University of Minnesota

Gradate Medical Education

2023-2024

Policy & Procedure Manual

Department of Surgery

Cardiothoracic Surgery Fellowship Program

The Institution Manual (http://z.umn.edu/gmeim) is designed to be an umbrella policy manual. Some programs may have policies that are more rigid than the Institution Manual in which case the program policy would be followed. Should a policy in a Program Manual conflict with the Institution Manual, the Institution Manual would take precedence.

Introduction and Explanation of Manual

This fellowship addendum outlines specific policies and procedures specific to your training program. Please refer to the General Surgery Residency Program Manual for further departmental policies and procedures.

Department of Surgery Mission Statement

The Department of Surgery at the University of Minnesota Medical School is driven to deliver clinical excellence, compassionate patient care, pioneering research, and the education of surgical leaders.

Our vision is to be the preeminent department of surgery in Minnesota, serving patients of the world where groundbreaking research and exceptional training come together to produce the unrivaled care that we demand for our loved ones.

Thoracic Surgery Program Mission Statement

The academic charge of the Division of Cardiothoracic Surgery at the University of Minnesota is to provide the ideal environment to facilitate training cardiovascular and thoracic surgery fellows, general surgery fellows, and medical students in the discipline of cardiovascular and thoracic surgical sciences.

SECTION 1 - STUDENT SERVICES

Refer to Institution Policy Manual

Mailbox and Mail Service

Each fellow has an assigned mailbox located in the Fellows' office (Mayo B639).

Mail is stamped once daily through the main office of the Division of Cardiothoracic Surgery (Mayo Memorial Building, Floor 6, B Wing). Bring your outgoing mail to the office for stamping and mailing.

Campus & USPS Mail Address

Division of Cardiothoracic Surgery
420 Delaware St SE, MMC 207
Minneapolis, MN 55455

Delivery Service Address (FedEx, UPS, DHL, etc.)

CT Surgery Division:

Division of Cardiothoracic Surgery
420 Delaware St SE, B639
Minneapolis, MN 55455

Program Administrator:

ATTN: Carol Nguyen
516 Delaware St. SE, Suite 11-145E
Minneapolis, MN 55455

E-Mail and Internet Access

The University provides each fellow with an email address at the start of training. The University assigned email account is the University's official means of communication with all fellows. Fellows are responsible for all information sent to them via their University assigned email account. Your @umn.edu account is considered "secure" and Protected Health Information (PHI) can be exchanged to other secure email accounts (e.g. @umphysicians.umn.edu, @fairview.org, etc.). To maintain the security of your @umn.edu account, you cannot set up mail forwarding to your personal (non-secure) email account (e.g. @gmail.com, @yahoo.com, etc.).

• Check your email at gmail.umn.edu

• Information and set-up guides for email; http://www.oit.umn.edu/email

Email and Protected Health Information (PHI)

If it is essential to include confidential information within e-mail, restrict the amount of information to the minimum necessary to complete the purpose of the transmission and send it only to those with a legitimate need to know. In addition, follow these guidelines:

• Subject Line: If an e-mail contains confidential information, type the word “PHI” or “Confidential” in the subject line so it is clear that the contents should be protected. Take measures to limit or exclude patient information or patient identifiers in the subject line since the subject line is readily viewable when an account is open on a desktop. 

• Identifiers: When able, exclude patient names, birth dates, and other unique identifiers so that if the e-mail is routed to an unintended recipient, it would be difficult or impossible for that person to determine the identity of the individual referenced in the e-mail. For example, if the e-mail is in reference to a situation that is very familiar to both parties, exclude unnecessary identifiers and communicate only the required information. If names and other identifiers are necessary for patient safety, you should include the identifiers and not take the risk of compromising patient safety. 

If a patient would like to contact your @umn.edu address and your response may include PHI, you should inform them of the risks: 

• E-mail sent over the Internet can be intercepted by others. 

• If you receive e-mail at work, your employer may have the right to save and read your e-mail. Your Internet service provider may also have the right to save and read your e-mail. 

• If you share an e-mail account, others may see your e-mail. 

• A copy of an e-mail may be saved on a computer system even though you deleted it. 

• If an e-mail address is not entered correctly, the e-mail can be sent to people it is not intended for. 

• E-mail can be used to spread computer viruses. 

Fairview provides an email consent form if you or the patient prefer to have written authorization; Fairview E‐mail Consent Form.

Email Signatures

In an effort to establish consistency in the way we all share contact information with our audiences, an email signature standard has been developed. We have implemented this within University Relations and ask for your help in implementing this within your campuses, colleges, and units. Please note that this standard is based on email signature best practices and does not allow for the addition of graphics or images.

Visit Our Brand: How to Convey It for email signature templates.

If you communicate PHI via email, Fairview recommends adding the following disclaimer to your signature:

The information transmitted in this e-mail is intended only for the person or entity to which it is addressed and may contain confidential and/or privileged material, including 'protected health information'. If you are not the intended recipient, you are hereby notified that any review, retransmission, dissemination, distribution, or copying of this message is strictly prohibited. If you have received this communication in error, please destroy and delete this message from any computer and contact us immediately by return e-mail.

Google Apps

Through a partnership with Google, University of Minnesota students, faculty, and staff can access a suite of Google-powered communication and collaboration tools designed to enhance our ability to work together. The suite of applications available under the Business Associate Agreement with Google include: Gmail, Google Calendar, Google Drive. Google Groups is also available, however users will be subject to certain controls to ensure that no Protected Health Information is contained in Google Groups. PHI should not be stored in The Box or Google Drive/Docs.

Your access to all other University Google Apps will be turned off after your transition to Gmail. This includes:

• Google Sites 

• Google Talk and Chat 

• Google Hangout 

If you are part of the University’s healthcare component and believe you have a business need to access Google Sites/YouTube/Hangouts (the “Additional Google Applications”), please review and complete the AHC Google Apps Exception Request Form. Please keep in mind that access to the Additional Google Applications will not be permitted in the event your need would result in transferring, creating, maintaining, storing or otherwise making accessible any Protected Health Information (“PHI”).

Additional information available online at: http://hub.ahc.umn.edu/ahc-information-systems/google-apps. 

Box Secure Storage

The Box is a HIPAA compliant, cloud-based storage solution authorized for storage of Protected Health Information (PHI). Trainees are responsible for using Box at UMN securely to store, collaborate or share restricted data such as PHI.

Trainees should enroll in this service at the start of the program: https://box.umn.edu/. Additional information available online at: https://it.umn.edu/technology/box-secure-storage.

Internet Access

The Office of Information Technology (OIT) recommends all University employees and students use the "eduroam" wireless service using Wi-Fi Protected Access 2 (WPA2) while on campus. This is a wireless security standard that provides strong data security and network access control. WPA2 limits network usage to authorized users by requiring user authentication. Another feature of WPA2 is data encryption, which secures wireless network traffic from eavesdropping. To connect to eduroam, trainees must enter in their full UMN email address (including @umn.edu) and password.

Pagers

The program administrator supplies alpha-numeric pagers from UMMC-Fairview to the incoming fellows at the start of their training. The number fellows are assigned remains the same for the duration of their training and is generated randomly. All U of MN faculty, staff, and fellow pagers are alpha-numeric.

• Alpha-text paging

• Pages sent numerically should be considered urgent and a call-back is expected. Alpha text does not usually require a response, unless indicated (e.g., Call me). Abbreviated text is used liberally. If in doubt, call the sender. 

