operator in specified Index Procedures at the completion of the Fellowship. A capability is a set of skills that can be developed through training from novice to expert and therefore these high-level clinical outcomes are known as Capabilities in Practice (CiPs). The 7 CiPs in relation to Complex Aortic Surgery are: 1) Manages an outpatient clinic with pre and post-operative Complex Aortic Surgery patients.2) Manages the unselected emergency take with reference to Complex Aortic Surgery.3) Manages ward rounds and the ongoing care of inpatients who have undergone Complex Aortic Surgery.

4) Manages an operating list which includes Complex Aortic cases.5) Manages a multi-disciplinary meeting including patients under consideration of Complex Aortic Surgery. 6) Manages patients within the appropriate area following Complex Aortic Surgery.7) Assesses surgical outcomes following Complex Aortic Surgery both at a personal and unit level. Index Procedures Aortic valve and ascending aortic replacement Aortic root replacement Hemiarch replacement Total arch replacement Repair of Acute Type A aortic dissection There is an indicative number of procedures during the Fellowship of 30. In addition Fellows will also have exposure to many more complex procedures or part procedures which may be undertaken under supervision including valve sparing root surgery, complex redo surgery, descending and thoracoabdominal aortic surgery and endovascular procedures in conjunction with the vascular team.

Critical Conditions Fellows must be able to demonstrate knowledge and understanding of the management of the critical conditions and complications of Complex Aortic Surgery including competence in the management of acute aortic dissection, aneurysmal disease throughout the aorta and aortic infective endocarditis. Service Commitment Fellows will be expected to conduct a daily weekday ward round of aortic inpatients and liaise with appropriate Consultant surgeons, ITU and ward-based teams. The Fellows are responsible for attending and running the weekly aortic clinics, one proximal and one distal. In addition, they organise and run the weekly regional proximal and distal aortic MDTs in conjunction with the aortic administrator.

**Learning agreements**: An initial Learning Agreement meeting will occur within two weeks of commencement of the Fellowship where objectives will be agreed in line with those stated above. Multiple Consultant Review at three monthly intervals with ongoing assessment and setting of objectives in line with early and late phases of the Fellowship. Ongoing informal appraisal as part of WBAs, teaching sessions and day to day discussions and feedback will occur.