Thoracic & Cardiovascular Surgery Residency

About the Thoracic & Cardiovascular Surgery Residency

Welcome to the website for the categorical thoracic surgery residency training program of the Loyola University Medical Center Department of Thoracic and Cardiovascular Surgery!  We hope this site will answer most of your questions about our two year program, and the environment in which we educate and practice.  If not, feel free to contact us using the link to the left.

Loyola University Medical Center is located in Maywood, Illinois, one of the western suburbs of the greater Chicago metropolitan area.  In partnership with the Stritch School of Medicine and the Cardinal Bernardin Cancer Center, and affiliated with the neighboring Hines Veteran Administration Hospital, we serve a diverse patient population with a varied spectrum of clinical disease from throughout the Midwest.

Our residents benefit from a rich volume of high-risk as well as bread-and-butter procedures performed in a modern tertiary care center with award winning nursing care, that is consistently ranked among the top cardiovascular centers in the nation by the U.S. News and World Report magazine.

Among the cutting edge technologies our program utilizes are Percutaneous Valves, Complex Endovascular Stent Grafting, Ventricular Assist Devices, Minimally Invasive Valves, Robot Assisted VATS resections, as well as lung and heart transplantation.

2014 saw our Department strengthened by the addition of new faculty at Loyola and the Hines VA Hospital.  Dr. Ed McGee has supplemented our busy Mechanical Circulatory Support program, and implanted our first Heartware LVAD in December.  Our volume of ECMO patients supported to either cardiac or pulmonary transplantation has increased significantly.  Loyola's Thoracic transplant team made national news with five patients receiving lung transplants within 24 hours.

2015 to date has seen two of an intended three new faculty members for our Thoracic Surgery section, reinforcing the strength of our pre-existing minimally invasive and robot assisted thoracic surgery volume. Dr. Jim Lubawski started in September, and Dr. Wickii Vigneswaran has agreed to become Chief of Thoracic Surgery.  Both of our new faculty come to us from well established practices in the greater Chicago metropolitan area.

​In response to the new volume generated by Drs. Vigneswaran and Lubawaski since January of this year, new opportunities have been created for elective time on the Thoracic Service during the second year of the residency.  Residents on the Thoracic Service will also benefit from the new Esophageal Service created by Dr. Vigneswaran in collaboration with Surgical Oncology at Loyola.

Faculty

Dr. Mamdouh Bakhos

Mamdouh Bakhos, MD
Chair, Professor

Dr. Michael Eng

Michael Eng, MD
Assistant Professor
Chief, Cardiovascular and Thoracic Surgery, Hines VA Hospital

Dr. Bryan Foy

Bryan K. Foy, MD
Professor

Dr. Jason Frazier

Jason Frazier, MD
Assistant Professor

Dr. Michel Ilbawi

Michel Ilbawi, MD
Lecturer
Director Pediatric Cardiac Surgery, Christ Hospital

Dr. James Lubawski

James Lubawski, MD
Assistant Professor

Dr. Ed McGee

Edwin McGee, Jr., MD
Professor

Dr. Anthony Perez-Tamayo

R. Anthony Perez-Tamayo, MD, PhD
Associate Professor
Residency Program Director

Dr. Jeffrey Schwartz

Jeffrey Schwartz, MD
Professor
Director, Heart and Lung Transplantation, Mechanical Circulatory Support

Dr. Lambros Tsonis

Lambros Tsonis, MD
Clinical Instructor

Dr. J. Michael Tuchek

J. Michael Tuchek, DO
Clinical Associate Professor

Dr. Wickii Vigneswaran

Wickii Vigneswaran, MD
Professor
Chief of Thoracic Surgery

Clinical Rotations of the Loyola University Two Year Categorical Training Program in Thoracic and Cardiovascular Surgery