• Keep devices at least 6 inches apart to avoid interference. Pagers carried too close to each other are prone to missing pages. 

• Batteries can be obtained from the OR front desk or your program administrator. 

• American Messaging User Guides

• Coverage Map

If your pager breaks or malfunctions, notify your program administrator and bring it to the UMMC-Fairview Hospital (University or Riverside) information desk; they will provide you with a new pager. Information desks are staffed 24/7, 365 days a year. If you have additional questions regarding this process, contact:

Karen Bloomberg
Fairview Customer Contact Center
(Pager) 612-899-3242
(Phone) 952-924-5860
kbloomb1@fairview.org

PageCopy

PageCopy is optional service provided by American Messaging, which allows pages to be sent to your mobile phone (in the form of a text message), or to your secure @umn.edu email address. Contact the program administrator to opt-in or opt-out at any time.

Privacy and Data Security Training (HIPAA)

The Surgical Administrative Center (SAC) provides instructions to incoming fellows for completing the Privacy and Data Security Training course online.

Tuition and Fees

Tuition and fees are being waived at this time. Fellows enrolled in Graduate School pay tuition and fees.

SECTION 2 - BENEFITS

Refer to Employment-Related Information or the Institution Policy Manual at http://z.umn.edu/gmeim

American College of Cardiology (ACC) Fellows in Training (FIT) Program

The American College of Cardiology (ACC) is pleased to invite Thoracic Surgery training programs to enroll surgeon trainees for ACC's Fellows in Training (FIT) complimentary membership program. Joining the ACC as a FIT member will give trainees unique opportunities to network, collaborate, educate and learn with cardiology colleagues.

In addition to enhanced collaboration, the complimentary membership available to Fellows in Training also provides:

• Free membership in ACC Chapters, Councils, Committees, and Sections including ACC's Surgeons' Section and many others. 

• Free print and online subscriptions to Journal of the American College of Cardiology (JACC), JACC: Imaging, JACC: Interventions, JACC: Heart Failure, JACC: Clinical Electrophysiology and JACC: Basic to Translational Science 

• Opportunities to submit to the JACC FIT and Early Career Page (online and print) 

• Opportunities for participation in national, regional and state-based surgery/cardiology collaborations 

• Eligibility for ACC FIT travel awards, including ACC Scientific Sessions and ACC Legislative Conference

• Access to the ACC.org Cardiac Surgery clinical topic collection as well as opportunities to contribute case studies, case reviews and articles

Self-Education Self-Assessment in Thoracic Surgery (SESATS)

The program will cover the $300 cost to purchase the Self-Education Self-Assessment in Thoracic Surgery (SESATS): http://www.sesats.org. If a fellow has access to an older version of SESATS, the program will cover the cost to upgrade to the most recent version available.

Fellows should submit their SESATS receipt to the Program Administrator within 30 days of purchase to receive reimbursement.

TSRA Multiple Choice Review of Cardiothoracic Surgery

The TSRA Multiple Choice Review of Cardiothoracic Surgery is available for download from the Apple App Store. It includes over 700 multiple choice questions to accompany the upcoming 2nd edition of the TSRA Review of Cardiothoracic Surgery. The MCQs are organized by section and chapter, and the app is designed to track individual progress in order to allow for either broad or focused study.

Fellows are encouraged to take advantage of this resource to enhance their knowledge of Cardiothoracic Surgery and become better prepared for the annual In-Training Exam and post-fellowship ABTS exams.

Discounts

UMMC-Fairview Employee Perks & Discounts:

• Health Club Discounts 

• Tickets including: 

• Local attractions 

• Movie tickets 

• Broadway shows 

• Concerts & other special events 

• Sporting events 

• Gift & Dining Cards 

• Bus Passes & Stamps 

• Cell Phones & Plans, including: 

• Verizon Wireless offers a 22% discount on service plans of $34.99 or higher and 250 free text messages. 

• AT&T offers a 20% percent discount on service plans (not including iPhone 2G services). Discount is limited to two family members with a $9.99 monthly charge for additional lines. iPhone 3G voice and data plans are included. 

• Sprint PCS offers a 17% discount on new accounts. 

• Hotels & Car Rental 

• Discounts for Medical Plan Members (Fellows not eligible) 

• Daycare Services & Discounts 

• Pharmacy 

Visit https://intranet.fairview.org/Benefits/EmployeeDiscounts/index.htm for more details. You will be asked to log in with your UMMC-Fairview username and password to access the site.

UMN Employee Perks & Discounts:

• Minnesota Employee Recreation & Services Council (MERSC) Discounts, including;

  • Coupons 

  • Theatres - Music - Museums 

  • Sports Tickets

  • Entertainment & Recreation 

  • Auto Sales & Service 

  • Education - Child Care 

  • Event Services 

  • Health & Wellness 

  • Home Services 

  • Professional Services 

  • Retail & Restaurants 

  • Travel - Hotels - Resorts 

  • Employee Services Resources 

  • Advertising Specialties / Awards 

  • Event Services & Sites / On-Site Sales 

  • Group Events / Consignment Tickets 

• U Card Faculty & Staff Checking

• Metropass

• Technology Products, including: 

  • AT&T - Receive an 8% discount on your cell phone plan through AT&T 

  • Sprint Nextel - Receive a 10% discount on your cell phone plan through Sprint Nextel 

  • T-Mobile - Receive a 10% discount on your cell phone plan through T-Mobile 

  • Discounts on Apple & Dell products (% varies) 

  • Discounts on Software (e.g. Microsoft Office, Photoshop) 

  • Discounts on Operating Systems 

• Discounted Tickets and Passes, including: 

  • Movie Passes 

  • Minnesota Zoo 

  • Moose Mountain Adventure Golf 

  • Minnesota Sea Life Aquarium 

  • Minnesota Children's Museum 

  • Water Park of America 

  • Science Museum of Minnesota 

  • Nickelodeon Universe 

  • Vertical Endeavors 

  • Additional seasonal offerings (e.g. State Fair, Renaissance Festival, Minnesota Wild, St. Paul Saints, etc.) 

• Travel: It is recommended that travelers use the University's U-Wide travel vendors for personal/business travel. Substantial cost savings accrue to the University when travelers use any of these contracts. 

  • Delta airfare (Discounts start at 2% and are negotiated on an annual basis based on usage) 

  • Lodging

  • 
    

Surgical Loupes

The program provides one pair of surgical loupes for each incoming fellow, with a target expense of approximately $2,500. Fellows may work with the vendor of their choice, but the contact for local representatives are included below for your convenience. Fellows may request for reimbursement or charge the expense to the program's credit card. If arranging payment by program credit card, the fellow should contact the Program Administrator. 

Kevin Brennhofer
Designs For Vision
Regional Sales Representative
Cell: 651-734-8698
Office: 631-585-3300 or 800-345-4009
kbrennhofer@dvimail.com

Stipends

Refer to Base Rates and Policies

Bereavement Leave

Refer to Institution Policy Manual

Family Medical Leave Act (FMLA)

Refer to Institution Policy Manual

Holidays

Refer to Twin Cities & Rochester Holiday Calendar

Holidays that occur during a leave of absence run concurrent with the leave and are not in addition to the leave. Holiday scheduling for trainees is rotation-specific by program. The educational requirements and the 24-hour operational needs of the hospital are taken into consideration when scheduling holiday time off. 

