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Surgical specialties

Cardiothoracic Surgery Diploma

Register interest

A diploma in adult cardiac and thoracic surgery built around the surgeon's decisions: who should have an operation rather than a catheter procedure, how to plan and protect the patient through surgery, and how to manage the complications and emergencies that follow.

Twenty-five weekly sessions across five modules take you from risk, cardiopulmonary bypass and postoperative care, through coronary, heart failure, valve and aortic surgery, to lung cancer, pleural and chest wall surgery and chest trauma. Teaching is anchored on the joint guidelines of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS), and on UK National Institute for Health and Care Excellence (NICE) and British Thoracic Society guidance, with US differences flagged. It covers extracorporeal membrane oxygenation (ECMO), video-assisted thoracoscopic surgery (VATS) and the work of the multidisciplinary team (MDT), and is taught live by practising surgeons you can question.

Course director
To be announced
Format
25 live weekly sessions on Zoom, in 5 modules
Dates
Confirmed when enrolment opens

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Chest X-ray detail after open-heart surgery showing a column of twisted sternal wires and, on the side view, the metal ring of a replacement heart valve.
Image: chest radiographs after open-heart surgery by Hellerhoff via Wikimedia Commons, licensed under CC BY-SA 3.0.

Who it is for

Senior trainees, fellows and early-career consultants in cardiothoracic surgery, and cardiologists, intensivists and anaesthetists who share the care of surgical heart and lung patients, worldwide.

The programme

25 one-hour sessions in 5 modules, each with its learning objectives. This is the draft programme: the course director reviews and refines it before enrolment opens, so session titles may change.

Module 1 · Sessions 1 to 5The cardiac surgical patient: risk, bypass and recovery

  1. 1. Risk assessment, the Heart Team and consent

    • Calculate EuroSCORE II and explain its limits for an individual patient
    • Assess frailty and its effect on recovery after cardiac surgery
    • Present a patient to the Heart Team with the information needed for a decision
    • Record a consent discussion that covers the alternatives, including no surgery

  2. 2. Cardiopulmonary bypass and myocardial protection

    • Plan a bypass strategy with the perfusionist and anaesthetist
    • Choose a cardioplegia strategy for the planned operation
    • Manage anticoagulation and heparin resistance on bypass
    • Apply measures that protect the brain and kidneys during bypass

  3. 3. Bleeding, transfusion and patient blood management

    • Optimise preoperative anaemia before elective cardiac surgery
    • Time the stopping of antiplatelet and anticoagulant drugs before surgery
    • Use viscoelastic testing to guide treatment of bleeding
    • Decide when to take a bleeding patient back to theatre

  4. 4. The first 48 hours after cardiac surgery

    • Diagnose and treat low cardiac output and vasoplegia after cardiac surgery
    • Recognise tamponade and decide on emergency resternotomy
    • Prevent and treat postoperative atrial fibrillation
    • Lead the response to cardiac arrest after cardiac surgery

  5. 5. Complications, enhanced recovery and rehabilitation

    • Apply enhanced recovery elements to a cardiac surgical pathway
    • Prevent and manage deep sternal wound infection
    • Recognise postoperative stroke and delirium and act early
    • Plan discharge, cardiac rehabilitation and follow-up
Module 2 · Sessions 6 to 10Coronary, heart failure and transplant surgery

  1. 6. Choosing coronary artery bypass grafting

    • Select patients whose survival or symptoms improve more with bypass surgery than with stenting
    • Use the SYNTAX score and comorbidity in Heart Team decisions
    • Apply trial evidence on revascularisation in ischaemic left ventricular dysfunction
    • Explain where European and US guidance on bypass surgery differ

  2. 7. Conduct of coronary surgery

    • Choose conduits for each target vessel using current evidence
    • Weigh bilateral internal mammary grafting against sternal wound risk
    • Decide when off-pump surgery is the better choice
    • Check graft function before leaving theatre

  3. 8. Mechanical complications of myocardial infarction and ischaemic mitral regurgitation

    • Recognise mechanical complications of myocardial infarction from clinical and echo findings
    • Time surgical repair of a post-infarct ventricular septal rupture
    • Use mechanical support to bridge an unstable patient to surgery
    • Decide when to repair or replace the mitral valve for ischaemic regurgitation

  4. 9. Mechanical circulatory support and ECMO

    • Select temporary mechanical support for post-cardiotomy and cardiogenic shock
    • Manage the complications of ECMO, including limb ischaemia and left ventricular distension
    • Select patients for a durable left ventricular assist device
    • Plan weaning or escalation with the shock team

  5. 10. Heart and lung transplantation

    • Identify patients who should be referred for heart or lung transplant assessment
    • Explain how donation after circulatory death has widened the donor pool
    • Recognise primary graft dysfunction and rejection early
    • Manage a transplant recipient who presents with an unrelated surgical problem
Module 3 · Sessions 11 to 15Valve and aortic surgery

