Cardiovascular Disease Fellowship

The cardiovascular fellowship is a three-year comprehensive training program, which includes all aspects of cardiology. Because BUMC is such a high-volume institution with a wide variety of patients, fellows gain enough experience to complete the program in three years, compared with four years at other institutions.

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Cardiovascular Disease Fellowship Curriculum

 

The training program in cardiovascular disease gives the opportunity to get subspecialty education in one of the busiest cardiac centers in North Texas.

 

The rotations are set up to cover the core competency as outlined in the ACGME curriculum guidelines. The educational program will provide training and experience in the evaluation and management of a wide variety of patients with acute and chronic cardiovascular conditions.

 

Such patient conditions include:

  • Chronic coronary heart disease
  • Advanced congestive heart failure
  • Arrhythmias
  • Acute myocardial infarction and other acute ischemic syndromes
  • Lipid disorders
  • Hypertension
  • Cardiomyopathy
  • Valvular heart disease
  • Pulmonary heart disease
  • Peripheral vascular disease
  • Infections and inflammatory heart disease
  • Adult congenital heart disease

 

During the three years, fellows will do the following rotations:

  • Cardiac Care Unit
  • Advanced Heart Failure
  • Nuclear Cardiology
  • Inpatient Consult Service
  • Cardiac Catheterization Lab
  • Noninvasive Cardiac Lab
  • Electrophysiology
  • Adult Congenital Heart Disease
  • Electives
  • Research
  • Continuity Clinic at Parkland Memorial Hospital


The typical schedule for the fellows is as follows:

 

First Year

  • Cardiac Cath Lab – 2 months
  • Echocardiography – 2 months
  • Cardiac Consults – 2 months
  • Nuclear Cardiology – 2 months
  • CCU – 2 months
  • Research – 1 month
  • Vacation – 3 weeks

 

Second Year

  • Cardiac Cath Lab – 2 months
  • Echocardiography – 2 months
  • Cardiac Consults – 1 month
  • Nuclear Cardiology – 1 month
  • CCU – 2 months
  • Research – 2 months
  • Vacation – 3 weeks

 

Third Year

  • Cardiac Consults – 1 month
  • Echocardiography – 1 month
  • CCU – 1 month
  • Research – 5 months
  • Elective – 4 months
  • Vacation – 3 weeks



Cardiovascular Disease Fellowship Rotation Details


Inpatient Cardiology Consult Service

The consult service comprises inpatient consults at both Baylor Heart and Vascular Hospital and Baylor University Medical Center at Dallas. It is an integral part of the cardiology fellowship.

 

Each fellow deals with a wide variety of pathology at this central downtown Dallas hospital and makes management decisions regarding pre-operative cardiac risk assessment, surgical evaluation and myocardial, pericardial and congenital heart diseases.

 

Consults are presented to the day consulting attending and staffed with them. Interesting cases with important imaging findings are presented at core conferences.

 

 

Cardiac Intensive Care Unit

The CCU unit cares for patients with acute coronary syndromes, cardiac arrhythmias, cardiogenic shock and post-operative complications.

 

The cardiovascular fellow works with the internal medicine residents and guides them in medical management of the patients and helps with patient flow. The fellow is also responsible for the education of residents and medical students on the service and leads didactic sessions.

 

The cardiovascular fellow also attends teaching rounds and highlight important discussion points.

 

 

Cardiac Catheterization

Being one of the busiest cardiac centers in Texas, Baylor Heart and Vascular Hospital's catheterization suite performs over 12,500 procedures a year.

 

Fellows on cardiac catheterization month get to participate and gain exposure to highly specialized procedures such as:

  • Chronic total occlusions
  • Complex PCI
  • Mitral clips
  • Transaortic valvular implantation
  • PFO closures
  • Aortic valvuloplasty

 

The general cardiology fellows work one-on-one with the interventional cardiologist for the duration of the procedure.

 

General cardiology fellows are required to spend four months over the three years in the lab and by the end of fellowship should be proficient in doing left and right heart catheterizations and evaluating and managing complications.

