Cardiology Fellowship

Educational Curriculum

We have designed an exciting educational curriculum to provide our trainees with a strong foundation on which to nurture their developing clinical skills. The core of our educational conferences are interactive subspecialty conferences allowing fellows to present their evolving skills in the arenas of cardiology. We have expanded our didactic lectures beyond the division of cardiology to develop multidisciplinary conferences with other pediatric subspecialties

Interactive Conference Series

  • Catheterization Conference. This is a weekly conference wherein the catheterization fellow presents recent procedures to the fellows and interventional faculty and focus their understanding of hemodynamics. They interpret angiography and describe the clinical indications for procedures and interventions. These presentations are followed by a brief lecture on the clinical element of the procedure to supplement the patient-specific presentation.
  • Echocardiography Diagnostic Forum. This interactive conference is conducted by the Director of Non-invasive Imaging, Dr. Timothy Cordes. Dr. Cordes sits with the fellows and presents interesting echocardiograms, allowing the fellows to interpret images, while presenting important instruction on image acquisition and clinical correlation to the diagnoses made. This is an excellent time to provide image acquisition critiques in a comfortable environment for the fellows.
  • MRI Conference. This monthly conference is organized by the Associate Director of Non-invasive Imaging and MRI specialist Dr. Tiffanie Johnson. Dr. Johnson selects interesting MRI cases from the prior month and has fellows present the finding and demonstrate interpretive skills. Clinical correlation is also discussed.
  • Electrophysiology Conference. The EP faculty meet with the fellows twice monthly to present ECGs, Holter tracings, and intracardiac tracings and allow fellows to test their knowledge and interpretive skills. These interactive sessions are supplemented with didactic lectures related to electrophysiology.
  • Pathology Conference. This once monthly conference allow fellows to handle and investigate congenital heart defects with autopsy specimens from our extensive bank of hearts from the department of Pathology.
  • Journal Club. Recently expanded from a fellow-focused conference, journal club is a monthly conference that allows a fellow to present an important manuscript of the medical literature for the cardiology section and invite discussion about new trends and therapies in pediatric cardiology. A faulty mentor is assigned each month to help the fellow select and organize their presentation.

Didactic Instruction

  • Core Lecture Series. These twice monthly conferences present the opportunity for fellows to supplement their education from the interactive series with directed topics that are difficult to present within the interactive series. These lectures include lectures form faculty from within and without the division of cardiology, as well as prepared topics from cardiology fellows.
  • CVICU Lecture Series. This conference has been developed to educate critical are and cardiology fellows on issues related to the management of children with congenital heart disease, with a focus on post-operative management. Lectures are presented by faculty from the division of critical care, cardiology, and pulmonology.
  • Physiology Series Meetings. A pilot, collaborative lecture series was created in 2014 to provide instruction to cardiology, pulmonology, critical care and neonatology fellows in fundamental physiology. Each meeting focuses on an element of physiology from each of these specialties. A fellow presents a clinical case followed by a discussion under the direction of Johnathan Tune, PhD from the department of Physiology.
  • Krannert ACHD Echocardiography Forum. This monthly conference occurs at Methodist Hospital. The format is a large group presentation with adult and pediatric cardiology faculty and fellows in attendance. The purpose is to allow adult and pediatric specialists to learn and collaborate about patients transitioning from pediatric specialists to the care of adult cardiologists trained to add their expertise in acquired “adult-onset” heart disease.

Patient Centered Conferences

  • Surgical Case Conference. This weekly conference focuses on presenting the following week surgical cases to the congenital heart surgeons. The fellows prepare presentations of echocardiograms, MRIs, catheterizations and direct the discussion of best approaches to surgical management. Problem cases are also presented in this meeting.
  • Complex Case Conference. Each month this conference provides a forum for cardiology faculty to present clinic patients with complex disease to determine best course of action. These patient presentations are geared toward decision making that does not involve surgical intervention. Fellows interact with the faculty and participate in the decision making process of caring for patients with complex heart disease.
  • Morbidity and Mortality Conference. This monthly conference recently expanded to include the critical care service as it pertains to cardiac patients. This allows a multidisciplinary discussion of best practices and how to maximize safety and outcomes.

Clinical Curriculum

Fellows rotate through five areas of clinical service on a monthly basis.

  • Echocardiography. Fellows rotating through this service will be trained in acquisition and interpretation of transthoracic echocardiography. There is some exposure to transesophageal and fetal echocardiography.  These skills will be refined in multiple environments including the outpatient clinic, hospital wards, and ICUs and the operative theaters. Those desiring a focused experience in cardiac MRI, advanced TEE’s and fetal echo will have the flexibility to do so.
  • Cardiac Catheterization and Intervention. Fellows have the opportunity to participate in a wide variety of catheterizations from diagnostic procedures of complex disease, to obtaining biopsy samples from children with heart transplants, to interventions to palliate cardiac defects. We have been participants in multiple clinical trials including those for newly developed septal occluders. Recent interventions added to those provided include: the Melody valve, Gore Septal Occluder ASD device, and Nit-Occlud PDA device.
  • Electrophysiology. Fellows have the opportunity to see all aspects of electrophysiology including participating in invasive ablation procedures, ICD and defibrillator implants. They will be instructed in the interpretation of ECGs, Holter and event monitors, and exercise stress testing. They participate in pacemaker clinics to learn the nuances of managing patients with complex rhythm abnormalities.
  • Cardiac intensive care unit. Fellows have the opportunity to work with collaborative team of cardiac intensivists, cardiologists, and cardiac surgeons in the management of post-operative children. This enhances their experience managing these patients as part of their on call duties.
  • Heart Center Ward Service. This experience is directed toward training fellows in the management of children with a variety of pre-operative and post-operative cardiac issues. They provide consultative services to the NICU and PICU while primarily managing those on the inpatient service. This experience provides them the opportunity to direct patient care rounds and educate residents and medical students. It is an opportunity to hone their leadership and organizational skills as future cardiologists.
  • Adult Congenital Heart Disease. While not a mandatory rotation for the fellows, our rapidly growing program allows interested fellows the opportunity to work alongside our adult congenital faculty in the inpatient and outpatient setting. The flexibility of our program allows fellows to design their training to include these opportunities.
  • Cardiology Call. Call is conducted in the hospital during weekdays, and at home on weekends. Responsibilities include management of patients on the inpatient and ICU services, consultation services and obtaining echocardiograms on requested patients. This provides the opportunity to provide continuity of care to post-operative patients and to develop skills in image acquisition.