Cardiology Fellowship

Program Goals & Curriculum

Program goals

With the aging of the population, the demand for clinical cardiologists is increasing. The program’s mission is to contribute well trained clinical Cardiologists to fulfill this need. The goal is to enable our trainees to care for patients, whether it is general Cardiology or to provide the opportunity for trainees to advance their training in Cardiovascular subspecialties. The fellowship is structured to enable our fellows with the knowledge, skills, and behavioral attributes necessary for success as a Cardiologist. By the end of their training, our fellows should demonstrate compassionate, professional, and comprehensive care of patients in all health care settings including the acute care hospital, longitudinal ambulatory settings, and other facilities.

All of our fellows complete their 3 years in a program designed to exceed ACGME requirements for Cardiovascular Medicine. During their third year of fellowship training, fellows are offered the opportunity to design 5 months of elective rotations, with the support of a faculty mentor, tailored to their clinical interests.

Curriculum

Fellows rotate through numerous rotations, either at JFK medical center or VA medical center:

  • Consults: Fellows will provide consultative services for all clinical services at JFK or VA, except pediatrics. Under the faculty’s supervision, the fellow has primary responsibility for all patients referred to the service and will cultivate expertise in preoperative evaluation and perioperative cardiac management.
  • CCU: This rotation will provide the fellow with knowledge about critical care cardiology participation in the inpatient care at JFK medical center. This fellowship will provide Level 1 training (per COCATs) in CCU, although aspects of Level 2 training may be available or pursued per the fellow’s interest.
  • Cath: This rotation will provide the fellow with knowledge about catheterization through participation in the cath lab. This fellowship will provide Level 1 training (per COCATs) in Catheterization, although aspects of Level 2 training may be available or pursued per the fellow’s interest.
  • Transesophagael/Cardiovascular surgery (TEE/CVS): This rotation combines Transesophageal Echocardiography with Cardiovascular Surgery. The fellow will participate directly in management of cardiac patients in the cardiac intensive care unit. The vast majority are patients who had recent cardiac surgery. The management is a team approach coordinated by an intensivist with collaboration with cardiothoracic surgeons and cardiologists. The fellow benefits from the interaction of a multidisciplinary team involving faculty of various backgrounds, in addition to learning how to interpret TEE 3D echos.
  • Nuclear: Nuclear cardiology provides important diagnostic and prognostic information that is an essential part of the knowledge base required of the well-trained cardiologist for optimal management of the cardiovascular patient. This fellowship will provide Level 1 training (per COCATs) in Nuclear Cardiology, although aspects of Level 2 training may be available or pursued per the fellow’s interest.
  • ECHO: This rotation will provide the fellow with knowledge about Echocardiography through participation in the ECHO lab. This fellowship will provide Level 1 training (per COCATs) in Echocardiography although all aspects of Level 2 training may be pursued per the fellow’s interest. Fellows will become familiar with the indications and contraindications for performing stress and transesophageal echo based on a wide variety of patients with a broad spectrum of cardiovascular disease referred from all services within the hospital.
  • EP: This fellowship will provide Level 1 training (per COCATs) in Electrophysiology, although aspects of Level 2 training may be available or pursued per the fellow’s interest.

1. Clinical and research components:

Fellows will receive exposure to all aspects of the cardiovascular spectrum of disease through clinical, imaging, and interventional rotations

Fellows will also be required to meet the program’s scholarly activity requirement:

  • 1 quality improvement project and
  • 1 additional project (can include a peer-reviewed publication, presentation at regional or national meeting, or book chapter)

2. Trainee’s supervisory and patient care responsibilities:

Fellows will learn to manage and evaluate cardiac patients with progressive responsibility on consultative, elective, ambulatory, and CCU rotations. A patient panel will also be followed on continuity clinic. Technical skills will be taught and performed under the direct supervision of a credentialed attending cardiologist on imaging and interventional rotations.

Fellows will have a role overseeing the clinical and educational experience of residents and students from the University of Miami Miller School of Medicine Regional Medical Campus on Consult and CCU rotations. This will include teaching and clinical supervision all under the oversight of the cardiology attending physician. Clinical volume will be monitored to ensure the fellows have adequate opportunity to independently evaluate and manage patients in all settings and that residents and students are not impacting the educational experience.

3. Clinical procedural requirements.

  • Echocardiography
  • Cardioversion
  • Exercise Stress Testing
  • Insertion and Management of Temporary Pacemakers
  • Programming and follow-up surveillance of permanent pacemakers and ICDs
  • Right and left heart catheterization including coronary arteriography
  • Interpretation of Chest X-Rays
  • Interpretation of Radionuclide studies of myocardial function and perfusion
  • Intra-aortic balloon counterpulsation
  • Intracardiac electrophysiologic studies
  • Percutaneous transluminal coronary angioplasty
  • Pericardiocentesis

4. Didactic sessions and teaching methods used to ensure program goals and objectives are met.

The program holds a variety of weekly and monthly core conferences including (but not limited) to core curriculum, evidence based medicine, journal club, multimodality imaging, ecg interpretation, case review, etc. There will also be a monthly Patient Safety Conference in the Department of Medicine.

J Pino