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Training and curriculum in the Cardiovascular Disease Fellowship prepares future physicians in this field.

Training and Curriculum

Mission Statement
To generate cardiovascular specialists focused on excellence in clinical medicine, scientific and clinical education with special emphasis on the creation of future cardiovascular leaders.

Program Aims
We aim to create clinicians and scientists with skills reflective of the requirements of current and future cardiovascular professionals with focus on providing each graduate expertise in atherosclerotic heart disease, heart failure including cardiac transplantation and mechanical circulatory assistance, cardiac electrophysiology and all aspects of cardiovascular imaging. Training is provided in a variety of practice environments serving a diversity of patient populations and cultural backgrounds.

Rotations

The first year of fellowship focuses on immersing fellows in clinical cardiology as well as providing a solid foundation of echo and cath for future development. There is also the opportunity for exposure to EP or research if so desired. Typically, 1st year fellows spend 8 months on consult services divided among Methodist, VA, and Eskenazi hospitals, with 1 month guaranteed at each. The remaining 4 months are typically divided 2:3 or 3:2 between cath rotation and an echo rotation. Call is from home and once weekly, fellows should expect to be called into the hospital on roughly 40-50% of their weekday calls.

The second year of fellowship continues to build upon the foundation of general cardiology laid in the first year while exposing fellows to more advanced specialties. The number of each individual rotation will vary based on interest, but fellows can expect a minimum of 2 months of cath, 2 months of EP, 2-3 months of CCU, with the remainder of the time advanced imaging with nuclear/CT/MRI, and 2 months of echo. Research, advanced heart failure exposure, or additional rotations in the aforementioned fields can be pursued with the additional time not filled. Primary call is approximately q30 while 2nd years also take home back up call once weekly (approximate call in rate 5-10%) and PCI call once a month.

The third year is the opportunity for fellows to finish any basic training requirements yet unmet and self-direct their learning. Fellows will be expected to cover the Eskenazi cath lab for 1-2 months with the rest of their time spent on research, EP, imaging, echo, heart failure, or other rotations as desired. Fellows going into EP will spend approximately 6 months acting as an EP fellow and involved in procedures as part of the EP program.

Hospitals

Eskenazi Health is an award-winning county hospital known nationally for its efficiency, excellent care outcomes, and state-of-the-art computerized order entry and patient database system. Eskenazi serves the indigent population of the city of Indianapolis and surrounding sections of Marion County. As a public safety net hospital, it provides a training site for a wide variety of medical problems within a diverse patient population. It is also home to the highly integrated Regenstrief Medical Record System, the longest continuously running EMR. Admissions come primarily through the level-one trauma center and very busy emergency room and the hospital's strategically placed community health centers and associated clinics. The EMR electronically links all of these clinical settings to help streamline care. Medicine residents play a key role in caring for patients in all of these venues. General medicine faculty primarily round on the wards.

IU Health at Methodist Hospital is the largest private hospital in Indiana. It is a regional referral center for complex cardiovascular care, critical care, trauma and surgical care. It serves as the headquarters of the IU Health Cardiovascular Service, Krannert Institute of Cardiology and cardiothoracic transplant services. A wide variety of medical disorders and patient populations serve as substrate for medical education directed towards fellows, residents and medical students. It also serves as the base of operations for the statewide IU Health Cardiovascular initiative.

IU Health University Hospital is a tertiary-care referral hospital with nationally and internationally recognized programs in specialized care including the Simon Comprehensive Cancer Center. It is also home to one of the largest solid organ transplant program in the midwestern US and the regional bone marrow transplant unit. Interventional gastroenterology is another expertise at IU Hospital. Housestaff are assigned to specialty services and work directly with the faculty experts on these services. Many of the patients referred to IU Hospital are diagnostic dilemmas or treatment challenges and are referred in from around the state and beyond.

The Richard L. Roudebush Veterans Administration Medical Center (VAMC) provides acute and chronic care for veterans and is a statewide and regional referral base for other VA hospitals. A host of highly-dedicated clinician educators support the high quality of teaching and learning. In addition to the general medicine wards, there is a closed ICU rotation, both MICU and CCU, and a highly-rated continuity clinic experience. The VA hospital serves veterans in Indiana and eastern Illinois. As such, it is both a primary and tertiary care center. Many patients from central Indiana use the hospital and its clinics as their source for primary care, while others may be referred in for complex problems requiring specialized care. The facility is fairly new, with state-of-the-art intensive care units updated in early 2000.

Conferences

Cardiology Grand Rounds occurs every Tuesday at 4:30 P.M. This conference is a mix of local and outside speakers giving talks on all aspects of clinical cardiology and/or clinical or basic science research as well.  Fellows also have the opportunity to meet with outside speakers in private or group sessions in a didactic or discussion setting.

Clinical Decision-Making Conference occurs every Friday at 7:30 A.M.  Conference features a case presentation by a first-year fellow and then a brief review of the literature and discussion of salient teaching points.  The conference has a robust faculty presence and often features spontaneous faculty/fellow discussion and ad hoc teaching.

M&M occurs once per month on Friday at 7:30 A.M. A 2nd or 3rd year fellow will select and present a case and lead a discussion of the safety issues encountered. This conference features a multi-disciplinary approach with participation usually including CV surgery, nursing staff, pharmacy, and other involved services.  The discussion includes both the broad issues encountered and also an evaluation of the local experience with such issues at IU.

On Tuesdays and Fridays, noon conferences are given.  These are often didactic sessions given by faculty and cover all aspects of cardiology including imaging, interventional, EP, heart failure, and journal clubs in addition to other topics.

 

Echo Conference occurs every Thursday at noon in the main cardiology conference room.  Fellows and staff on the echo rotation will select interesting cases for other fellows to read and present didactic material. Usually one conference per month will be dedicated to congenital heart disease. 

In addition to the conferences listed above, each sub-specialty at IU has their own morning didactic conferences that general fellows are welcome to attend at their discretion and encouraged to attend when they are on rotation with that specialty.  EP has conference Monday-Thursday at 7 A.M. featuring journal clubs, faculty lectures, and case-based discussion. Interventional offers case-based discussion on Tuesdays at 7:30 A.M. and didactic session on Wednesdays at 7:30 AM. The heart failure team has an advanced heart failure conference on Mondays at 7 A.M.