the Program

PROGRAM FACTS

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OVERVIEW

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The Aurora Health Care Cardiovascular Disease Fellowship Program

We invite you to become acquainted with our fellowship program in the subspecialties of Adult Cardiovascular Disease. We will introduce our program directors and faculty members, describe our clinical and laboratory facilities, and tell you what it's like to live and work in Milwaukee.

The best gauge of a fellowship program is how it shapes the careers of its graduates.

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Cardiovascular Disease Fellowship
(3 year program)

The program consist of 36 months of clinical cardiology.
Six new fellows are selected each year

Clinical campuses:

  • Aurora St. Luke's Medical Center
  • Aurora Sinai Medical Center

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First Year- Clinical Cardiology

  • Three months at Aurora Sinai
    • One echo/Stress lab/ Nuclear
    • 2 Consult service
  • Nine months at Aurora St. Luke's Medical Centers
    • 2 Consult service/ Chest Pain Service
    • 3 CCU
    • 2 Echo
    • 1 Nuclear
    • 1 Research
  • Call
    • Normally on call 1 weeknight every other week (26 for year) and 16 weekend calls over the entire year.
  • Consult/CCU
    • Fellows serve as teaching resource for the internal medicine and family practice residents
    • Focus is on chest pain work-up, critical care management, arrhythmia management, hemodynamics, use of inotropes and pressors, and management of all acute cardiac disorders
  • Non-invasive
    • Fellows learn monitoring and interpreting of exercise and pharmacological stress studies. Including interpret non-invasive peripheral vascular studies.
  • Outpatient clincs
    • Spend equivalent of one half-day per week in a general cardiology consultation clinic
  • Research
    • Each first-year fellow selects a faculty mentor and initiates a research project
    • A project should be well under way by the completion of the first year
    • Research activities run concurrent with clinical responsibilities

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Second Year- Clinical Cardiology

  • 12 months at Aurora St. Luke’s Medical Center
    • Six months in Cardiac Catheterization Laboratory
    • Two months of Electrophysiology service
    • Two months of Heart Failure Service
    • One month of Echo lab
    • One month of Adult Congenital Heart Disease diagnosis and management
  • Call:
    • Normally on call an average of 2-3 weeknight calls per month and 14 weekend calls averaged out over the enter year.
  • Cardiac Catheterization and Peripheral Vascular Laboratory:
    • During this six months rotation, fellows are responsible for pre-procedure
    • assessment, participating in the procedure, interpretation of studies, and
    • post-procedure patient management
    • Techniques in the Cath lab:
      Diagnostic heart catheterization
      Management/intervention in acute MI
      Device and pharmaceutical trials
      Pericardiocentesis
      Endomyocardial biopsy
      Second assist in interventional procedures
      Peripheral vascular angiography
      Intra-aortic balloon pumps
      Thrombolytic and IIb/IIIa therapies
      Invasive Coronary Physiology Studies
      Complex hemodynamics and valvular Cases
  • Congenital Heart Disease
    • Fellows are supervised in outpatient rotation at Adult Congenital Heart Disease Clinic with Dr. A. Jamil Tajik
  • Heart Failure, Transplant:
    • Fellows are supervised in inpatient, Cath lab and outpatient setting
    • Activities include inpatient and outpatient consultations, introduction to the catheterization laboratory, and care of post-transplantation patients
  • Electrophysiology:
    • During electrophysiology service fellows develop a basic understanding of management and treatment of arrhythmia, a well as appropriate use of noninvasive and invasive electrophysiology techniques during: Electrophysiology Studies, Cardioverter-defibrillator implantation and maintenance, Clinical EP consultation (inpatient/office), Comprehensive invasive EP testing, advanced Intracardiac mapping, Tilt-table testing, Catheter and intraoperative ablation, transtelephonic monitoring for PM and loop recorders, Pacemaker implantation, testing and follow-up
  • Research
    • Protocols designed in the first year are implemented throughout the course of the second year
    • Faculty mentoring continues during this phase of research development
    • Projects are expected to be presented at a national/international meeting or submitted to a peer review referenced journal
    • Research activities run concurrent with clinical responsibilities

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Third Year- Clinical Cardiology