Jury/Witness Duty

Refer to Institution Policy Manual

Medical Leave

Refer to Institution Policy Manual

Military Leave

Refer to Institution Policy Manual

Parental Leave

Refer to Institution Policy Manual

Personal Leave of Absence

Refer to Institution Policy Manual

Professional / Academic Leave

Time off to attend an event that holds educational value is considered professional / academic leave (e.g. society meetings, courses, ABS board exams, etc.) and does not count against vacation / PTO leave balances. Fellows must request professional / academic leave at least two months in advance to the Program Administrator by using the specified program leave request form and are responsible for accurately logging their professional / academic leave in RMS-New Innovations if the event is required by the program. The CT Fellow Leave Google Calendar should be referenced when planning any time away to ensure there will be appropriate coverage. Whenever applicable, RMS professional / academic leave logs should include weekends and holidays. 

Two travel days are included for out-of-town (domestic) events; additional travel days may be approved for international travel at the discretion of the Program Director. Fellows are allowed five weekdays of professional / academic leave to attend one national meeting per year for domestic meetings within the contiguous states. Fellows are allowed up to an additional three weekdays of professional / academic leave to present a manuscripts or poster that is accepted at approved meetings, as determined by the Program Director (limited to travel and presentation time only). Additional meetings may be allowed when a fellow has peer-reviewed data to present, at the discretion of the Program Director.

Fellows must request all professional / academic leave in writing to the Program Administrator at least 45 days prior to the requested leave date(s) using the specified program leave request form. The CT Fellow Leave Google Calendar should be referenced when planning any time away to ensure there is appropriate staffing and coverage. All time off must be approved at least two weeks prior to the time away requested; call coverage must be secured at the time of the request.

Refer to Travel UMN for travel policies and guidelines. Fellows must first complete an Authorization to Travel form and submit it to the Program Director and Program Administrator for approval before expenses can be charged or reimbursed.

Refer to Eligible Expenses & Reimbursement section for expense and reimbursement related University policies and procedures

Vacation Leave / Personal Time Off (PTO)

First and second year fellows receive 14 days vacation days and 7 personal days per academic year. Third year fellows receive 14 vacation days and 14 personal days per academic year - these additional personal days are allowed for the purpose of interviewing.

It's strongly recommend fellows discuss time off plans with the rotation director, co-fellows, and staff early when planning for time away. Vacation leave should be taken as a one-week period every six-months (August - January, February - July), with personal days scattered through the year for emergency situations (e.g. sick leave or medical appointments) or interviews. Vacation and personal days not utilized during the academic year will not be carried over to the following academic year. Time off requests must include applicable weekends/holidays. Although weekends and holidays do not count against vacation leave or PTO balances, the program must be informed of this time off primarily to prevent issues with call scheduling and coverage. 

Fellows must request all vacation leave and/or anticipated PTO in writing to the Program Administrator at least 45 days prior to the requested leave date(s) using the specified program leave request form. The CT Fellow Leave Google Calendar should be referenced when planning any time away to ensure there is appropriate staffing and coverage. All time off must be approved at least two weeks prior to the time away requested; call coverage must be secured at the time of the request.

Policy on Effect of Leave for Satisfying Completion of Program 

ABTS Residency Requirements state that, “Candidates for certification must complete a minimum of 24 months of residency training in thoracic and cardiovascular surgery in a program accredited by the RRC-TS. This must include 12 months of continuous senior responsibility.”

Health Services

Fairview Employee Occupational Health Services (ph: 612-672-5050) is open Monday - Friday, 7:30 AM - 4:00 PM, and located at;

Mayo Memorial Building
420 Delaware Street SE, room B324 (3rd floor, B-wing)
Minneapolis, MN 55455

They provide support to fellows through services such as;

• immunizations—seasonal flu, MMR, TDAP and Varicella 

• mantoux screenings and testing 

• coordination of fit testing/respiratory protection 

• blood-borne pathogen exposure follow-up 

Health & Professional Liability Insurance

Refer to Office of Student Health Benefits for more information regarding health, dental, life insurance, etc.

Refer to Medical Malpractice Credentialing / Insurance Verificaton > http://www.finsys.umn.edu/riskmgmt/RUMINCOandWorkCompCOI.pdf for policy and certificate of liability insurance information. Procedure for requesting liability credentialing / malpractice claims history / loss-run report: the fellow must sign an authorization using a generic template (electronic signature or verbal authorization is not acceptable) and submit the request by email with attached authorization to medcred@umn.edu.

Meal Tickets/Food Services

Meal cards are provided for use in the UMMC-Fairview Bridges Cafeteria and the UMMC, Fairview Riverside West Bank Cafe. At the VA, the kitchen has a list of who is on call. At all other sites, the on-site Graduate Medical Education Office should provide you with the details of your meal allowances, if applicable.

In order to receive a UMMC-Fairview meal card, fellows will be provided with the Meal Card Policy and Procedure at the start of each academic year, and will be required to sign and return the Statement of Acknowledgement to the Program Administrator.

Lab Coats

The program provides incoming fellows with two lab coats embroidered with their name, credentials, and Cardiothoracic Surgery. If needed, fellows may purchase additional coats at their own expense.

Laundry Services

Soiled coats can be dropped off in the hamper in the Department of Surgery. Clean coats may be picked up one to two weeks later at the same location. Contact the Critical Care receptionist at (Office): 612-625-4424 for the key to the locked closet in the Phillips-Wangensteen Building, 11th Floor, that the hamper and coats are stored in.

Eligible Expenses & Reimbursement 

The University of Minnesota will provide reimbursement to fellows for eligible expenses including surgical loupes, SESATS, academic-related travel, and other approved expenses as identified in the program manual. Fellows must first complete an Authorization to Travel form if traveling on University funding and submit it to the Program Director and Program Administrator for approval before expenses can be charged or reimbursed.

Fellows must provide the Program Administrator with all applicable receipts, with the exception of travel meal receipts, within 30 days of the fellow's return date or original purchase. Bank statements are not accepted as receipts or in lieu of. If you no longer have a receipt, complete a Statement in Lieu of Receipt. Travel meal receipts are not required; the fellow will simply be reimbursed the appropriate meal per diem according to the GSA website. 

Expenses Eligible for Reimbursement:

• Taxi fares to/from home, airport, and hotel; airport parking (*Car rentals in lieu of taxi service require prior approval from the program and written justification from the fellow if seeking reimbursement)

• Airfare (coach/economy class only, includes flight, luggage, and seating fees; upgrades are not reimbursable)

• Conference/meeting/course registration fees

• Hotel fees (must be at conference rate; if the hotel does not offer a conference rate, reimbursement is only allowable up to 150% of the nightly lodging rate pre-taxes for the destination city, as referenced on the US Government General Services Administration (GSA) website for domestic lodging).

Reimbursement Guidelines:

• Requests for reimbursement must be submitted to Program Administrator within 30 days of the fellow's return date or original purchase with all required documentation.

• Bank statements will not be accepted as receipts. Receipts must be clearly itemized and labeled for all reimbursable transactions. If travel was booked booked through an online travel service such as Expedia, Orbitz, etc,..individual flights and associated luggage fees must be clearly listed on the receipt.

• Receipts from meals do not need to be submitted with reimbursement paperwork. UMN requires meal reimbursement based on GSA meal per diem rates, which will be calculated into your final expense worksheet.

Tech Center

The Academic Health Center Office of Information Systems (AHC-IS) Tech Center is your one stop shop for all of your computer needs. Services range from a general computer question to a complete operating system restore. Technicians are Apple and Dell certified so you can rest assured that your computer needs will be met. AHC-IS has the same troubleshooting tools and certifications that you would find at a Genius Bar in an Apple store. If you have a serious problem or if you have a general concern, they are here to help.

