Nuclear Cardiology and Stress Laboratories – 6 weeks
Non-invasive imaging and stress testing are integral pieces of a up-to-date approach to the patient with Acute Coronary Syndromes. Training in these areas will expose the fellow to the potential benefits and limitations of this type of testing on patients seen in the acute setting and in follow-up visits. The fellow, however, will not be able to independently interpret nuclear cardiology studies after such training.
The fellow will learn:
- various exercise protocols
- various nuclear scintigraphy imaging procedures
- about interpretation of nuclear images of myocardial perfusion and wall motion
- risk assessment strategies based on a combination of nuclear/stress lab data and clinical variables
- The fellow will be expected to supervise and interpret the minimum required number of exercise stress tests to become certified in this stress testing
Echocardiography – 6 weeks
Echocardiography is a powerful bedside imaging tool that can be utilized by to diagnosis a variety of acute cardiac conditions and guide emergent treatment.The fellow will receive exposure to the fundamental performance and interpretation of echocardiograms for the detection of life-threatening conditions of the cardiovascular system.
CPC Administration – 4 weeks
The operation of a Chest Pain Center requires both clinical and administrative skill. This month will be spent learning and addressing day-to-day issues of quality improvement, data tracking, interdepartmental relations, finance, and hospital administration.The fellow will work closely with the Director of the Chest Pain Center by:
- Attending CPC staff meetings
- Participating in interdepartmental quality improvement initiatives
- Maintaining departmental clinical practice standards
ED Cardiology Consult Service/ED Follow-up Clinic – 8 weeks
This block of time will be spent on the combined activities of performing consults in the Chest Pain Center and providing outpatient follow-up for these same patients after discharge from the CPC.The fellow will be a member of the Cardiology Consultation team with particular focus on Emergency Department patients. The team is supervised by one of our attending cardiologists and will also be composed of Cardiology Fellows, residents, and medical students.This consultation experience will not only expose the fellow to real-time strategies for non-invasive testing to rule out acute coronary syndrome, but also to the management of cardiac arrhythmias presenting to the ED.
Experience in the outpatient follow-up of patients seen in the Emergency Department for possible cardiovascular emergencies will provide the fellow with an important perspective on patient outcome after discharge from the ED. Short-term follow-up of chest pain patients will be the focus. All patients are presented to an attending cardiologist in the clinic.
This exposure to outpatient Cardiology will give the fellow additional insight into the cardiologist’s view of the diagnostic and therapeutic decisions made in the CPC setting as well as those made in the sub-acute setting of the follow-up clinic.
Research/Independent Study – 24 weeks
The fellow will have ample opportunity to conduct research or concentrate on developing a specific area of clinical expertise within the area of cardiovascular emergencies.Participation in existing research projects mentored by our faculty members is encouraged. Clinical and basic science projects are active in the Department of Emergency Medicine and the Division of Cardiovascular Medicine. Alternatively, the fellow can develop his or her own research project with the guidance of the fellowship directors.
Independent study of a specific clinical area in order to acquire a special expertise is another potential use of this time period. Any of the clinical or administrative areas within the broad area of cardiovascular emergencies are acceptable fields of study.
In either case, the fellow is expected to produce one scholarly work of publication quality prior to completing the fellowship
Vacation – 4 weeks
Emergency Medicine lecture series
Morbidity and mortality (adult, pediatric)
- ECG case conference
- Radiology Conference
- Resident Follow-up conference
Cardiovascular Medicine lecture series
- Cardiology Grand Rounds (weekly)
- Cardiology Research Conference (monthly)
- Clinical Cardiology Conference (rotating weekly)
- ECG/Electrophysiology Conference
- Noninvasive Conference
- Cardiac Clinical Pathology Conference
- Cardiology Journal Club (monthly)