UMM logo

Maryland Heart Center

Cardiovascular Disease Fellowship

Overview | Curriculum | Preparation & Certification | Rotations | Application

 

Curriculum

The core 36-month curriculum is divided as
follows (Figure 1):

Figure 1: Pie Chart-36 month curriculum

Figure 1

For further information on the exact content and structure of each of these blocks, see the ACC Revised Recommendations for Training in Adult Cardiovascular Medicine Core Cardiology Training II (COCATS II): http://www.acc.org

First Year

Clinical training during the first year is all performed at the University of Maryland and includes:

  1. 3 months experience in the Coronary Care Unit (CCU)
  2. 3 months of training in Echocardiography and Ambulatory and Stress Electrocardiography
  3. 2 months of Consultative Cardiology
  4. 1 month of Cardiac Electrophysiology
  5. 3 months of training in the Cardiac Catheterization Laboratory

Additionally, Fellows will begin a longitudinal experience in the outpatient department comprising ½ day per week for the duration of three years of training.

  1. The University of Maryland Hospital CCU has 15 beds, each equipped with telemetric monitoring capability. There are approximately 840 admissions per year with an average length of stay of 2.5 days. Responsibilities of the cardiology fellow include the direct evaluation of patients and formulation of management decisions in conjunction with the housestaff and attending cardiologists. The fellows will also be supervised in the insertion of pulmonary artery catheters, temporary transvenous pacing catheters, and central line insertion. Patients with a wide variety of disease processes, including both complicated and uncomplicated myocardial infarction, advanced heart failure, valvular heart disease, and complex arrhythmias are cared for in this unit.

  2. During the Echo/Graphics rotation the fellow is exposed to approximately 1000 ECG's, 200 stress tests, and 80 Holter monitor recordings. Daily feedback is given on ECG and stress test interpretation by the attending cardiologist. In the Echocardiography Lab, the fellow is exposed to approximately 1000 echoes, reads with the attending echocardiographer daily, and participates in the weekly echo conference. The fellow also receives 'hands-on' training in the performance of an echocardiographic examination.

  3. While on the Cardiology Consult Service, the fellow sees a wide array of patients, including patients admitted to other services and patients in the Emergency Department with chest pain, patients requiring pre-operative cardiac risk assessment, and patients with heart failure and arrhythmias on non-medical services. The fellow will be exposed to an average of five new consults daily, and these patients, along with those being followed will be staffed with an attending cardiologist.

  4. While on Cardiac Electrophysiology the fellow will develop more advanced skills for the interpretation of complex cardiac arrhythmias and will learn treatment options for such. Additionally, the fellow will begin to be exposed to invasive EP testing, pacemaker and defibrillator implantation and follow-up, and ablative techniques for treatment of arrhythmias. The fellow will be supervised at all times by an attending electrophysiologist. The fellow will also participate in Consultative Electrophysiology.

  5. During the three months in the Catheterization Laboratory, fellows will learn introductory techniques integral to the performance and interpretation of diagnostic catheterizations. This includes developing expertise in the interpretation of coronary angiograms, ventriculography, aortography, and in the interpretation of hemodynamics. Fellows will also be taught principles of radiation safety, and will learn the indications and contraindications of catheterization, and how to manage complications of this procedure.

Second Year

During the second year of training, fellows will

  1. have six months of protected research time
  2. rotate through the Cardiac Intensive Care Unit (CICU) of the Baltimore VAMC for three months
  3. rotate through one more month of inpatient cardiology consults at University of Maryland, and
  4. will participate in 1-2 more months of either the Catheterization Lab or the EP Lab

The CICU at the BVAMC is a 7-bed intensive care unit with telemetric monitoring equipment. There are approximately 750 admissions per year with an average length of stay of 2.6 days. Responsibilities of the fellow are similar to those previously elaborated for the UMH-CCU. Additionally, while on this rotation, the fellow will be involved with the interpretation of echocardiographic studies performed at the BVAMC and will participate in Cardiac Consultative services at the BVAMC.

Third Year

Clinical duties in the third year include rotation through Rehabilitative Cardiology, Congenital Heart Disease/Pediatric Cardiology, and the completion of core requirements outlined in COCATS II not completed during years one and two. Additionally, many fellows use this time to pursue Level II training in Nuclear Cardiology, Level II training in Cardiac Catheterization, and other modalities of non-invasive imaging including cardiac MRI, trans-esophageal echocardiography, advances echo techniques such as dobutamine stress echocardiography, or non-cardiac vascular imaging (carotid and peripheral vascular imaging).

Regularly scheduled fellow oriented conferences and seminars occur throughout the year. During July and August "core curriculum" conferences are given three times weekly by faculty to the incoming fellows.

From September to June conferences include:

Fellows are evaluated after each clinical rotation and are given verbal and written feedback on their performance. Procedural skills (quantity and quality) are documented. The fellows each meet with the Program Director at least twice yearly to review their performance, their procedures, and their career plans.


Please call if you would like to make an appointment or talk to someone about our services. Patients dial 1-800-492-5538 or 410-328-5842, physicians dial 410-328-6622 or 1-800-318-1019.