The table below demonstrates the rotations for the two residents per clinical year of our two year program.  While at Loyola, the two to three residents on the Thoracic and Adult Cardiovascular rotations have great flexibility in covering those cases they feel give them the greatest opportunity for education, while taking into account the benefits of longitudinal care.  While on the Thoracic rotation, the resident is understood to be primarily dedicated to that service, but if no outpatient or other clinical demand is concerned, he/she is free to scrub on any case.  Beyond obligations to orient the junior residents at the beginning of the year, there is no hierarchy between years, though the order of the rotations has been organized to take maximum advantage of clinical progress in training.  Therefore, by the time the junior residents rotate on the Congenital Cardiothoracic Service in the third or fourth quarters of the year, they have had a strong background in adult cardiothoracic practice to prepare them.  Similarly, the first year will prepare the resident to seize every opportunity for supervised autonomy at the Hines VA Hospital during the second year of residency, and to handle the most complex cases on Adult Cardiovascular and Thoracic services while at Loyola.

Our two year program has typically produced board eligible practitioners, ready to assume an independent clinical practice at the end of training:  many have sought no further fellowship training.  For those who want to obtain an advanced surgical credential through residency training in Congenital, or superfellowship in a specific discipline, the brevity of a two year program allows time saved compared to three year programs.

  Q1 Q2 Q3 Q4
JUNIOR 1 Thoracic Adult CV Adult CV Pediatric (Hope)
JUNIOR 2 Adult CV Thoracic Pediatric (Hope) Adult CV
SENIOR 1 Hines VA Adult CV Hines VA Adult CV
SENIOR 2 Adult CV Hines VA Adult CV Hines VA

 

NEW OPPORTUNITIES AS OF 2016:  ELECTIVE TIME AND THE ESOPHAGEAL SERVICE

At the request of the resident, a six-week portion or the entirety of one of the Loyola Adult CV blocks can be taken on the Loyola Thoracic Service during Q3 or Q4.  While our program has always provided our graduates with the confidence to start work in Cardiovascular or Thoracic Surgery, we offer this elective time for the resident who plans on a primarily Thoracic career.  Elective time on Thoracic Surgery during the latter half of the year will smooth the transition from resident to attending for an individual who wishes to concentrate on this field, while allowing the first year resident exclusive access to that volume during the first two quarters of their first year.

In collaboration with Surgical Oncology at Loyola, the resident on the Thoracic Service will take charge of a new Esophageal Service, through which all esophageal malignancies will be directed.  The patients will be managed by the Thoracic Service resident in the Cardiothoracic Intensive Care Unit, under the supervision of the combined Thoracic Surgery/Surgical Oncology staff.

Didactic Sessions

Monday Morning TSDA Curriculum Conference

Every Monday morning after ICU rounds, all residents on rotation at Loyola and the Hines VA gather to review the weekly readings from the TSDA Curriculum Moodle Web-brain with a faculty member. The faculty member has reviewed the readings and visual material as well, and leads an interactive discussion that emphasizes elements vital to clinical practice, and relevant for the written Thoracic boards. The two-year version of the curriculum covers the full spectrum of Cardiac, Thoracic, and Congenital Cardiothoracic disease, as well as advanced topics in Critical Care.

Simulation Lab

Once every other month, the Monday morning session is devoted to a two hour simulation lab using porcine tissues in the Stritch School of Medicine Center for Simulation in Education.  The thoracic residents, and general surgery residents rotating on our services perform such procedures as aortic root enlargements, complex mitral repairs, and anatomic pulmonary resections, led by a faculty member.  These sessions alternate with a coronary anastomosis workshop. The porcine model allow a stress free examination of all relevant anatomic relationships as well as the ability to speed mastery of technique.

Simulation lab

Simulation lab

Simulation lab

Wednesday Morning Conference

Wednesday morning conference rotates regularly between the following formats:

Mortality and Morbidity

Held the first week of every month, cardiovascular and thoracic outcomes are discussed by faculty and residents, reviewing diagnostic and therapeutic decision making as well as the relevant literature.

Journal Club

Over the course of a month, each resident selects a recent peer-reviewed publication for discussion.  The selection process takes into consideration the degree to which the publication changes understanding and treatment of a disease relevant to cardiothoracic practice, and the validity of the paper's experimental design and methods.

