Correspondence Address:
Sarvesh Pal Singh
Departments of Cardio-Thoracic and Vascular Surgery, Cardio-Thoracic Sciences Center, All India Institute of Medical Sciences, New Delhi - 110 029
India

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Dear Editor,

Cardiac surgery is thriving in India. India is already a tourist destination for health care in Asia, but gradually patients from all over the world are visiting India for cardiac surgical procedures. Among them, notable are surgeries for complex congenital diseases, heart transplantation, and ventricular assist devices (VADs). All these surgical procedures require intensive care in the postoperative period. Until now, there has been no structured course to train doctors in cardiac surgical intensive care. The Department of Cardio-Thoracic and Vascular Surgery (CTVS) at All India Institute of Medical Sciences [Figure 1], New Delhi, has started a DM course in Cardiac Surgical Intensive Care to fill this void. It is a 3-year course and candidates can apply after their postgraduation in Anesthesia, Medicine, Pulmonary medicine, or Pediatrics. There is an entrance examination with multiple choice questions for 80 marks and a viva voce examination for 20 marks as departmental assessment afterward. The CTVS Intensive Care Unit (ICU) [Figure 2] is a well-equipped unit with highest standards matching those all over the world. More than 4000 surgeries are performed every year and all patients channel through ICU. The selected candidates will be trained in routine intensive care (arterial blood gas interpretation, vascular cannulation, cardiopulmonary resuscitation, sepsis, hemodynamic management, tracheostomy, ultrasonography, echocardiography, bronchoscopy, intercostal drain insertion, emergency management, management of myocardial infarction, etc., to name a few) as well as advanced critical care support solutions (extracorporeal membrane oxygenation, VAD management, and heart transplantation). The details of the course are beyond the scope of this article.{Figure 1}{Figure 2}

In India, currently, cardiac surgical ICUs are managed by cardiac surgeons or with cardiac anesthetists in consultation with each other. Candidates successfully completing this course will have the composite knowledge of cardiac surgery, anesthesia, and intensive care. With the increase in the number of cardiac centers, ECMOs per year, and progressive increase in the implantation of VADs and heart transplantations, it is imperative we have a trained workforce to manage patients in the cardiac surgical ICUs.

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