Cardiovascular Disease Fellowship

About the program

Our fellowship is aimed at developing cardiologists for clinical practice. During the three years, the fellows rotate through the various areas of cardiology, with the amount of time spent in each area determined by the minimal requirements of the American College of Cardiology, as well as the interest of each fellow.

The rotations during the fellowship are composed of the following:

• Invasive cardiology (cath lab): eight months
• Non-invasive section: eight months
• Clinical (includes CCU): eight months
• VA Hospital: six to nine months
• Electrophysiology: two months
• Nuclear: six months
• Research: three months
• Elective time: three months
  (individual tracks for EP, invasive or non-invasive cardiology may be tailored to the trainee's career goals)

Rotations

Invasive cardiology (cath lab)

The cath lab performs more than 2,500 catheterizations per year. In addition to extensive experience in cardiac catheterization and coronary angiography, our fellows perform approximately 800 coronary angioplasty procedures per year.

Most fellows spend eight rotations during their training in the cath lab, gaining experience with more than 300 cases.

Non-invasive section

This rotation includes color Doppler echocardiology exercise testing, Thallium SPECT scan and transesophageal echo. A large volume of EKGs and Holter monitors are read with staff supervision.

Echocardiography training provides the basic knowledge and experience necessary to be fully capable of performing and interpreting examination in a clinical setting.

Clinical cardiology and intensive care (CCU)

The CCU has more than 14,000 clinic visits per year and 2,000 hospital admissions per year. A program has been developed for fellowship involvement in the outpatient clinic practice, where fellows become familiar with the longitudinal care of ambulatory cardiac patients as well as performing consultations for other internists. This patient load is optimal for educational purposes.

The CCU includes a coronary care unit complete with hemodynamic monitoring and capability for insertion of intra-aortic balloon pumps, Swan-Ganz catheters, temporary pacemakers, etc. Intensive Care Cardiology is an excellent opportunity to gain primary service experience in the care of acute myocardial infarctions, unstable angina, cardiogenic shock and post-operative open heart patients.

During this experience, fellows progress to direct the care of CCU patients and are expected to function as junior staff overseeing the medical residents and students. They are responsible for procedures necessary on CCU patients.

Electrophysiology

This rotation includes exposure to diagnostic and therapeutic EP studies, ICD implants and permanent pacemaker implants.

Fellows spend a minimum of two months attending the pacemaker follow-up clinic or equivalent for a concentrated exposure to interpretation of pacing electrocardiograms and the various problems peculiar to pacemaker patients.

Fellows are responsible for consults to the electrical service and will assist on electrophysiology studies, pacer and ICD implants.

Nuclear

Two months general training for all fellows is designated to make fellows conversant in the field of nuclear cardiology, with the primary responsibility being Thallium stress test monitoring. Individual rotations are arranged with nuclear radiology regarding specific jobs and responsibilities.

Fellows have the opportunity to spend six months in training, if desired, in order to meet requirements for credentialing to interpret nuclear cardiology studies.

Conferences

Active participation in the preparation of lectures, seminars and conferences is expected of each fellow.

Regularly scheduled cardiology teaching and conference activities include:

• Textbook review
• Surgical morbidity and mortality conference
• EKG review
• Journal club
• Invasive cardiology lecture series
• Cath conference
• Cardiology morbidity and mortality conference

There is also a monthly meeting for research-related topics.