Congenital Heart Practical

Preserved autopsy specimens of typical congenital malformations are reviewed in a 'hands-on' fashion with Dr. Saroja Bharati, co-author with Drs. Lev and Kirklin of the classic textbook, Cardiac Surgery and the Conduction System.  The specimens often include unsuccessful attempts at correction, yielding valuable insights into technical pitfalls of repair techniques.

Didactic sessions

Dr. Bharati points out details of ventriculoseptal defect variants to the residents.

Clinical Case Conference

Using a format designed to prepare residents for oral boards, one resident presents a case to another resident who is unfamiliar with the patient.  The presentation of the history and physical prompts the on-the-spot resident to propose a workup, and the resident is then required to 'cold read' imaging studies, and come up with a differential diagnosis and treatment plan.  The actual treatment plan, and intra-operative images are then reviewed and compared to the resident plan.  The assembled faculty provide constructive criticism of the resident's decision-making process.

Lectures

Faculty from our own and other Departments of the Medical Center, as well as distinguished visiting professors from other institutions present their insights and research results.

 

With a very active heart and lung transplant program, as well as its regional leadership in advanced technology such as endovascular grafting, percutaneous valve implantation, and destination therapy circulatory support, Loyola performs cardiovascular and thoracic procedures far in excess of what can be staffed by our complement of categorical residents. This provides an environment where residents can involve themselves with those cases they believe will most benefit their education, while our surgical assistants cover the remainder. Similarly, our dedicated Cardiovascular and Thoracic Intensive Care Unit is staffed by Anesthesia residents who carry out the majority of the 'front-line' care with the oversight of our trainees, so that our Thoracic residents are freed to pursue their technical development while building their clinical management skills. On the wards and in clinic, our team of Nurse Clinicians and Physician Assistants effectively manage inpatient and outpatient care with resident involvement as necessary.

Loyola Adult Cardiovascular Surgery

Picture

The figure above represents Cardiovascular Surgery volume for Fiscal Year 2014.  2013 has seen a greater than ten percent growth across the board, with exceptional growth in such areas as our Bridge to Transplant/Destination Therapy VAD implantation (over 40 Heartmate II implants to date) and in Thoracoabdominal Aortic Surgery.  A substantial amount of our volume is valvular.  Since the time of the early Heartport experience, Loyola has been a leader in minimally invasive valvular surgery, with particular preeminence in advanced mitral repair, and valve sparing aortic root procedures.  The figure below highlights the stability of these volumes, and the extent to which they exceed resident coverage.

Adult cardiovascular surgery

Loyola Thoracic Surgery

Loyola Thoracic Surgery has always drawn complex patients from around the Midwest, as has the Cardinal Bernardin Cancer Center, which offers our patients close coordination of our care with multi-disciplinary oncology teams.  The Thoracic Section also features a very busy lung transplant service, as well as experience with robot assisted surgery.  In the last quarter of 2013, Dr. Marcelo DaSilva, a former Loyola Thoracic and Cardiovascular Surgery Resident, joined the faculty as the Chief of the Thoracic Section after several years on the faculty of the Brigham and Women's Hospital in Boston.  He brings cutting edge minimally invasive skills and a particular interest in tracheal reconstruction and esophageal procedures to supplement the traditional strength of the resident's experience.  

Thoracic surgery

Hines Veteran's Administration Hospital

Hines VA Administration
Total Thoracic and Cardiovascular Procedures and Those Covered by Residents, by Year 

The Hines VA Hospital, physically contiguous with Loyola University Medical Center, is an invaluable training site for the residency program, and a favorite rotation for our residents, both for the opportunity to care for our nation's veterans, and for the chance to "put together" what they have learned about technique, clinical decision making, and practice management in an environment where they are allowed carefully supervised autonomy.  The yearly volume of 175 to 250 cases is thus almost completely resident covered. The recently renovated operating rooms, intensive care units, and wards handle complex cases, including minimally invasive procedures, referred from throughout VISN 12.

