Program Description & History

The postgraduate residency program for PAs interested in Cardiothoracic Critical Care (CTCC) is offered by St. Joseph Mercy Hospital-Ann Arbor (SJMH-AA) in conjunction with IHA Cardiovascular & Thoracic Surgeons. The program provides the graduate physician assistant with an opportunity to obtain advanced training in the critical care of cardiothoracic surgery patients.

The residency program is a 12-month didactic and clinical training program for licensed, board-certified PAs who wish to specialize in cardiothoracic surgery critical care. It expands upon the basic training of the PA in diagnosis and management of conditions common to cardiothoracic surgery patients. The PA resident participates in all phases of care of the cardiothoracic surgical patient, including preoperative preparation, observing in the operating room, and all aspects of postoperative care with intense focus on the surgical intensive care unit (SICU).


Institutional Affiliation

St. Joseph Mercy Hospital is a 537-bed, award-winning academic teaching hospital and tertiary care center providing specialized care not typically available at community hospitals. Located near Ann Arbor, Michigan, it is one of several large teaching institutions in the suburban Detroit area, participating in the education of PA students, medical students and physician residents.

SJMH-AA is a premiere center for cardiac surgery, having been designated as a 3-star program based on STS outcomes in 2014 (top decile for the country), as well as a Truven Health Analytics Top 50 Cardiovascular Hospital in 2015. The SICU admits approximately 700 postoperative cardiac and thoracic surgery patients each year, with a range of surgeries including coronary artery bypass (conventional and off-pump robotic revascularizations); ascending/descending aortic replacement; complex valve repair & replacement (including the Ross Procedure and robotic mitral valve repair); and complex thoracic procedures, such as esophagectomy, minimally invasive pulmonary resections, robotic excision of mediastinal masses, and advanced airway management.

The high acuity and fast pace of the SICU provides current residents with a rich learning environment.  Intense training in patient management, procedural skills, and service leadership skills will be abundant. The resident will also develop administrative skills as they will attend service delivery committee and educational meetings. The program utilizes all forms of learning, ranging from textbooks, self-driven internet based didactic modules, critical care medicine webinars, monthly journal club, M&M conferences, resident quality improvement projects, and simulation-based training for procedural and code skills, including emergent bedside resternotomy for postoperative arrest in the postop cardiac surgery patient population.

These innovative approaches to cardiothoracic surgery education, coupled with the advanced proficiency of the SJMH cardiothoracic surgery service, will provide an excellent foundation for PAs interested in excelling in cardiothoracic surgery critical care management. Additionally, SJMH conducts a surgical PA residency program in cardiothoracic surgery, which was approved in 1999 and has been endorsed by the Society of Thoracic Surgeons.


Admission Requirements

Applicants must be graduates of an ARC-PA accredited physician assistant program and be eligible for (or have passed) the NCCPA board exam. Residents must obtain a Michigan PA license upon acceptance into the program and undergo a pre-employment background check.  Applicant must have ACLS certification.



The program will be 12 months in length, admitting one PA resident per year. The residents will attend 3-5 hours per week of didactic sessions, including lectures, conferences, grand rounds, lunch & learn, and journal club. Clinical training will be concurrent with the didactic sessions, and will include simulation-based training; suturing clinic; intensive care orientation for the Surgical ICU; and daily multidisciplinary patients rounds in the SICU and progressive care units with other advanced practice professionals (PAs & NPs), respiratory therapists, clinical nutritionists, clinical pharmacists, nurses, and physicians. There will also be opportunities for observing and participating in operative procedures to aid understanding of the anatomy and physiology of cardiothoracic disease states and responses to surgical interventions.


Financial Information

  • Salary/Stipend: $65,000 for the year plus $250 per month food/sundries allowance per hospital cafeteria and convenience store
  • Benefits: Flexible benefits program including personal & family health plan, dental & vision plans, professional liability
  • Equipment: Personalized lab coats with laundry service, required text books, and access to reference sources (medical library, computer/internet access)
  • Travel: Interview-related expenses are the responsibility of each candidate
  • Housing: Relocation and housing costs are the responsibility of each PA resident
  • PA student loan repayment is the responsibility of each PA resident, however can often be deferred pending completion of the residency program. Determination of this eligibility is the responsibility of each PA resident.

Program Calendar

  • July-Sept Start Depending on Graduation Date
  • Application Deadline: March 15
  • Interview Notification: March 31
  • Interview Dates: Typically the 1st Saturday of May (subject to change)
  • Selection Notification: Mid-May (approx. 2 weeks post-interview)
  • Commitment to Program: May 31 (approx. 3 weeks post-interview)

Application Components

  • Completed Application Form (available from Program Office or Web Site)
  • Application Fee ($25, Non-Refundable)
  • Passport or Similar-Sized Photo (to aid interview identification)
  • Personal Statement – 1 page in length, expressing career goals and source of interest in cardiothoracic critical care
  • Curriculum Vitae
  • 3 Letters of Recommendation: For Recent Graduates, 1 must be from PA Program Director. (If not a recent graduate, 1 letter must be from current or recent employer.
  • Official PA Program Transcripts

Selection Criteria

  • Work and Life Experience (Surgical experience is not required, but some prior exposure to cardiothoracic surgery is considered important.)
  • Education / Academic Records
  • Letters of Recommendation
  • Personal Statement
  • Communication / Interpersonal Skills
  • Completion & Submission of all Application Components
  • Personal Interview (Applicants will be screened for a limited number of interview slots based on materials submitted.)


Credential Awarded

Upon completion of the residency program, the PA resident is awarded a certificate of training signed by department and program directors.

The SJMH PA Residency in Cardiothoracic Surgery Critical Care provides 50 Category I CME Credit approved by the APPA.



Information provided in this listing is current as of January 2016 and is subject to change. To verify information contact Lynda ZB Vivian, PA-C, Program Co-Director at Lynda.Vivian@stjoeshealth.org or David C. Holmes, PA-C, Program Co-Director at David.Holmes@stjoeshealth.org.