  1. 11. Aortic valve disease: surgery, TAVI and lifetime management

    • Apply the 2025 ESC/EACTS guideline to choose between surgical and transcatheter replacement
    • Choose a mechanical or biological prosthesis with the patient
    • Plan lifetime management, including future valve-in-valve options
    • Select patients for aortic valve repair or pulmonary autograft replacement

  2. 12. Mitral valve surgery

    • Time surgery for asymptomatic severe degenerative mitral regurgitation
    • Plan a durable mitral repair and judge when replacement is safer
    • Choose between surgery and transcatheter edge-to-edge repair
    • Manage rheumatic mitral disease in regions where it is common

  3. 13. Tricuspid valve surgery and surgical treatment of atrial fibrillation

    • Decide when to repair the tricuspid valve during left-sided valve surgery
    • Select patients for isolated tricuspid surgery or transcatheter treatment
    • Choose patients for concomitant surgical ablation of atrial fibrillation
    • Apply LAAOS III evidence on appendage occlusion during cardiac surgery

  4. 14. Surgery for infective endocarditis

    • Decide the indication and timing of surgery for infective endocarditis
    • Plan surgery after an embolic stroke or intracranial bleed
    • Manage prosthetic valve endocarditis and aortic root abscess
    • Plan care for people who inject drugs, including addiction support

  5. 15. Type A aortic dissection and aortic root and arch surgery

    • Diagnose type A aortic dissection and take the patient to theatre without delay
    • Manage malperfusion before and after dissection repair
    • Choose between valve-sparing root replacement and composite graft replacement
    • Set intervention thresholds for heritable aortic disease
Module 4 · Sessions 16 to 20Thoracic surgery

  1. 16. Lung cancer: diagnosis, staging and fitness for surgery

    • Stage non-small cell lung cancer using the ninth edition TNM classification
    • Plan mediastinal staging with PET-CT and endobronchial ultrasound
    • Assess fitness for lung resection using lung function and exercise testing
    • Manage screen-detected lung nodules with the multidisciplinary team

  2. 17. Lung resection: how much lung and which approach

    • Select patients for segmentectomy rather than lobectomy
    • Choose between VATS, robotic and open approaches
    • Perform a lymph node assessment that meets staging standards
    • Prevent and manage prolonged air leak after lung resection

  3. 18. Multimodality treatment of lung cancer

    • Explain the trial evidence for neoadjuvant and perioperative immunotherapy
    • Identify patients who need biomarker testing before surgery
    • Plan surgery after induction treatment
    • Decide with the multidisciplinary team when surgery has a role in N2 and oligometastatic disease

  4. 19. Pleural disease

    • Choose between conservative care, ambulatory drainage and surgery for pneumothorax
    • Decide when pleural infection needs surgery rather than drainage and fibrinolytics
    • Choose between talc pleurodesis and an indwelling pleural catheter
    • Explain the MARS 2 trial result to a patient with mesothelioma

  5. 20. Mediastinum, chest wall and airway

    • Plan investigation and resection of an anterior mediastinal mass
    • Select patients with myasthenia gravis for thymectomy
    • Choose between lung volume reduction surgery and endobronchial valves for emphysema
    • Assess airway stenosis and plan its management with the airway team
Module 5 · Sessions 21 to 25Chest trauma, emergencies and professional practice

  1. 21. Chest trauma

    • Assess chest injuries within a structured primary survey
    • Decide when a traumatic haemothorax needs surgery
    • Select patients for surgical stabilisation of rib fractures
    • Recognise the indications for resuscitative thoracotomy

  2. 22. Thoracic emergencies

    • Secure the airway and isolate the bleeding lung in massive haemoptysis
    • Plan management of oesophageal perforation with the upper gastrointestinal team
    • Manage a bronchopleural fistula after lung resection
    • Recognise descending necrotising mediastinitis and plan drainage

  3. 23. Pulmonary vascular, pericardial and adult congenital surgery

    • Refer suitable patients with chronic thromboembolic pulmonary hypertension for pulmonary endarterectomy
    • Decide when surgical embolectomy is needed for pulmonary embolism
    • Select patients with constrictive pericarditis for pericardiectomy
    • Plan a safe redo sternotomy in an adult with congenital heart disease

  4. 24. Quality, outcomes and new technology

    • Interpret risk-adjusted outcome data for a surgeon or unit
    • Respond to an outlier alert with a structured review
    • Plan a safe learning curve for a robotic surgery programme
    • Introduce a new procedure through local governance and NICE guidance

  5. 25. Complex case review and professional practice

    • Apply the course to complex cardiothoracic cases in a panel discussion
    • Present a cardiothoracic complication at a morbidity and mortality meeting
    • Fulfil the professional duty of candour after harm to a surgical patient
    • Plan your own development towards a cardiac, thoracic or mixed practice

What the diploma includes

  • 25 live sessions on Zoom, one evening a week, with recordings for the weeks you miss.
  • Practising specialists teaching live, so you can put your questions to them.
  • Weekly MCQs and a final written assessment.
  • A digital certificate carrying your final classification.

Lead or teach the Cardiothoracic Surgery Diploma

We are looking for a course director and faculty from the specialty. Sessions are one hour in the UK evening, live on Zoom, and paid.

Apply to teach