Hines VA Hospital
Hines VA Hospital

Congenital Cardiothoracic Surgery

Congenital Cardiothoracic Surgery

Though some congenital cardiothoracic cases are performed at Loyola, the vast majority of the resident experience in this field is acquired at Christ Hospital, where Dr. Ilbawi's team tackles the full spectrum of complex repairs of congenital malformations.  Residents are typically extremely satisfied with the technical education they receive from our faculty there, and though they could satisfy American Board of Thoracic Surgery case requirements in a third of the allotted time, it is strongly agreed that the physiology and decision making can only be appreciated in the course of a three month rotation.

 

Current Fellows

Dr. Rachel Hargrove Rachel Hargrove, MD
Second Year Resident

College: The University of the South
Medical School: Loyola University Stritch School of Medicine
General Surgery Residency: Loma Linda University

Dr. Ashok Venkataraman Ashok Venkataraman, MD
Second Year Resident

College: National University of Singapore Yong Loo Lin School of Medicine
Medical School: National University of Singapore Yong Loo Lin School of Medicine
General Surgery Residency: University of North Carolina at Chapel Hill

Dr. Dharmraj Chauhan Dharmraj Chauhan, MD
First Year Resident

College: University of Michigan
Medical School: St. George's University School of Medicine
General Surgery Residency: Morristown Medical Center

Dr. Tedi Vlahu Tedi Vlahu, MD
First Year Residnet

College: Indiana University
Medical School: Indiana University School of Medicine
General Surgery Residency: Grand Rapids Medical Education Partners in Affiliation with Michigan State University

Incoming Fellows

Picture

 

​John Costello, MD

Incoming Resident

College: University of Wisconsin at Madison

Medical School: Johns Hopkins

General Surgery Residency: Georgetown

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Charles Ghee, MD

College:  Oglethorpe

Graduate School:  Georgia State

Medical School:  Morehouse

General Surgery Residency:  INOVA at Fairfax, Virginia

 

Recent Graduates

Dr. Chris Clancy

Chris Clancy, MD

College: Kent State University
Medical School: Northeastern Ohio University College of Medicine
General Surgery Residency: Medical College of Toledotol

Dr. Shea Pribyl

Shea Pribyl, DO

College: United States Merchant Marine Academy
Graduate School: MBA, Rockhurst University
Medical School: University Health Science College of Osteopathic Medicine-Kansas City
General

 

Parth Amin, MD

Parth Amin, MD

Dr Amin completed general surgery, critical care, and vascular surgery training prior to joining the academic faculty at the University of Iowa. He chose to further his training at Loyola because of the rich experience in complex adult cardiac surgery, heart and lung transplantation, and aortic surgery. He has since moved back to Michigan and is working as a cardiac and vascular surgeon.

Ryan Plichta, MD

Ryan Plichta, MD

Previously considered a Loyola lifer, Dr Plichta completed medical school and general surgery residency after spending time as a research scientist. His interests at Loyola included the large volume of mitral valve repairs, reoperative procedures, and TAVR. He is at the Cleveland Clinic, where he has gained an excellent experience with endovascular skills and has found he has been well prepared for independent practice.

Dr. Brett Beecher

Brett Beecher, MD 
University Medical Group Cardiothoracic Surgery
Augusta, Georgia

An Oklahoma native, Dr Beecher, was interested in cardiac surgery from early on his training. He came to Loyola after completing his general surgery residency in his home state. His primary interest in the Loyola program was its long standing history of producing independent cardiothoracic surgeons in two years. He now practices in Georgia and is has been instrumental in developing the robotic thoracic service line there.

Dr. Jason Frazier

Jason Frazier, MD 
Edward Hines Jr. Veterans Administration Hospital
Hines, Illinois

Dr Frazier began his medical training at Loyola and has not left the area since moving from Washington D.C. His primary interest in the Loyola cardiovascular program was the acuity and breadth of experience offered to the fellows. His interest in minimally invasive techniques have prompted him to bring robotic surgery to the forefront of care at the Hines VA, where he is faculty.

Alfred Casillan, MD

Alfred Casillan, MD, PhD

Dr Casillan completed undergraduate work, general surgery residency, and a Ph.D. in molecular biology at the University of Kansas prior to starting his training at Loyola. Here, he developed an interest in heart and lung transplantation and dedicated a formal year to these interests. He has gone back home to Topeka where he has a busy practice.