| Detail | For this role |
|---|---|
| Department | Clinical and Medical |
| Level | Mid level |
| Reports to | Chief of Surgery |
| Direct reports | Perfusionist, Senior Resident Doctor |
| Experience | 4 to 10 years after MCh, with a record of independent open-heart surgery |
Cardiothoracic Surgeon job description template
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Job title: Cardiothoracic Surgeon
Department: Clinical and Medical
Reports to: Chief of Surgery
Location: [City], [office, branch or site]
About the role
A Cardiothoracic Surgeon operates on the heart, lungs, chest wall and major blood vessels. Typical cases in Indian hospitals are coronary bypass, valve repair and replacement, congenital heart defects, lung resections and chest trauma. The surgeon leads a team of perfusionists, cardiac anaesthetists and ICU staff, and follows patients through the cardiac surgical ICU. A good CTVS surgeon has low mortality for their case mix, a working heart team with cardiology, and families who understand the risks before surgery.
Key responsibilities
- Assess patients referred for bypass, valve or thoracic surgery, review angiograms, echo and CT findings, and decide the operation and its timing.
- Discuss borderline cases in the heart team meeting with cardiologists to choose between angioplasty, surgery and medical treatment.
- Explain the operation, expected risks, ICU stay and package costs to the patient and family, and document informed consent with a risk score.
- Perform coronary bypass grafting, valve repair or replacement, aortic surgery and congenital heart operations within approved privileges.
- Perform lung and mediastinal surgery, including thoracoscopic procedures where the hospital has the equipment.
- Agree the perfusion plan with the perfusionist and cardiac anaesthetist before each case, and brief the OT team.
- Lead daily rounds in the cardiac surgical ICU and decide on ventilation, drains, inotropes, re-exploration and step-down.
- Handle chest trauma, aortic dissection and post-operative complications at any hour while on call.
- Keep a personal outcomes register covering mortality, re-exploration, sternal wound infection and stroke, and present it at surgical audits.
- Run follow-up clinics for anticoagulation checks and wound reviews, and refer patients to cardiac rehabilitation.
Requirements
- MCh or DrNB in Cardiothoracic and Vascular Surgery after MS General Surgery, or a six-year integrated MCh
- Valid registration with the National Medical Commission or a State Medical Council
- Fellowship in paediatric cardiac, aortic or minimally invasive cardiac surgery is an advantage
- 4 to 10 years after MCh, with a record of independent open-heart surgery
KRAs and KPIs for a Cardiothoracic Surgeon
Key result areas for the appraisal form, each with a KPI you can measure every month or quarter.
| Key result area | How to measure it |
|---|---|
| Surgical outcomes | Risk-adjusted mortality for bypass and valve surgery within the department target, reviewed every quarter |
| Re-exploration for bleeding | Re-exploration within 24 hours below 3 percent of open-heart cases |
| Sternal wound infection | Deep sternal wound infection below 1 percent of sternotomies in the year |
| Heart team decisions | 100 percent of elective multivessel disease cases discussed in the heart team before treatment is decided |
| ICU stay | Median cardiac surgical ICU stay of 3 days or less for routine bypass cases |
| Consent quality | Consent with a documented risk score in 100 percent of elective cases |
Skills and tools
Tools used day to day: Heart-lung machine, Transoesophageal echocardiography, Intra-aortic balloon pump, ECMO circuit, VATS thoracoscopy set, Cardiac surgical ICU monitors.
Reporting line and career path
Next roles: Head of Department (Clinical), Chief of Surgery
Interview questions for a Cardiothoracic Surgeon
- A 68-year-old diabetic with triple vessel disease and weak heart function wants only angioplasty. How do you counsel him?
- Your patient is bleeding heavily four hours after bypass. Walk me through your decisions.
- What are your personal outcomes for isolated bypass surgery over the last two years?
- How do you decide between repair and replacement for mitral regurgitation?
- How do you keep the team focused through a six-hour operation, including the perfusionist and nurses?
- When would you refuse to operate even though the family insists?
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What does a cardiothoracic surgeon do?
A cardiothoracic surgeon operates on the heart, lungs, oesophagus and major blood vessels in the chest. Common operations include coronary bypass, valve replacement, repair of congenital heart defects and lung resections. The surgeon also manages patients in the cardiac surgical ICU and handles emergencies such as chest trauma and aortic dissection.
What is CTVS in a hospital?
CTVS stands for Cardiothoracic and Vascular Surgery, the department that handles operations on the heart, lungs and major blood vessels. It works closely with cardiology, cardiac anaesthesia, perfusion and the cardiac surgical ICU. Surgeons in the department hold an MCh or DrNB in CTVS.
How long does it take to become a cardiothoracic surgeon in India?
The usual route takes about 11 to 12 years after school: MBBS with internship, three years of MS in General Surgery, then three years of MCh or DrNB in CTVS. Some institutes offer a six-year integrated MCh after MBBS. Independent open-heart work usually needs a few more years under senior surgeons.