Cardiovascular Disease Fellowship Curriculum
Clinical experiences for the Cardiovascular Disease Fellowship Program at Allegheny Health Network (AHN) include:
Inpatient cardiology rotations
Our program contains inpatient cardiology rotations in non-invasive consultative cardiology, cardiac critical care, electrophysiology, and advanced heart failure, pulmonary hypertension, mechanical circulatory support, and cardiac transplantation.
Non-invasive consultative cardiology (4 months)
The non-invasive consultative cardiology rotation will cover the following skills:
- Lead a multidisciplinary team in partnership with a cardiology attending
- Diagnose and manage a diverse patient population with wide-ranging cardiac pathophysiology
- Develop communication skills to interface with referring providers and other members of the healthcare team
- Teach other members of the multidisciplinary team
Cardiac critical care (5 months)
The cardiac critical care rotation rotates between the Coronary Intensive Care Unit (CICU) and Surgical Intensive Care Unit (SICU) during day or overnight shifts.
- Day CICU (2 months): Fellows, under the guidance of a supervising cardiologist, spend a total of 2 months in their second/third years leading the Coronary Intensive Care Unit (CICU) team of residents, advanced practice providers, and medical students in the management of high-acuity, complex, critically-ill cardiovascular patients.
- Nightfloat (2 months): Fellows complete 8 total weeks of Nightfloat during their first/second years, primarily overseeing the CICU.
- Fellows complete 8 total weeks of Nightfloat during their first/second years, primarily overseeing the CICU
- SICU (1 month): Third-year fellows also round for one month in the Surgical Intensive Care Unit and Cardiothoracic OR alongside SICU intensivists.
Electrophysiology (3 Months, Level I)
The electrophysiology rotation will cover the following skills:
- Inpatient Consultative Electrophysiology (2 months)
- Cardiac Device Clinic (1 month)
- Exposure to Electrophysiology Laboratory with introduction to intracardiac recordings, stimulation protocols, device implantation, catheter mapping, and complex catheter-based ablations
- Opportunities for additional exposure (i.e. Level II) based on individual interest
Advanced Heart Failure, Pulmonary Hypertension, Mechanical Circulatory Support, and Cardiac Transplantation (2 Months, Level II)
The advanced heart failure, pulmonary hypertension, mechanical circulatory support, and cardiac transplantation rotation will cover the following skills:
- 2 weeks per month on inpatient consult service, focusing on evaluation and management of full spectrum of Advanced Heart Failure
- 2 weeks per month in outpatient heart failure rotation, divided between clinic and the heart failure catheterization laboratory
Cardiac Imaging Rotations
Our program contains cardiac imaging rotations in echocardiography, nuclear cardiology and stress testing, and cardiac computed tomography/magnetic resonance imaging:
Echocardiography (6 Months, Level II)
The echocardiography rotation will cover the following skills:
- All fellows complete core rotations in transthoracic, transesophageal, and stress echocardiography with a focus on performing and interpreting all studies
- Several fellows each year commit 3 additional elective months to achieve Level III certification prior to graduation
- Extensive opportunities to interface with our busy Structural Heart Disease program
Nuclear Cardiology and Stress Testing, including Cardiac PET (4 Months, Level II)
The nuclear cardiology and stress testing rotation will cover the following skills:
- The only cardiac PET center in Western PA
- All fellows focus on achieving proficiency in the indications, contraindications, performance, and interpretation of all forms of stress testing
Cardiac Computed Tomography/Magnetic Resonance Imaging (1 Month, Level I)
The cardiac computed tomography/magnetic resonance imaging rotation will cover the following skills:
- Fellows become familiar with the essentials of cardiac CT and MRI, including their indications, contraindications, and applications
- Several fellows dedicate additional elective months to achieving Level II competency, and a few fellows stay for a non-ACGME fourth year of advanced imaging training (ie to achieve Level III in both modalities)
- Cardiac CT/MRI labs are exclusively staffed and led by cardiologists
Cardiac Catheterization Lab (6 Months)
Our program contains a rotation in the Cardiac Catheterization Lab, and covers the following skills:
- Fellows work closely with the Interventional Cardiology faculty across all three years. While all first-year fellows are based at Allegheny General Hospital (AGH), second-year and third-years fellows typically split their time between AGH and West Penn Hospital to achieve Level II.
- Fellows learn and perform diagnostic coronary angiography and interventional cardiology with additional exposure to percutaneous valve implantation (including TAVR and MitraClip), transseptal catheterizations, balloon valvuloplasty, paravalvular leak repairs, and insertion of percutaneous circulatory support devices, including intra-aortic balloon pumps, percutaneous biventricular assist devices, and ECMO.
- Additional proficiency in Swan-Ganz catheter and temporary transvenous pacemaker insertion
- Focus on management of acute coronary syndromes and chronic ischemic heart disease, valvular heart disease, and adult congenital heart disease.
- Fellows interested in Level 3 training are required to train for an additional year as an Interventional cardiology fellow.
Research (1 Month)
Our program contains a rotation in the Research, and covers the following skills:
- Fellows enjoy dedicated time to focus on scholarly output, including formulation of a hypothesis, completion of IRB, data analysis, and manuscript development.
Ambulatory Cardiology Continuity Clinic (3 Years)
Our program contains a rotation in the Ambulatory Cardiology Continuity Clinic, and covers the following skills:
- Each fellow enjoys following their own patients alongside their clinic mentor for an average of one half-day per week.
- Fellows function as both primary cardiologists and consultants for a diverse patient population, following them longitudinally and during inpatient admissions.
- All fellows receive Level 1 training in Preventive Cardiovascular Medicine.
Elective Rotations (6 Months)
Our program allows you to pursue rotations in the following elective options:
Noninvasive vascular ultrasound laboratory (1 month elective)
The noninvasive vascular ultrasound laboratory rotation will cover the following skills:
- Fellows perform and interpret vascular duplex ultrasound studies involving the cervical, carotid, vertebral circulation as well as venous and arterial circulation (PVR) with and without stress testing.
- This rotation can be integrated with an invasive rotation in the catheterization laboratory for certification
Pediatric Cardiology/Adult Congenital Heart Disease
The pediatric cardiology/adult congenital heart disease rotation will cover the following experience:
- Fellows in previous years have completed elective rotations at Cleveland Clinic, Mayo Clinic, and Children’s Hospitals of Boston, Columbus, and Pittsburgh.
Additional Elective Time
Fellow can also select to spend additional elective time in the Cardiac Catheterization Lab, Electrophysiology Lab, CT/MRI Lab, Advanced Heart Failure Teams, Research, or in pursuit of other valuable training experience can also be arranged.