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Cardiology Fellowships

Training Schedule

Year I

Clinical Rotation
The fellow is responsible, together with an attending, for the provision of clinical consultative services for all inpatients, surgical patients, and emergencies during 2-4 week block period, and for the teaching of students and residents.

Outpatients
Outpatients are seen daily, and the fellow will participate in the evaluation of these patients, together with the attending, sharing in the evaluation of the noninvasive testing and in the formulation of management plans. Fellows are assigned to a specific clinic day and proctor to allow for continuity of care.

Intensive Care Skills
While on the clinical rotation, the fellow will spend time in the Neonatal and Pediatric Intensive Care Units. Fellows will share in the management of the postoperative cardiac patients and of the acutely ill neonate with heart disease. Patient care is managed in collaboration with the intensivists and cardiac surgeons.

Electrophysiology
Rotation on the Electrophysiology Service takes place during year I-II. The fellow participates in pacemaker clinic; outpatient assessment of arrhythmia patients including Holter and event recorder assessment, tilt table and stress testing, and invasive procedures. Division faculty also participates in placement of intravenous pacemakers and AICD.

Pathology
Monthly didactic pathology sessions are held with the division throughout the year. Elective periods of at least two weeks in the Department of Pathology are available.

Noninvasive Testing
A fully equipped echocardiography laboratory is the site for training of fellows in the interpretation of two-dimensional echocardiography imaging and Doppler studies as well as detailed quantitative studies of systolic and diastolic function. The fellow is trained to interpret and perform high-quality studies using these techniques. Fetal echocardiography, transesophageal echocardiography, and 3D echocardiography are highlighted as well. The laboratory performs approximately 6,000 echocardiograms annually. Dobutamine echocardiography stress testing is available. Training in magnetic resonance imaging is available through a collaboration effort between Pediatric Cardiology faculty and Radiology faculty.

Invasive Laboratory
A newly constructed, dedicated pediatric catheterization laboratory is the setting for this training. Training in diagnostic and interventional cardiac catheterization techniques and angiography is a major component of our fellowship program. The fellow is expected to gradually become proficient in cardiac catheterization and the obtaining of data, its interpretation, and its significance. Additional training is provided in interventional techniques, such as pulmonary and aortic valvuloplasty, arterial dilatations, and myocardial biopsy, stent placement and device closures of PDAs and ASDs to fellows with a focused interest in interventional procedures. The training is enhanced by the weekly patient management/post-catheterization conferences.

Electives
Elective time can be arranged in our department and in others within the School of Medicine. Some examples are electrophysiology, pathology, NICU, PICU, anesthesiology, cardiac surgery, adult cardiology, genetics and any of the basic science laboratories.

Teaching Sessions

I. Conferences

  • Clinical Service Conference Weekly
  • Management Conference/Cath Conference Weekly
  • Morbidity and Mortality Conference  Monthly
  • Didactic Teaching Conference  Weekly
  • Ward Rounds Daily
  • Journal Club Monthly
  • Echo Conference Weekly
  • Research /Academic Conference Monthly
  • Pathology Conference Monthly


II. Research Design

A two-week course in research design is offered through the Johns Hopkins School of Pubic Health and attended by our fellows. Fellows are expected to identify a research interest and to develop a research proposal during the first year. Selected fellows may apply to the graduate training program in clinical investigation, collaboration between the School of Medicine and Bloomberg School of Hygiene and Public Health.

Year II

Second-year fellows will continue to gain experience in the clinical areas with the emphasis on increased responsibility of patient care. There will be a major emphasis during Year II on carrying out a research project based on the proposal developed in Year I.

Year III

A year to refine clinical skills and complete research projects. The third year schedule is designed to strengthen areas of expertise based on the fellow’s career goals and the faculties’ evaluation of the fellow’s knowledge.

Year IV

A provisional fourth year for continuing research is offered for those fellows wishing to further pursue their chosen area of clinical or basic pediatric cardiology research. The fellow is expected to seek research funding for this year from one of several available sources. Alternative plans are available, for example with 2 year laboratory experience, years 1-2 followed by years 3-4 devoted primarily to clinical training.

Research Areas
The research areas available include both basic and clinical projects. Trainees are encouraged o reach out beyond the division into other divisions or the Basic Science Departments of the Medical School. Research is currently ongoing in many areas, including:

• Innovative Interventional Techniques in the Treatment of Congenital Heart Disease
• Biochemistry of Myocardial Contraction in the Developing heart
• Fetal Echocardiography
• Electrophysiology, clinical or basic
• Hyperlipidemia
• Genetics of Congenital Heart disease
• Connective Tissue Disorder
• New 3D & echocardiographic imaging
• Clinical outcomes

Course Work
Course work is available within the John Hopkins University as well as within the Basic Science Division of the Johns Hopkins Medical Intuitions and the Johns Hopkins Bloomberg School of Hygiene and Public Health.


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