Curriculum

The Cardiology Fellowship Program at Scott & White is a three-year program aimed at developing cardiologists for clinical practice. During the three years, the fellows rotate through the various sections in the Division of Cardiology, with the amount of time spent in each area determined by the minimal requirements of the American College of Cardiology, as well as the interest of each fellow.

The rotations during the Fellowship are comprised of the following:

Invasive Cardiology (Cath Lab)	8 months
Non-invasive section (Rotation = 30 days)	8 months
Clinical (includes CCU)	8 months
Electrophysiology	2 months
Nuclear	6 months
Research	6 months

* Research time can be included during elective rotations.

The Section of Invasive Cardiology (Cath Lab) performed 2500 catheterizations during the past year. In addition to extensive experience in cardiac catheterization and coronary angiography, coronary angioplasty procedures are being performed at a rate of 800 per year.

Most fellows spend eight rotations during their training in the cath lab, gaining experience with over 300 cases.

There are two interventional cardiology fellows each year.

The Section of Non-Invasive Cardiology includes color Doppler echocardiology exercise testing, Thallium SPECT scan and transesophageal echo. A large volume of EKG's and Holter monitors are read with staff supervision.

Echocardiography training provides the basic knowledge and experience necessary to be fully capable of performing and interpreting examination in a clinical setting.

The Section of Clinical Cardiology has greater than 14,000 clinic visits per year and 2,000 hospital admissions per year. A program has been developed for fellowship involvement in the outpatient clinic practice where fellows become familiar with the longitudinal care of ambulatory cardiac patients as well as performing consulations for other internists. This patient load is optimal for educational purposes.

The Section of Intensive Care (CCU) sees in excess of 1,000 patients annually. The $35 million Critical Care Center includes a coronary care unit complete with hemodynamic monitoring and capability for insertion of intra-aortic balloon pumps, Swan-Ganz catheters, temporary pacemakers, etc. Intensive Care Cardiology is an excellent opportunity to gain primary service experience in the care of acute myocardial infarctions, unstable angina, cardiogenic shock and post-operative open heart patients.

During this experience Cardiology Fellows progress to direct the care of CCU patients and are expected to function as junior staff overseeing the medical residents and students. They are responsible for procedures necessary on CCU patients.

The Section of Electrophysiology includes diagnostic and therapeutic EP studies, ICD implants and permanent pacemaker implants.

Fellows will spend a minimum of two months attending the pacemaker follow-up clinic or equivalent for a concentrated exposure to interpretation of pacing electrocardiograms and the various problems peculiar to pacemaker patients.

Fellows are responsible for consults to the lectrical service and will assist on electrophysiology studies, pacer and ICD implants.

Nuclear: Two months general training for all Cardiology Fellows is designated to make fellows conversant in the field of nuclear cardiology, with the primary responsibility being Thallium stress test monitoring. Individual rotations are arranged with the Nuclear Radiology Department regarding specific jobs and responsibilities.

Fellows have the opportunity to spend six months in training if desired in order to meet requirements for credentialling to interpretate nuclear cardiology studies.

Research: Scott & White provides many fine resources to assist with research, including nurse clinicians, biostatisticians and publication support.

Conferences: Active participation in the preparation of lectures, seminars and conferences is expected of each Fellow. Regularly scheduled cardiology teaching and conference activites include Textbook Review, Basic Science Lecture Series, Surgical Morbidity and Mortality Conference, EKG Review, Invasive Cardiology Lecture Series, Cath Conference and Cardiology Morbidity and Mortality Conference. There is a monthly meeting for research-related topics.

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