Support is offered to fellows using University of Minnesota devices, but not undergraduate students.

Tech Stop

The Office of Information Technology (OIT) Tech Stop provides a central location for students (e.g. fellows) to receive face-to-face technology consultations, support and training.

Tech Stop staff offer walk-in assistance and support for University technology services including Google Apps, email application configuration; Internet password changes; Symantec AntiVirus installation or assistance; consultations on virus removal; wireless network configuration for mobile devices; ResNet connection problem troubleshooting; updating drivers; VPN installation; common good software such as email, Moodle; and much more, including general "how do I get started with…" questions.

Tech Warranty & Repair

The M Tech Store at the U of M Bookstore in Coffman Memorial Union is the official Apple Authorized Service provider for University of Minnesota students, staff, and faculty. Also offers fee-based out of warranty repairs on all makes and models of PC computers and common repair services for many brands of cell phones and tablets including Apple and Samsung.

Visit M Tech Warranty & Repair for detailed information about services offered.

Textbooks and Educational Materials

The program provides a one-time $300 reimbursement toward academic book purchases or journal subscriptions not provided by the program, to be purchased during the first year of training. This should be ordered through the Program Administrator.

Travel (UMN)

The program will provide up to $2,500 to attend at least one national meeting or board review course per academic year. If a fellow has funds remaining, it may be applied toward subsequent approved meetings with Program Director approval. Unused funds will not be applied toward subsequent academic years or other types of purchases (e.g. loupes). For pre-approved international travel, fellows should use a U of MN Contracted Travel Agency due to the Fly America Act (49 U.S.C. 40118).

The program encourages fellows to refer to the CT Fellow Leave Google Calendar and discuss among themselves which meeting/conference they would like to attend prior to or at the start of the academic year to ensure coverage is always available. 

Refer to Professional / Academic Leave section for policies and procedures on how to request time away for educational events. 

Refer to Eligible Expenses & Reimbursement section for policies on eligible expenses and procedure for requesting reimbursement.

Podium Presentation

If a fellow is invited to give a podium presentation at a national meeting, the fellow may use up to $2,500 of their annual travel allowance to attend the meeting. If the fellow's annual travel allowance has exceeded from attending and/or presenting at a previous conference/meeting, the program and divisions may provide additional funding at the discretion of the Program Director for the fellow to attend the day prior and day of the podium presentation. Funds left over from these meetings may not be applied toward subsequent meetings and will not accrue.

In order to receive reimbursement, the fellow must provide the Program Administrator with a copy of the letter indicating acceptance of the presentation/abstract/manuscript, and a copy of the presentation/abstract/manuscript itself. A copy of the cover letter to the editor of the journal to which the manuscript has been submitted should also be enclosed, if applicable. 

Refer to Professional / Academic Leave section for policies and procedures on how to request time away for educational events. 

Refer to Eligible Expenses & Reimbursement section for policies on eligible expenses and procedure for requesting reimbursement.  

UCard

Your student UCard may be used for:

• After Hours Door Access (if activated) 

• Authorized Secured Building Access (if activated) 

• Computer Labs 

• Gopher GOLD

• Passport Photos

• Recreational Sports Center

• TCF Checking

• Ticket discounts

• University Libraries

URL shortening service

z.umn.edu is available to anybody with a University of Minnesota X500 account.

Worker’s Compensation Program Specific Policies and Procedures

Refer to Institution Policy Manual

Resident and Fellow Assistance Program (RAP)

RAP is for fellows and their family members, faculty, attending physicians, department heads and supervisors who need help in dealing with fellow and fellow-related concerns. There is no charge associated with assessment and short term counseling services provided through the RAP program.

Counselors are available to help address issues and personal concerns such as the examples listed below.

• My debts have become overwhelming. How can I get a handle on them? 

• I think the stress of my residency is impacting my health. How do I discreetly find out? 

• I worry about my career choice. Who should I talk to? 

• My relationship isn't fulfilling but I don't want to be alone. What do I do now? 

• My spouse is having difficulty adjusting to my residency. How do we adjust in a way that works for both of us? 

Parking

UMMC, Fairview University Campus (East Bank) 

• Fellows receive a parking card for the East River Road Garage. There is no charge to the fellow for this parking contract. Contact Program Administrator with questions regarding parking on the east bank. Issues with parking card contracts or facility access should be directed to UMN Parking & Transportation. 

UMMC, Fairview Riverside Campus (West Bank) 

• Parking is embedded in UMMC-Fairview ID Badge. Contact Fairview Parking Services at 612-273-7275 with questions regarding parking on the Riverside campus. 

• A refundable payment of $25 is required for Riverside parking, and includes after-hours parking on the East Bank. Fellows should return their Fairview ID badge at the end of their fellowship to receive their $25 deposit back. This expense is not reimbursed by the program. 

UMMC-Fairview Additional Night/Weekend Privileges 

• Fellows who have paid the $25 deposit for Riverside parking receive reciprocal parking privileges, which allow you to park in a specific location on a campus other than your assigned facility, if space is available. Reciprocal space is not guaranteed. When event rates are in effect or there is a large group reservation, space availability is at the discretion of the parking attendant on duty. 

• Monday - Friday, after 4:30 PM 

• All day Saturday - Sunday 

• Official University holidays

• East Bank: 

  • Lots C33, C55, C58, C59 

  • Gateway Lot 

  • Gold Lot 

  • Gopher Lot 

  • Fourth Street Ramp 

  • Oak Street Ramp 

  • Patient/Visitor Parking Ramp 

  • University Avenue Ramp 

  • Washington Avenue Ramp 

  • East River Road Garage 

  • Nolte Center Garage 

• West Bank: 

  • 19th Avenue Ramp 

  • 21st Avenue Ramp 

  • West Bank Office Building (lower levels) 

  • C86 

  • C98 (top of WBOB Ramp) 

• St. Paul:

  • Gortner Avenue Ramp 

SECTION 3 - INSTITUTION RESPONSIBILITIES

Refer to Institution Policy Manual

SECTION 4 - DISCIPLINARY AND GRIEVANCE PROCEDURES

Refer to Institution Policy Manual

SECTION 5 - GENERAL POLICIES AND PROCEDURES

ACLS/BLS/PALS Certification Requirements

Certification requirements vary by hospital site. Fellows are expected to maintain certification as requested by hospital sites. Review the UMN GME Affiliated Sites Life Support Certification Resource for information, costs, and contacts for scheduling life support certification training at other affiliated hospital sites. Additional information provided at: http://hub.med.umn.edu/resident-fellow-administration/life-support-certification

Reminder: The American Board of Thoracic Surgery (ABTS) requires proof of expired or current ACLS, ATLS, and FLS certification to be eligible to apply for board certification.

Program-Specific Visa Policies

The J-1 alien physician visa sponsored by ECFMG is the preferred visa status for foreign national trainees in all U of MN graduate medical education programs, as well as the Thoracic Surgery training program. We will also consider applicants with H-1B visas.

Fellows with visas will work with gmevisas@umn.edu, not their Program Coordinator, to maintain visa status. Review the GME’s website about Maintaining Your J-1 Visa Status. This site contains important reminders about how to maintain your J-1 status throughout the academic year, along with answers to our most frequently-asked questions from J-1 visa holders.