  • Two months at Aurora Sinai
    • Non-invasive lab rotation
  • Ten months at Aurora St. Luke’s
    • Two months of core advanced cath lab rotation
    • One month of electrophysiology rotation
    • One month TEE/Echo rotation
    • One month of CCU (in 1st 6 months)
    • Five months of Electives - Individually designed by the trainee and the program director
  • Call
    • Normally on call an average 2-3 weeknight calls per month and 11 weekend calls averaged out over the entire year.
  • Cardiac Catheterization and Peripheral Vascular Laboratory:
    • Spend differing amounts of time in this laboratory (a minimum of two months)
    • Third-year fellows typically spend 25% of this year in the Cardiac Catheterization Laboratory
    • Participation in research involving investigational devices and drug trials will be part of this rotation.
    • Techniques:
      All procedures previously listed, plus...
      Percutaneous transluminal coronary angioplasty (PTCA) and stenting and atherectomies
      Exposure to transseptal catheterization and valvuloplasty
      Peripheral vascular angiography and intervention including AAA and TAA
      Endomyocardial biopsy
      Limb salvage
      Pharmacologic management with thrombolytics and IIb/IIIa inhibitors
      Structural Heart Disease including ASD/PFO closures, Percutaneous Valve Replacement/Repair
  • Non-invasive Cardiology:
    • A fellow who chooses additional experience in the non-invasive laboratories is allowed to select two months of elective time during the third year
    • The goal is to prepare the third-year fellow to function on the same level clinically as would a junior attending
    • May be granted permission to attend a course for licensing in nuclear cardiology and participation in performing transesophageal echocardiography
    • Cardiac CT experience and setting takes place in an office-base practice non- invasive lab located on Aurora St. Luke's Campus.
  • Elective Pulmonary Hypertension Rotation
    • A fellow has the option to choose four weeks of focus learning in pulmonary hypertension at Aurora St. Luke's
    • Activities include inpatient and outpatient consultations, introduction to the catheterization laboratory and care of post catheterization patients.
  • Research
    • Prior to graduation, each fellow must complete one qualified research project(s)
    • Fellows' research efforts, activities and times are designed to run concurrent with clinical experience throughout the three years of fellows's traning.

 

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Preventive Cardiology Experience

The primary goal of preventive and rehab cardiology curriculum is to provide the learner with the knowledge, skills and strategies for successfully initiating a maintaining preventive care using a team approach in the practice of clinical cardiology. The program provides additional educational, clinical and research opportunities for fellows interested in cardiology careers with an emphasis on prevention.

Our program utilizes the available resources to provide comprehensive teaching and self-guided learning opportunities in cardiovascular physiology, pathology, pharmacology and epidemiology related to the following diseases with emphasis on prevention.

Atherosclerosis: Ischemic heart disease, peripheral vascular diseases and vascular aneurysms. These topics and related subjects which have significant impact on atherosclerosis such as tobacco abuse, metabolic syndrome, insulin resistance, diabetes, obesity, exercise, dyslipidemias and platelet function are covered.

Hypertension: Topics include renin-angiotensin-aldosterone system, sympatheric nervous system, endothelium function and related peripheral humoral system, vascular smooth muscle function are discussed.

Heart failure: Left ventricular function and improvement of its performance with various pharmacological modalities are covered.

Conferences, along with journal clubs and research conferences provide fellows with extensive resources for their learning experience.

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Fellows Required Conferences:

  • Monday noon-1 pm- Fellow's Journal Club Conference (Cardiology Fellows’ Journal Club presentations) - bi-weekly
  • Monday noon-1 pm- Board Review- bi-weekly (alternating with Journal Club)
  • Tuesday 5-7 pm- Cath Conference weekly
  • Tuesday Noon-1 pm- ECG Lecture Series - bimonthly
  • Wednesday noon-1 pm- Cardiology Grand Rounds Conference
  • Friday noon-1 pm- Clinical Cardiology Conference weekly
  • One Saturday a month 7-9 am. Research conference
  • Annual research retreat - yearly
  • Optional Conferences:
    • Heart Failure Conference - weekly (optional, unless on HF rotation)
    • Cardiovascular Imaging Conference - weekly (optional, unless on echo rotation)
    • Interventional Cardiology Cath Conference - monthly (optional, unless on cath rotation