Cardiovascular Disease Fellowship Clinical Training

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The clinical curriculum was designed to meet Core Cardiology Training Symposium (COCATS 3) recommendations by the American College of Cardiology for both procedural volume and training time for competency in cardiovascular disease. However, the curriculum is moving to a milestone, competency-based model, designed to meet the new COCATS 4 recommendations. Core rotations include:

Cardiac Intensive Care Unit
Echocardiography/Imaging
Cardiac Catheterization
Nuclear/ETT
Consults
Electrophysiology
Cardiology Inpatient Service (HVI)
Cardiovascular Medicine Continuity Clinic (1/2 day per week)

Procedures
The procedural volume meets training recommendations of the American College of Cardiology (COCATS). Procedural volume is tracked throughout training by the specific laboratories (HeartLabs database) and by maintenance of procedural/case logs.

Right and left heart catheterization including coronary arteriography
Bedside right heart catheterization
Percutaneous transluminal coronary angioplasty
Insertion and management of temporary pacemakers including transvenous and transcutaneous
Exercise stress testing
Echocardiography, including transesophageal, exercise and pharmacologic stress testing
Radionuclide studies of myocardial function and perfusion
Cardiac magnetic resonance imaging/computed tomography
Electrocardiograms
Ambulatory ECG recordings
Programming and follow-up surveillance of ICDs and permanent pacemakers
Cardioversion
Intracardiac electrophysiologic studies
Intra-aortic balloon counterpulsation (insertion and management)
Pericardiocentesis

Mentored Research
One of the major strengths of the Cardiovascular Fellowship program at University Hospitals Cleveland Medical Center is the opportunity for innovative basic, translational, and clinical research. Fellows initially identify a faculty mentor and explore clinical, translational and basic science laboratories during the first two clinical years; one to three additional years of dedicated and protected research time are available during the fellowship for a mentored research project(s). Throughout the clinical years of training, fellows are encouraged to initiate and develop plans for research years. This critically important component of fellowship training is strongly encouraged and emphasized in regular meetings with the Program Director and other key faculty members. Grant writing/submission is strongly encouraged for those seeking extended research training, and mentors assist targeting appropriate grants and agencies.

Evaluations
The Cardiovascular Fellowship program uses MyEvaluationsTM, through which faculty evaluations are posted at the conclusion of each clinical assignment. Fellows also have a face-to-face meeting with the responsible faculty member. In addition, there is a twice yearly summative evaluation, in which fellows meet individually with the Program Director to review the Fellow’s evaluations, procedure logs, lecture attendance, research project progress, quality improvement project, and individualized learning portfolios. Fellows evaluate faculty after each rotation, and at the end of the year, both evaluate the program.

In addition to the above evaluations, fellows will participate in 360-degree evaluations, which incorporate feedback from nurses, laboratory staff and patients. This feedback provides the fellow with information about his/her performance from multiple perspectives, and in this manner, the fellow is able to set goals for self-development. These 360-degree evaluations occur in the Cardiac Intensive Care Unit (CICU), the Cardiac Catheterization and Echocardiography Laboratories, and the Hellerstein/HVI service.

Evaluation of the mentored research portion of the fellowship occurs under the auspices of the designated mentor. This includes description of a research plan prior to initiation of research, as well as periodic evaluations of the progress in the research plan.