If you plan to travel, there is also additional information outlined on this website. Please notify the TPL (gmevisas@umn.edu) of any travel plans 60 days in advance.

Program Curriculum

All conferences, events, etc. are noted on the CT Conference Schedule (Google Calendar). This calendar is shared with fellow’s @umn.edu account at the start of training. Reminders are sent by the Program Coordinator via email. Fellows are expected to refer to the conference calendar regularly to be aware of upcoming conferences.

Fellows are expected to attend all program conferences. Faculty are expected to attend when hosting Core Curriculum, and if available for Fellow Talks and Journal Club.

• Core Curriculum: Faculty hosts use Thoracic Surgical Curriculum provided by Joint Counsel for Thoracic Surgery Education.

• Fellow Talks: Fellows are expected to provide two presentations per academic year on topics of their choice.

• Journal Club: Faculty member selects articles for review.

• Mock Orals: Faculty host prepares fellows for ABTS Oral Boards.

• Mentoring Program: A faculty mentor will be identified for each fellow within the first half-year of their training in the program. The faculty mentor will serve as someone in which the fellow can discuss future plans with and potential crises as they arise.

• Cardiothoracic, Vascular and Pediatric Cardiac Surgical Clinical Excellence Unit (CEU) Presentation (Expanded M&M Quality Conference): Conferences will be held monthly, and cases presented will be from the previous month. All cases performed by each division/section with a listing of all complications will be tabulated 10 days prior to the conference. All deaths and selected complications will be presented

Faculty, residents, and fellows will be expected to participate in presentations from all divisions/sections to act as peer reviewers. Advanced practice providers, nurses, data collectors who are part of the team may participate.

Program Goals and Objectives

Specific rotation curriculum including competency based goals and objectives are assigned for fellows to review in RMS 7 days prior to the start of each rotation. They are also accessible on our online website at the following URL: https://sites.google.com/a/umn.edu/ctpolicymanual/home/GoalsandObjectives 

Goals and Objectives for Teaching Medical Students

Fellows who supervise or teach medical students must be familiar with the educational objectives of the course: http://www.meded.umn.edu/clerkships/SURG_7500.php

The student will be exposed to the full spectrum of General Surgery while on the rotation. Overlapping areas covered may include Vascular Disease and Post-Op Management, Complications.

Students are required to be involved in the pre-operative evaluation and post-operative management of patients on the General Surgery Service and in clinic, and are expected to assist in the operating room.

Training/Graduation Requirements

Program Director uses evaluations, In-Training Exam scores, ACGME Milestones data, and Clinical Competency Committee recommendations to determine whether the fellow is prepared to advance to the next training year or graduate and practice independently.

ABTS Operative Requirements are available at: https://www.abts.org/ABTS/Initial_Certification/Operative_Requirements_Home_Page.aspx 

ABTS/ACGME Case Log Index is available at: https://www.abts.org/ABTS/Initial_Certification/Operative_Requirements/Index%20Case%20Requirements-2017.aspx 

ACGME Competencies

Refer to Thoracic Surgery Program Requirements, Section IV.A.5. ACGME Competencies (pages 15 - 19) 

ACGME Milestones Sub-competencies

Refer to Thoracic Surgery Milestones Project

Dictation Completion

The expectation is that dictation will be completed timely, i.e. operative report within 24 hours of leaving the Operating Room. Additionally, discharge summaries should be dictated within seven days following hospital discharge. Dictation instructions can be found in RMS-New Innovations under "Site Information" powerpoints for each respective site.

Clinical Experience and Education (Duty Hours)

The program policy for clinical experience and education (formerly known as duty hours) follows ACGME Common Program Requirements. Duty hours are defined as all clinical and academic activities related to or required by the program, such as:

• inpatient and outpatient care 

• administrative duties relative to patient care 

• the provision for transfer of patient care 

• time spent in-house during call activities 

• scheduled activities (e.g. conferences) 

Duty hours do not include reading and preparation time spent away from the duty site. Duty hours must be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities. Fellows must be provided with one day in seven free from all educational and clinical responsibilities, averaged over a four-week period, inclusive of call. Adequate time for rest and personal activities must be provided. This should consist of a 10-hour rest period provided between all daily duty periods and after in-house call.

Fellows are expected to complete a monthly duty hour survey on the 1st of each month for the prior month's hours. Fellows are encouraged to contact the site director or program director if they feel their workload is negatively affecting the quality of their education or is not adhering to required guidelines. 

The fellow must provide a justification for violating duty hours, or the survey will be returned to the fellow for more information.

Evaluation

Evaluation of Faculty 

• Fellows are asked to evaluate faculty performance after each rotation. These evaluations include a review of the faculty’s clinical teaching abilities, commitment to the educational program, clinical knowledge, professionalism, and scholarly activities. 

• Fellows also evaluate faculty performance overall during annual program evaluation.

• Faculty may request a summary report of their evaluations from the Program Coordinator at any time. The Program Coordinator will provide the report if at least three fellows have evaluated the faculty member, in order to keep responses confidential.

• The program director will review fellow evaluations of faculty and approve the continued participation of program faculty based on evaluations. 

Evaluation of Fellow: Formative

• Program faculty are expected to evaluate fellow performance in a timely manner at the conclusion of each rotation. Faculty complete fellow evaluations using RMS. 

• Faculty are expected to provide objective assessments of fellow competence in patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice. 

• Fellows may request a summary report of their rotation evaluations from the program coordinator at any time. The program coordinator will provide the report if at least three faculty members have evaluated the fellow, in order to keep faculty responses confidential. 

Evaluation of Fellow: Mid-Year and End-of-Year (Semiannual)

• The program director meets with each fellow individually for a semiannual evaluation of performance with feedback, in January and June. The meeting focuses on the previous months of training (July – Dec., Jan - June.), and will include a review of the following; 

  • Case logs 

  • Compliance in completing rotation and faculty evaluations 

  • Duty Hours Summary, including violations 

  • Evaluations 

    • Faculty Evaluation of Fellow 

    • Milestones 

  • In Training Exam scores 

Fellow Evaluation: Summative

• The program director provides a summative evaluation for each fellow upon completion of the program. The program director can provide a copy of the summative evaluation to the fellow at the time of the meeting. 

• This evaluation documents the fellow’s performance during the final period of education, and verifies that the fellow has demonstrated sufficient competence to enter practice without direct supervision. 

Fellow Advancement

First year fellows are exposed to six months of general thoracic surgery and six months of general cardiac and thoracic surgery. In these rotations, they are introduced to the core competencies for each specialty. They learn basic surgical tenants and techniques.

The second year continues with more specific specialties including: pediatric cardiovascular surgery, thoracic endovascular surgery, minimally invasive cardiac and thoracic surgery, and general cardiothoracic surgery in a private practice environment.

The third year emphasizes independence, increased responsibility, and advanced specialization including heart and lung transplantation, ventricular assist device implantation, advanced surgery for heart failure, valve sparing techniques, robotic techniques and surgery on the great vessels. The goal of our sequence is to have the fellow fully independent and ready for practice of thoracic surgery upon graduation.

All fellows attend outpatient clinics where preoperative patients are seen in consultation. They participate alongside the attending faculty in reviewing all the pertinent patient data including the history and physical, any notes from referring physicians, catheterization data, and any other imaging information that may be available. The process for inpatient consultation is very similar. The fellows then document his/her findings with respect to the individual patient in the patient’s medical record.

