Cardiology Fellowship Program: Year 1
The first year is devoted primarily to developing clinical interests.
A strong, integrated program, the Children's Heart Center takes a collaborative team approach to improve quality and outcomes, providing pediatric cardiology specialty care to more than 5,000 infants, children, adolescents, and young adults each year. Services include: initial diagnostic consultation, transthoracic and transesophageal echocardiography, exercise testing, electrophysiologic testing, diagnostic and interventional cardiac catheterization, postoperative consultation, and long-term follow-up care. Through this team approach, daily input from the surgeon, attending cardiologist, the child's cardiologist, nurse practitioners, social workers, floor nurses and floor physicians is sought to maximize the quality and consistency of the child's care. In the outpatient setting, patients being considered for surgical or interventional procedures are discussed in the Clinical Management Conference to foster input from each of these providers in a formal manner.
Outpatient clinics are held daily. In the general cardiology clinics, children with suspected cardiac disease and those with existing disease, both preoperative and postoperative, are evaluated and cared for. Each fellow will attend a half-day clinic each week for the three-year period of fellowship. Thus, under the guidance of the attending cardiologist, the fellow will follow his/her own patients for the duration of the program. In his/her clinic, the fellow will be responsible for the complete work-up of the patient, discussions with the family, and reviewing the findings with the attending cardiologist.
Subspecialty clinics are also held during these ten clinics. The cardiology fellow will have the opportunity to participate in these clinics. Subspecialty clinics include: adults with congenital heart disease, cardiomyopathy, cardiovascular genetics, fetal cardiology, and preventive cardiology.
While assigned to the Inpatient Service, the fellow will be responsible for all cardiology patients on the inpatient pediatric floors, the Pediatric Cardiac Intensive Care Unit, and the Neonatal Intensive Care Unit. The fellow will consult with the attending cardiologist regarding these patients. The team has direct responsibility for these patients. The fellow will make daily work rounds on all cardiology patients and cardiac surgery patients and will assist and supervise the residents and students in their evaluations of the patients under their care. In addition, the fellow will be responsible for both formal and informal teaching of residents and students associated with cardiology patients or consults.
Congenital Heart Surgery Service
When the fellow is assigned to the surgery service, he/she will make rounds with our surgeon and assist in surgery. Most surgical patients are admitted through Same Day Admission and go to the Pediatric Cardiac Intensive Care Unit following their procedure. From the Pediatric Cardiac Intensive Care Unit, patients go to the general pediatric floor for monitoring until discharge. Since the Congenital Heart Surgery Service is part of the Children's Heart Center Team, rounds on surgical patients include the surgery and cardiology providers; thus concurrent care is provided regardless of the location of the patient. When discharged from the hospital, the patient will return either to the fellow's clinic or to their cardiologist's clinic for follow-up care.
Diagnostic Cardiac Testing
The Pediatric Cardiology echocardiography, exercise and electrocardiography/pacemaker laboratories are located in the Children's Heart Center ambulatory suite. All patients, both inpatient and outpatient, except those in the NICU or PCICU, come to the outpatient suite for their studies. The fellow is responsible for the performance and initial interpretation of studies while on the subspecialty service. After completion of a study, the fellow, working with the supervising cardiologist, correlates the data and prepares a report for the medical record and the referring physician.
The Catheterization Laboratory is on the ground floor of the Hospital. While on the Catheterization service, the fellow will perform and interpret hemodynamic, angiographic, and interventional studies, correlate the data, present the data at Clinical Management conference, and prepare the medical record report with the attending cardiologist.