Thoracic Surgery (Independent) ACGME case minimums
Fellows in Thoracic Surgery (Independent) have a published ACGME minimum in 68 of 69 case categories, and the largest single minimum is 415. Each row below cites the ACGME requirement it was read from.
By Chris, CA-1, anesthesiology
Thoracic Surgery (Independent) minimums by category
| Category | Thoracic pathway | Cardiothoracic pathway | Cardiac pathway |
|---|---|---|---|
| Congenital Heart Disease | 10 | 20 | 20 |
| Primary Surgeon | — | 5 | 5 |
| First Assistant | 10 | 15 | 15 |
| Acquired Valvular Heart Disease | 30 | 60 | 90 |
| Aortic Valve Repair/Replacement | 15 | 25 | 25 |
| Mitral Valve Repair/Replacement | 5 | 15 | — |
| Mitral Valve Repair | — | — | 10 |
| Mitral Valve Replacement | — | — | 5 |
| Tricuspid Valve Repair/Replacement, Annuloplasty | 5 | 5 | 5 |
| TAVR as primary | — | 5 | 20 |
| TAVR as assistant | 5 | 10 | 20 |
| Transcatheter Mitral/Tricuspid Intervention | — | — | 5 |
| Myocardial Revascularization | 35 | 80 | 80 |
| Primary CABG | — | — | 60 |
| Complex CABG (Multiple Arterial, Hybrid, Beating Heart, Redo) | — | — | 20 |
| Redo Sternotomy** (Can be double counted with any cardiac procedure; not counted in Adult Cardiac Total) | 5 | 15 | 15 |
| Interventional Wire-Based Procedures | — | 5 | 35 |
| Left heart catheter, PCI, TEVAR, Mitral Clip | — | 5 | 20 |
| Intravascular ultrasound** (may be double counted)No published minimum | — | — | — |
| Transeptal puncture** (may be double counted) | — | — | 10 |
| Ultrasound guided access** (may be double counted) | — | — | 5 |
| Conduit Dissection and Preparation - Open or endoscopic saphenous/radial vein harvest and preparation** (Can be double counted with CABG) | 5 | 5 | 10 |
| Radial Artery Harvest (open or endoscopic) | — | — | 5 |
| Saphenous Vein Open Harvest | — | — | 5 |
| Aortic Procedures - Any combination of ascending aorta/aortic root replacement, descending aortic replacement, aortic dissection, aortic trauma** (Can be double counted with CABG/Valve Procedures) | 5 | 10 | 25 |
| TEVAR and EVAR | — | 5 | 15 |
| Aortic Root Replacement (including VSRR or Composite Valve Graft) | — | — | 5 |
| Replacement of Ascending Aorta, Arch, Descending Aorta; Surgery for Aortic Dissection | — | — | 5 |
| Arrhythmia Surgery | — | 10 | 15 |
| Left atrial or biatrial maze, pulmonary vein isolation, right-sided maze, isthmus ablation ** (Can be double counted with CABG/ valve procedures) | — | 5 | 10 |
| Pacemaker insertion or pacemaker removal | — | 5 | 5 |
| Cardiopulmonary Bypass Set-up and Pump Run with Perfusionist | 5 | 5 | 5 |
| Circulatory Assist - Any combination of ECMO, VAD** (Can be double counted with another operation) | 10 | 20 | 35 |
| Intra-aortic balloon pump | 5 | 10 | 5 |
| Ventricular Assist Device Implant (Temporary Endovascular, Paracorporeal Ventricular Assist or implantable Durable Ventricular Support) | — | — | 15 |
| Extracorporeal membrane oxygenator support (VA or VV) | — | — | 10 |
| Thoracic Transplant (any combination of heart or lung implant, heart, or lung procurement) | — | — | 5 |
| Subtotal Adult Cardiac (and Congenital Heart Disease) Experience (Note: The American Board of Thoracic Surgery does not include congenital cases in this total number) | 100 | 215 | 315 |
| Lung | 105 | 60 | 45 |