In the postoperative period, fellows work on the respective thoracic services, are in charge of the care of the patients on those services. Because of fellow work hour restrictions, we have integrated surgical intensive care unit services into the care of some of the postoperative cardiac and thoracic patients. It is important to point out that the fellow in cardiac and thoracic surgery under these respective services is expected to direct the care, under the supervision of the appropriate cardiothoracic and thoracic surgery faculty. Once the patient leaves the surgical intensive care unit, the thoracic surgery fellow remains in charge of the care until the patient is discharged from the hospital.

The same model pertains to trauma and emergency patients, as well as pediatric cardiac patients.

Our goal is to advance and graduate fellows to function as qualified practitioners of surgery at the high level of performance expected of a specialist at their level. To achieve this goal, we engage fellows in a planned curriculum delivered via lectures and conferences, In Training exams, at bedside and in the operating room with progressively graded clinical and operative experience. Through appropriate supervision and guidance and a structured evaluation system, fellows develop a high level of professionalism, as well as the requisite clinical and surgical skills.

On Call Schedules

Heart & Lung Procurement (0540) 

• 3rd year fellows provide procurement schedule to Program Administrator. 

• 3rd year fellow is on call every night except for the days that s/he is marked off or when s/he is not on weekend call – on those days when s/he is not covering, then 3rd year UMH fellow or the CVT Transplant fellow covers. 

• In rare circumstances when both 3rd year CT fellows or the CVT Transplant fellow is out of town, they must assign a 2nd year to cover procurement. 2nd year must be certified by LifeSource to do heart and lung procurements. 

Adult CV + Transplant (0245)

• 3rd year UMH fellow covers the same weekends s/he is scheduled to cover heart & lung procurement (0540) 

• 3rd year UMH fellow is on call every night except for the days that s/he is marked off or when s/he is not on weekend call – on those days when s/he is not covering, then 1st year UMH fellow covers. 

Thoracic (0171)

• 3rd year UMH fellow covers the same weekends s/he is scheduled to cover heart & lung procurement (0540) 

• 1st year UMH fellow will be on call every day except for the when s/he is off or not on weekend call – on those days when s/he is not covering, then 3rd year UMH fellow covers. 

Program Administrator is responsible for entering above schedules into Qgenda, and circulating to the “Call Schedule” email list.

Caroline Orth is responsible for the VA fellow schedule.

2nd year FVS fellow covers two weekdays at FSH. Fellow should notify Program Administrator what weekends s/he plans to cover. Faculty cover call when the fellow is off.  

*Weekends include Fridays.

On Call Rooms

UMMC, Fairview has 18 on call rooms located on the 4th floor of the Mayo building. All rooms have punch code security access which is changed daily and contain a desk, TV, clock radio, and air conditioning, with a security monitor on duty from 2:00 pm - 8:00 am. On call fellows, medical students, fellows, physicians and certain on call hospital staff are eligible to check-in to a call room. Check-in can only occur during the designated check-in hours of 2:30 pm until 7:00 am.

Go to the check-in desk located in the Fellow Lounge (Mayo C496). The check-in desk is staffed by a security monitor during set hours 7 days/week and will require you to present your hospital ID badge. The security monitor will assign you a room and give you the access code along with the locker room and lounge access codes. All individuals must be out of their rooms by 8:00 am. Housekeeping will come to begin cleaning by 7:00 am. If you wish to sleep until 8:00 am, make sure your DO NOT DISTURB sign is indicated on your door. No room is checked out to the same service two days in a row. Belongings left in room past noon will be removed and kept in a security locker. Belongings can be picked up any time after 2:30 pm from the security monitor.

UMMC, Fairview on call room assignments are made in order of priority based on the individual’s status and responsibilities. Assignment Order:

1. Fellows and residents required to take call from the hospital 

2. 3rd and 4th year medical students required to take call from the hospital (1st and 2nd year medical students are not required to take in-house call) 

3. Faculty required to take call from the hospital 

4. All other trainees, staff physicians, or medical students needing an on-call room 

5. Non-medical staff, excluding CRNAs 

A trainee who is on call and must remain at UMMC, Fairview is guaranteed a room in which to sleep. The trainee will have the first option for selection of on call rooms on the 4th floor of the Mayo Building until 9:00 PM. Thereafter, call rooms will be distributed on a first-come, first-served basis. If the on-call rooms on the 4th floor of the Mayo Building are full, the nursing supervisor will be contacted and they will locate a room for the trainee. Every effort will be made to secure call rooms for 3rd and 4th year medical students and/or attending staff physicians who are on call and need to remain in the hospital overnight.

• Mayo Lounge: 612-626-6330 

• Nursing Supervisors: 

  • Riverside: 612-273-6535 

  • University: 612-273-6235 

The Cardiothoracic Fellow’s lounge is located at 305 VCRC and is equipped with a rocker/recliner, reclining sofa, refrigerator, microwave, and coffee pot. There are two computers, scanner, and printer, as well as current medical books on the bookshelves. Contact the Program Coordinator for the door access code.

A similar office space is maintained at the VA for use by fellows assigned to that location.

Support Services

Refer to the Program Coordinator for all program-related questions, including but not limited to all of the topics covered in this Program Manual.

Needle Sticks & Blood Borne Pathogen Exposure (BBPE) Management

Follow this link for detailed instructions; http://www.gme.umn.edu/fellows/needle/home.html. Fellows are considered employees as far as bloodborne pathogen exposures are concerned (not students). Identify yourself as a fellow to Employee Health, as this is considered a worker's comp issue and should be handled accordingly.

• Go to the Employee Occupational Health Service at the site the needle stick occurred ASAP. Initial care should occur at your training site, either through the Employee Health Service or the Emergency Department. If the exposure occurs when these facilities are not open, go to the nearest HealthPartners Urgent Care location or Emergency Department. The Centers for Disease Control and Prevention recommend that the exposed person seek treatment within 1-2 hours after initial exposure. It is your responsibility to learn facility-specific exposure protocols when you begin your rotation. 

  • If you are unsure of where to receive treatment, call the 24-hour HealthPartners Care Line at 612-339-3663 or 800-551-0859. The Triage Nurse will direct you to the appropriate location for care. 

• Identify the source patient with the help of your preceptor and/or the designated representative of the facility. The source patient’s blood should be tested after consent is obtained according to your treatment site practices. If the source patient has a known history of HBV, HCV, or HIV, it is unnecessary to test for the specific disease. 

• Within 8 hours, submit an e-FROI (First Report of Injury). This is to ensure appropriate follow-up and to be eligible for Workers Compensation coverage. After you complete the E-FROI, you will be contacted for post-exposure care within 3 business days by HealthPartners Occupational and Environmental Medicine (HPOEM). 

• Within 24 business hours (3 work days), fellows must ask the faculty member who was supervising them at the time of the stick to complete a Supervisor Incident Investigation Report (DOC). 

• If a fellow, fellow, or medical student is infected with HCV, HBV, or HIV, he/she must report this infection to the Medical School’s Bloodborne Infectious Disease Review Panel by contacting the University of Minnesota Office of Occupational Health and Safety at uohs@umn.edu or 612-626-5008. This reporting is required by Minnesota law. 

  • If the exposure occurred as a result of contact with a contaminated sharp, the injury must be reported to the Office of Occupational Health and Safety at uohs@umn.edu. The log will protect the confidentiality of the injured employee but will contain the following information: 

    • the type and brand of device involved in the incident; 

    • the department or work area where the exposure incident occurred; and 

    • explanation of how the incident occurred. 

