The area of study that deals with the surgical treatment and care of diseases, disorders, and injuries of organs in the thoracic cavity.
The area of study that deals with the surgical treatment and care of diseases, disorders, and injuries of organs in the thoracic cavity, that is, all the organs of the upper abdomen including the lungs, oesophagus, and the heart is called the speciality of cardiovascular & thoracic surgery or cardiothoracic surgery. Conditions such as coronary artery blockage, stenosis, prolapse, atresia, and other such heart valve diseases, aortic aneurysm, heart failure, heart arrhythmia, congenital heart conditions, lung cancer, severe emphysema, oesophagal cancer, swallowing disorders, Hiatal hernias, injuries due to accidents, etcetera are treated by cardiothoracic surgeons. The procedures employed by them include angioplasty, stent placement, ablation, pacemaker implantations, open-heart surgery, coronary artery bypass grafting, heart transplant, lobectomy, pneumonectomy, wedge resection, and so on. Modern methods like beating heart surgery and minimally invasive surgery using externally operated machines are also gaining ground. Usually, such surgeons do not diagnose but are usually suggested by cardiologists or pulmonologists. As a complex and highly in-demand field of medicine, it has witnessed rapid changes which makes the future bright and exciting. Some of the recent advances include arterial switch procedure, Fontan procedure and its applications, cardiopulmonary bypass system, BD Glenn surgery, machine-controlled minimally invasive procedures, major lung resections using uniportal VATS, advances in bronchoscopy, robotic thoracic surgery, and others.
M.Ch. in cardiovascular & thoracic surgery is a course designed to produce knowledgeable surgeons who can diagnose, care, conduct any required surgical procedures and oversee post-surgical rehabilitation of patients with any disorders of the thoracic organs. The syllabus includes topics such as critical care & post-operative management, cardiopulmonary bypass, myocardial protection, circulatory support, ischaemic heart disease, heart valve disease, aorta vascular disease, cardiothoracic trauma, general management of a patient undergoing thoracic surgery, neoplasms of the lungs, disorders of the pleura, disorders of the chest wall, disorders of the diaphragm, emphysema & bullae, disorders of the pericardium, disorders of the mediastinum, disorders of the airway, soft skills, legal medicine, seminars, practicals, and clinical teachings. Candidates are expected to maintain a logbook and carry out an assigned research project. Also, candidates must have assisted in major procedures and performed lobectomy/pneumonectomy in the manner prescribed by the institute during the course duration. After the completion of the course, candidates are expected to have acquired the knowledge to diagnose and prepare a suitable treatment strategy for any cardio-vascular ailment presented to them. They must be able to perform and interpret any adequate diagnostic procedure. They should be able to perform any required cardiothoracic surgical procedure and oversee patient rehabilitation. They should be able to train upcoming residents and paramedical staff. They are expected to manage emergencies efficiently and swiftly, cooperate with other specialists, and possess effective communication skills. Candidates are expected to perform their duties with empathy, care, and within the ethical and legal ambits of the nation.
Students having MS/DNB in general surgery from an institution recognized by the medical council are eligible to attend the three-year M.Ch. course subject to them qualifying the entrance tests and other requirements of the respective institutions. Residents on the admission day shall act as the doctor on duty and demonstrate resuscitation skills and other duties in front of a panel. Successful candidates shall have various career opportunities such as cardiothoracic specialist, surgery coder, surgery demonstrator, clinical manager, research associate, or lecturer. With several studies and research going on in the field, specialists are in dire need and the speciality offers a bright and exciting future.