CV building for a career in cardiothoracic anaesthesia / cardiothoracic ICU.
Advice on careers in cardiothoracic is, at times, difficult to come by, particularly if you have limited exposure to the subspecialty in the early portion of your training. Therefore, with the help of ACTACC Trainee Subcommittee we have added some useful pointers below.
Clinical Experience
When applying for a consultant post, one will be expected to have significant experience of at least 12 months in cardiothoracic anaesthesia or cardiothoracic intensive care, which may be as a dedicated special interest area during training, or as an out-of-training or post-CCT fellowship.
When thinking about fellowship location, it is important to consider long term career plans and what different sites can offer in terms of case mix and specialist practice. International fellowships can add an extra dimension to an application, and whilst often a lot of fun, may not be practical for everyone and are certainly not essential. If you are applying to an ECMO centre then previous ECMO or MCS experience will be required.
When applying for fellowships, the required clinical experience is obviously far less. However, you would be expected to have a portfolio that can show an enthusiastic and hard-working nature, and ideally be able to demonstrate some enthusiasm for the specialty already (e.g. professional memberships, attendance at conferences, experience of cardiothoracic theme quality improvement etc.).
Echo
EACVI (European) or BSE (British) transoesophageal echocardiography accreditation is either essential or desirable for consultant jobs in cardiothoracic anaesthesia or ICM. There is an excellent artcle on this on the CAP website. There is also a US accreditation, although this is far less commonly undertaken in the UK. A good starting place for developing echo skills during anaesthesia or ICM training is FUSIC heart accreditation, run by the Intensive Care Society. There is also a wealth of information on echocardiography available online and ACTACC are currently developing a programme of echo training resources, also available online. View on the CAP website.
Leadership / Management
As a consultant you will be expected to be a clinical leader and evidence of this will be explored at interview. To fulfil this there are opportunities within training programmes, such as being on Trust, educational, regional or national committees; clinical leadership and management courses; and positions outside of medicine, such as leadership within an academic or administrative body.
When applying for fellow posts, some evidence of leadership roles will also be beneficial, but not essential. If you have not held any formal leadership position, consider referencing projects you have led or leadership experience you have outside of clinical practice.
Teaching
Formal evidence of educational practice, such as running courses would be beneficial, particularly courses relevant to cardiothoracic anaesthesia and ICM. An educational qualification, such as a PGCert in Medical Education, is invariably listed as desirable on consultant job applications. Resuscitation instructor status, formal training in education and experience of undergraduate and multi-disciplinary teaching are sensible options to consider undertaking. Again, undertaking these activities in a cardiothoracic sphere, (e.g. becoming a Cardiac Advanced Life Support (CALS) trainer or a FUSIC heart mentor) could be useful.
Research
Research and quality improvement experience in cardiac anaesthesia is desirable and most cardiac centres will be running research projects that you can get involved in. These may be small projects you develop and lead yourself, or may be that you contribute as part of a site investigation team, to a multi-centre project. Being asked to reflect on what you learnt and show an undertaking of research and QI may be explored during interviews.
A formal period of research such as a masters or doctorate would give you an advantage when applying for consultant jobs, especially in academic centres. However this is absolutely not essential.
"Value Added"
It is a good idea to have a “unique selling point” that you can talk about at interview to set you apart from the other candidates. This may be a particular interest or skill, or experience of a particular area of cardiothoracic anaesthesia or ITU which is lacking within the department. These may be emerging areas of research, such as perioperative medicine in cardiothoracic surgery, or interest in enhanced recovery, regional anaesthesia and pain management. Evidence of non-clinical achievements (as above) may also be your unique selling point. Having passed the MRCP exam and/or dual accredited in FFICM and FRCA is also often a desirable, although not essential, criteria on most current consultant job adverts.