If you encounter any problems with this process, notify Carol Sundberg, GME Operations Director, at sundb001@umn.edu or 612-626-3317.

Fairview Attire Policy (UMMC, East & West Banks)

Review Attire, Surgery/Invasive Procedure areas and Personal Belongings—Perioperative Services—UMMC policy.

As of September 2015, auditing of compliance to the policy will occur. Each campus, including Sports and OB, will be audited each month by Infection Control. "In the moment" corrections will be made by the auditor for anyone not adhering to the policy. Auditors will report names to the appropriate department leadership each month. Because this is a policy, pushback to the auditors will not be tolerated. Any push back will be reported to the appropriate leader and may result in discipline. Please, also, feel free to correct attire noncompliance as you see it. It is everyone's responsibility to provide the safest environment for our patients.

Fairview Laboratory & Pathology Services

Fairview Diagnostic Laboratories Guidelines and Tools

Fairview Laboratory and Pathology Contacts, Policies and Procedures

Fairview Radiology Services

Fairview Radiology and Imaging Information

Medical Records

Fairview Medical Record Contacts and Forms

Fairview Medical Record Content Policy

Security/Safety

The Security Monitor Program (SMP) is a branch of the University of Minnesota Police Department. SMP offers a walking/biking escort service to and from campus locations and nearby adjacent neighborhoods. This service is available completely free to students, staff, faculty, and visitors to the University of Minnesota Twin Cities campus. To request an escort from a trained student security monitor, call 624-WALK shortly before your desired departure time.

UMMC, Fairview employee security officers who are on duty 24 hours a day to respond to emergencies and to escort persons to and from the parking facilities. Call 612-273-4544 if you wish to have an escort, and a security officer will meet you at your location.

Moonlighting

Moonlighting is not permitted.

Supervision & Levels of Supervision

All patient care activities are supervised by qualified faculty. The program director ensures, directs, and documents adequate supervision of fellows at all times. The fellows are provided with rapid, reliable systems for communicating with supervising faculty. The faculty schedules are structured to provide fellows with continuous supervision and consultation. The faculty and fellows have been educated to recognize the signs of fatigue and to adopt and apply the appropriate policies to prevent and counteract the potential negative effects of fatigue.

The attending physician is responsible for all aspects of the care of each patient and will supervise the conduct of each fellow’s patient care. The level of complexity and independence in patient care provided by each fellow on service will be determined by each faculty member. This determination will be based on the fellow’s level of training and skill. This progressive delegation of responsibility is designed to allow the fellow to develop increasing degrees of autonomy in preoperative, intraoperative, and postoperative patient management. Staff surgeons will perform patient care rounds with the fellows and will maintain written records in accordance with each institution’s guidelines. A staff surgeon will be available at all times to assist in his/her patient’s care.

The staff surgeon will supervise fellows in preoperative patient evaluations, obtaining consent and postoperative care (including the maintenance of the medical record). The staff surgeon will be present for all operative procedures and will appropriately document his/her participation in each operation.

Three levels of supervision are recognized. They are:

Direct Supervision

• The supervising physician is physically present with the resident or fellow during the key portions of the patient interaction; or

• The supervising physician and/or patient is not physically present with the resident or fellow and the supervising physician is concurrently monitoring the patient care through appropriate telecommunication technology. 

Indirect Supervision

• The supervising physician is not providing physical or concurrent visual or audio supervision but is immediately available to the resident or fellow for guidance and is available to provide appropriate direct supervision. 

Oversight

• The supervising physician is available to provide review of procedures/encounters with feedback provided after the care is delivered.

Faculty Responsibilities for Supervision

Faculty supervision assignments are of sufficient duration to assess the knowledge and skills of each fellow and resident. Based on this assessment, the supervising faculty will delegate to the fellow or resident the appropriate level of patient care authority and responsibility. The principles which apply to delegation of the privilege of progressive authority and responsibility and conditional independence are as follow:

• At all times, faculty members will determine the appropriate level of supervision for all trainees.

• Fellows will be supervised according to their PG level; the severity and complexity of patient illness/condition; and the individual fellow’s knowledge, experience, and skill.

• The physical presence of a supervising physician is required during key portions of emergency operations, resuscitation of hemodynamically unstable patients, and any other circumstance deemed necessary by the supervising physician.

Faculty Supervision Backup Plan

In the event that a supervising faculty member (attending of record or on-call physician) is unable to be reached, the trainee should contact the site director at that hospital. Should any of these individuals be unreachable, the trainee should contact the Program Director, Associate Program Director, or the Division Chief. If these individuals are not reachable, the trainee should contact the Chief of Surgery, Dr. Sayeed Ikramuddin (or designee). In the event none of these individuals is able to be reached, the fellow should contact the Chief Medical Officer.

Fellows’ Responsibilities for patient care

The principles which apply to delegation of the privilege of progressive authority and responsibility are as follow:

• In recognition of the fellows’ progress towards independence, faculty members functioning as supervising physicians will delegate portions of care to fellows and residents based on the needs of the patient and the skills of each trainee

• These privileges are assigned by the program director and faculty members.

• With oversight from faculty, the fellow will supervise the daily patient care by knowing the progress of every patient every day and personally examine patients experiencing problems.

Guidelines for circumstances and events in which fellows and residents must communicate with the supervising faculty member(s)

All residents and fellows, regardless of year of training, must communicate with the appropriate

supervising faculty member, according to these guidelines:

• Patient admission (excluding post-op)

• New consults

• Patient transfers

• Patient demonstrates significant pain of unexplained etiology

• Patient requires unexpected transfusion of blood or blood product

• Change in patient’s vital signs or condition, including:

  • Initiation of inotropic or other supportive agents

  • Unanticipated intubation or ventilator support

  • Development of new, significant neurologic changes

  • Development of new, significant cardiopulmonary complications

  • Transfer to higher level of care or potential need for surgery

  • Decision for palliative or end-of-life care

  • Death

Progressive Responsibility for Patient Management

The principles which apply to delegating a supervisory role in patient care are as follow:

• Each fellow must know the limits of his or her scope of authority, and the circumstances under which he or she is permitted to act with conditional independence.

• Progressive authority and responsibility, conditional independence, and a supervisory role in patient care will be delegated to each fellow by the program director. These privileges will be granted on the basis of the fellow’s abilities based on specific criteria including formative evaluations, level of training, and clinical experience and will be guided by the milestones.

• With oversight from the faculty, supervise fellow under indirect supervision with direct supervision immediately available. This privilege is granted in recognition of the fellow’s progress towards independence, based on the needs of each patient and the skills of the individual fellow.

Transitions of Care and Handoffs

Fellows receive focused and relevant transitions of care and handoffs training during their GME orientation to build these skills, use clear assessment strategies, and document this competency. 

Fellows and faculty members are expected to demonstrate responsiveness to patient needs that supersedes self-interest. They must recognize that under certain circumstances, the best interests of the patient may be served by transitioning that patient’s care to another qualified and rested provider.

Handoff Checklist - University of Minnesota Medical Center

1. Patient name and medical record number 

2. Consult vs. primary patient 

3. Attending for the patient 

4. Procedure performed or reason for consult 

5. # days post op or # of days in-house if pre-op 

6. Any complications or unusual circumstances re procedure 

7. Issues with recovery, medical comorbidities, special medications 

8. Weight bearing status, elevation, dangling 

9. Anticipated discharge date, possible discharge issues (if over the weekend and covering fellow is going to discharge) 

10. Anticipated pages and response (what to do if a situation arises that is specific to the patient) 

The fellow on the service discusses the above checklist with the fellow either taking over for the evening or weekend, prior to the time changeover occurs. The fellow on the service keeps the patient list current in EPIC.