 

Fellows interested in interventional cardiology can spend their elective months in the catheterization lab as well. Many of our fellows get COCATS level 2 training by the end of their clinical fellowship.

 

 

Echocardiography

The Baylor Heart and Vascular Hospital Non-Invasive Department does over 24,000 procedures per year with over 10,000 transthoracic echocardiogram being done any given year.

 

Fellows are required to spend six months over the course of fellowship in the non-invasive labs and read over 300 echocardiograms at a minimum to achieve COCATS level 2 training.

 

At the end of clinical fellowship, fellows are expected to be proficient with the use of echocardiogram in diagnosis and making management decisions.

 

All fellows are expected to be proficient in performing a complete transesophageal echocardiogram and interpreting the results and discussing with ordering physicians. Most fellows take the exam offered by the National Board of Echocardiography.

 

Vascular ultrasound training is also offered for those interested in doing peripheral imaging as part of their career.

 

 

Electrophysiology

With over 5,000 EP procedures being performed per year and a center for advanced trials in electrophysiology, Baylor Heart and Vascular Hospital provides a great opportunity to become familiar with innovative strategies and learn essential concept.

 

Fellows spend two months in electrophysiology, deal with a broad spectrum of arrhythmias and complex cases, and are involved in diagnosis and management of these patients.

 

Fellows have the opportunity to spend more time in the EP labs and partake in cases if they are interested in the field.

 

Fellows also participate in an interactive electrophysiology conference on Monday mornings where interesting electrophysiology cases from the week are discussed.

 

 

Advanced Heart Failure Service

As the largest transplant center in the state of Texas and a rapidly expanding program, fellows get a wide variety of experience in management of advanced heart failure.

 

Fellows are expected to do a pre-transplant and a post-transplant month during their clinical training. During the pre-transplant month, fellows gain experience with physical exam-based diagnosis, performing and interpretation of hemodynamic findings of right heart catheterization, IABP, impellas and use of inotropic support.

 

On the post-transplant month, fellows get proficient in management of advance circulatory support devices such as LVAD, RVAD, total artificial heart and BiVAD.

 

Fellows actively participate in pre-transplant evaluation and approval of transplant patients at the weekly transplant conferences. Fellows also participate and present at weekly advanced heart failure M&M conferences.

 

 

Nuclear Cardiology

Fellows spend a total of four months during the fellowship training in nuclear imaging, performing and interpreting exercise and pharmacologic stress testing.

 

Fellows work with a dedicated nuclear cardiology attending as they become familiar with the physiologic principles of PET and SPECT imaging.

 

Fellows have the option to go to additional imaging courses as part of the rotation to get additional experience in advanced imaging.

 

 

Adult Congenital Heart Disease

The Adult Congenital Heart Disease experience is at Parkland Memorial Hospital where third-year fellows spend a month with a congenital heart disease specialist. The fellow is involved in the management and follow-up of complex congenital cases.

 

As we expand the congenital heart disease program at Baylor Heart and Vascular Hospital, fellows will have the opportunity to do a rotation at their home institution as well.

 

 

Cardiovascular Clinic

Our continuity clinic experience is at Parkland Memorial Hospital, which serves largely a low-income, underserved population that lives in the Dallas area.

 

Here, fellows get to collaborate with the fellows from UT Southwestern Medical Center and work with UT Southwestern Faculty as well.

 

The clinic gives a broad exposure to a wide variety of cardiac pathology, including advanced heart failure, complex arrhythmias and coronary, valvular and congenital diseases.

 

Third year of continuity clinic also includes experience at the Baylor University Medical Center at Dallas Cardiovascular Clinic where fellows get to work in an autonomous environment and take care of patient referrals from Baylor University Medical Center at Dallas Internal Medicine Clinic.

 

Clinic sessions are scheduled for one half day per week for at least three years of fellowship training. Fellows have a great deal of autonomy in making management decisions.



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