| Major anatomic resections: open, VATS, or RATS (segmentectomy, lobectomy, pneumonectomy, lung transplantation**) **Only 1 pneumonectomy can be counted along with bilateral lung transplant. | 50 | 30 | 30 |
| VATS/RATS lobectomy specifically | 25 | 5 | — |
| Open or VATS lung biopsy/wedge resection | 30 | 25 | — |
| MIS Lobectomy, Biopsy, Wedge Resection | — | — | 15 |
| Pleura | 25 | 10 | 10 |
| Major (empyema decortication, pleurectomy decortication, other pleural tumor resection) | 5 | — | — |
| Minor (biopsy, pleurectomy, VATS sympathectomy, VATS Bleb resection, VATS pleurodesis, evacuation of hemothorax) | 15 | — | — |
| Interventional: In-dwelling cuffed pleural catheter insertion | 5 | — | — |
| Chest Wall and Diaphragm - Chest wall resection**, rib resection, rib plating, pectus repair, diaphragm resection or plication, repair of Morgagni, Bochdalek, traumatic hernia (**chest wall resection may be double counted with pulmonary resection) | 10 | 5 | 3 |
| Mediastinum - Tumor/cyst/mass resection via open, VATS, or robotic technique | 10 | 5 | — |
| Tracheobronchial - Airway Surgery** - Tracheal resection, laryngotracheal resection, sleeve lobectomy, carinal pneumonectomy, transplantation airway anastomosis (**Sleeve lobectomy and carinal pneumonectomy can be double counted with major anatomic lung resection) | 5 | — | — |
| Esophagus | 35 | 10 | 5 |
| Esophagectomy (Open or MIE) | 20 | 5 | — |
| Benign Esophagus: Repair of perforation, drain perforation, diverticulectomy, myotomy, hiatal hernia repair | 10 | 5 | — |
| Laparoscopic hiatal or paraesophageal repair | 5 | — | — |
| Subtotal General Thoracic Experience | 190 | 90 | 63 |
| TOTAL MAJOR OPERATIVE EXPERIENCE | 290 | 305 | 378 |
| Bronchoscopy | 40 | 30 | 20 |
| Simple (BAL, diagnostic, TBBx, Bx) | 30 | — | — |
| Complex (laser, dilation, stent, navigational bronchoscopy, photodynamic therapy, cryotherapy) | 10 | — | — |
| UGI - Endoscopy | 30 | 10 | 5 |
| Simple (diagnostic, Bx) | 20 | — | — |
| Complex (dilation, stent, EUS, EMR) | 10 | — | — |
| Mediastinal Assessment | 55 | 15 | 10 |
| Mediastinoscopy, Chamberlain (mediastinotomy) | 15 | 5 | — |
| EBUS/FNA | 10 | — | — |
| Mediastinal node dissection/systematic sampling during lung resection | 30 | 10 | — |
| Subtotal Minor Procedures | 125 | 55 | 35 |
| TOTAL OPERATIVE EXPERIENCE | 415 | 360 | 413 |
| CT Critical Care Index Case (CCIC) log | 20 | 20 | 20 |
An em-dash means the ACGME publishes no minimum on that row — not a minimum of zero.
Thoracic Surgery (Independent) · ACGME specialty 460.
Capnolog counts these live for anesthesiology and neurological surgery; other specialties are reference only.
What counts toward a minimum?
- Fellows log cases into categories the ACGME defines, not by procedure code.
- Each minimum is read in its own column: “Thoracic pathway”, “Cardiothoracic pathway” and “Cardiac pathway”.
- 44 rows are drawn from a larger row: those cases count toward that row too, never on top of it.
- 1 row carries no published number and shows an em-dash, which is not a minimum of zero.
- The ACGME Review Committee that accredits Thoracic Surgery (Independent) programs sets these requirements.
Where do these numbers come from?
- Case Log categories and minimum numbers, October 2022
- Program Requirements, July 1, 2026
Capnolog is independent of the ACGME. Where a number here and the ACGME's own document disagree, the document is right.