The fellow on evening call or weekend call will give a check out to the fellow on the service prior to the time changeover occurs in the morning. Any changes in the patient's status or important clinical activity is discussed in the check out. Any new admissions, surgical cases or consults are also discussed with the above checklist used as a template.

Monitoring of Fellow Well-Being

The Cardiothoracic Surgery Program is committed to monitoring the well-being of the fellows in the training program.  Daily contact between faculty and fellows provides opportunities to observe fellows on a regular basis.  Faculty observe for signs of fatigue, distraction, tardiness, or other signs that could indicate overwork or personal problems.  The faculty and trainees are instructed to understand and notice signs of fatigue and to intervene for coverage as needed. 

The GME office provides an orientation for all incoming residents and fellows that includes the topic of Physician Well Being.  During this orientation, fellows are made aware of the confidential Resident Assistance Program that is available for fellows and their families should they require outside assistance.

The University's GME office provides a comprehensive listing of "well-being tools" and resources for fellows: https://med.umn.edu/gme/education/current-residents-fellows/support-resources

Fighting Fatigue: A Guide for Cardiothoracic Surgery Fellows 

Working at night is an essential part of providing a comprehensive 24-hour service to patients. However, night work requires fellows to remain awake and alert when physiologically programmed to be asleep. Fellows may take 24-hour calls or procurement calls on certain rotations, and, on these occasions, fellows often may find it necessary to stay away and working throughout the entire night.

The aim of Fighting Fatigue: A Guide for Cardiothoracic Surgery Fellows is to provide simple advice on how to prepare to work at night. It includes guidance on managing sleep at home, staying as alert and refreshed as possible while on duty at night, and how to recover from working nights in the most efficient and effective way. Although the Guide has been written with those working extended night or on-call rotations in mind, much of the advice is applicable to those fellows taking more prolonged calls. Indeed, these longer calls carry the risk of even more severe sleep deprivation, than simple night call.

Resource: https://tsda.org/resources/surgeon-and-resident-well-being/

Policy to Ensure Coverage of Patient Care in the Event That a Fellow is Unable to Perform Patient Care Responsibilities

In unusual circumstances in which a fellow is unable to attend work due to such circumstances

as fatigue, illness, or family emergencies, the following procedures are in place:

• The fellow or designee must notify the Program Director and Program Administrator that the fellow is unable to work. The Program Director or designee will ensure appropriate action, including appropriate evaluation/care of the trainee and follow-up.

• The site director and supervising attendings will be notified that fellow coverage will be unavailable during the normal working hours.

• The Program Director and Program Administrator will rearrange the fellow call schedule to accommodate the trainee’s absence.

• The fellow or designee must notify the Program Director and Program Administrator the duration that they will be away from work.

Options for trainees who may be too fatigued to safely return home:

• Sleep in designated call room until adequately rested

• UMMC Cab Voucher Policy: In order to provide for the wellbeing of residents and fellows, all residents and fellows who drive to work and have finished an in-house overnight call or an extended shift but feel they are too impaired (or are identified by their peers as being impaired) to drive home safely will be able to return home using a cab voucher (maximum value of $35).

• For fellows at the other rotation sites, fellow may take Uber/Lyft or taxi home and keep receipts. The division will reimburse the trainee for this ride. 

SECTION 6 – ADMINISTRATION

Program Director:

Rosemary Kelly, MD 

Email: kelly071@umn.edu 

Pager: 612-899-8284 

Associate Program Directors:

Amit Bhargava, MD

Email: bharg041@umn.edu

Pager: 612-899-9837

Matthew Soule, MD

Email: soule062@umn.edu

Pager: 612-899-3612

Program Administrator:

Carol Nguyen

Email: nguye432@umn.edu

Phone: 612-301-2921

Administrative

Johnson, Jenn (ewin0012@umn.edu)

Castillo, Rick (casti020@umn.edu)

Russell, Tina (russe041@umn.edu)

Orth, Caroline (caroline.orth@va.gov)

Faculty

Andrade, Rafael

Pager: 612-899-6005 

Bhargava, Amit

Pager: 612-899-9837

Diaz Gutierrez, Ilitch

Pager: 612-899-2367

Huddleston, Stephen

Pager: 612-899-5114

John, Ranjit

Pager: 612-899-2075

Kelly, Rosemary

Pager: 612-899-8284 

Knoper, Ryan

Pager: 612-899-7355

Mohammed, Azmath

Pager: 612-899-1131

Rao, Madhuri

Pager: 612-899-3434

Shaffer, Andrew 

Pager: 612-899-9707

Shumway, Sara

Pager: 612-899-2009

Sinha, Pranava

Pager: 612-899-TBD  

Soule, Matthew

Pager: 612-899-3612

Voeller, Rochus

Pager: 612-899-5116

Fellows

Mendez, Richard

Pager: 612-899-

Polycarpou, Andreas

Pager: 612-899-

Rigg, Devin

Pager: 612-899-1867

Salami, Aitua

Pager: 612-899-2854

Vaidya, Yash

Pager: 612-899-1866

Verma, Ankit

Pager: 612-899‐2875

NP/PA/RN

Benyo-Albrecht, Kathy RN

Pager: 612-899-1584 

Bonnert, Eileen RN

Pager: 612-899-9891

Carda, Dustin PA

Pager: 612-899-9822

Droege, Alec PA

Pager: 612-899-3638

Engelhart, Chad PA

Pager: 612-899-4382 

Hart, Taylor NP

Pager: 612-899-9895

Frendin, Erin PA

Pager: 612-899-2496 

Kerns, Natalie PA

Pager: 612-899-5287 

McKay, Katie RN

Pager: 612-899-3344 

Schmelz, Marie RN

Pager: 612-899-4633 

Sirian Pearson, Angela PA

Pager: 612-899-5488 

Smith, Brittany PA

Pager: 612-899-7494

Webb, Arielle PA

Pager: 612-899-6814

Perfusionists

Bello, Tony 

Pager: 612-899-5662

Bezek, Hannah

Pager: 612-899-4409

Carlson, David

Pager: 612-899-9833

Davis, Mercede

Pager: 612-899-6536

Day, Travis

Pager: 612-899-4485

Jarmoluk, Doug 

Pager: 612-538-5043 

Johnston, Luke 

Pager: 612-899-5657

Joyner, Nitasha 

Pager: 612-899-2918 

Keller, Daniel

Pager: 612-899-6142

Michelson, Cara

Pager: 612-899-9715 

Mueller, Roger 

Pager: 612-538-6911 

VAD Coordinators

Berg-Williams, Doug

Pager: 612-899-9493

Drake, Megan 

Pager: 612-899-5378 

Gillard, Bekah

Pager: 612-899-1732

Hamre, Darcy 

Pager: 612-899-3293 

Lilla, Charlotte 

Pager: 612-899-1733 

Wilkerson, Camille

Pager: 612-899-9873

Confirmation of Receipt of your Fellowship Addendum

Academic Year 2023-2024

By signing this document, you are confirming that you have received and reviewed your Fellowship Addendum for this academic year. This policy manual contains policies and procedures pertinent to your training program. This receipt will be kept in your personnel file.

Fellow Name (Please print) _______________________________________________

Fellow Signature ________________________________________________________

Date __________________

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