Fellows in the Cardiovascular Disease program rotate through all the diagnostic laboratories, as well as inpatient ward services, the Cardiac Intensive Care Unit (CICU), and provide inpatient consultative services. The first year fellow is assigned a comprehensive schedule to afford broad exposure across all the disciplines. The majority of diagnostic lab time is arranged in a contiguous fashion, to ensure a solid foundation of fundamental skills develop. Rotations in the CICU typically occur during the second half of a fellow’s first training year. This allows time for trainees to acquire the necessary subspecialty expertise before providing direct care of the most critically ill patients. The 2nd and 3rd year rotations are designed to have approximately 6 and 9 month elective time respectively. Each fellow works individually with the program director to align long-term goals with diagnostic lab rotations during this elective time. In addition, all fellows have their own continuity clinic with their designated preceptor a half day in the afternoon each week.
All fellows are encouraged to engage in research activities. Early in the first year, each fellow is expected to identify a primary area of interest so that academic goals can be pursued during the second and third years of training. A broad spectrum of basic research opportunities is available and active clinical research programs are ongoing in all cardiac diagnostic laboratories, outpatient clinics, and on the Inpatient (CCU) Service. There are opportunities for epidemiological work with the University Of North Carolina School Of Public Health, and we have a strong collaborative research program in clinical outcomes based at the Medical Review of North Carolina in Raleigh.
Teaching is an important responsibility of all trainees. In their daily work, our fellows teach medical students, technicians, nurses, housestaff, and colleagues in the cognitive aspects of cardiology, as well as the appropriate clinical application and performance of technical procedures. Each trainee also prepares and presents formal divisional teaching conferences. Additional teaching opportunities (leading medical student small groups during their Cardiovascular blocks, talks to EMS, ECG teaching to advanced degree nursing, didactic lectures to Physician Assistant trainees) are available for those fellows who have a strong interest in medical education.
In addition to our T32 research positions, our division also offers opportunities for extended training including 4th year positions in basic and translational research, molecular cardiology, interventional cardiology with peripheral vascular experience, clinical cardiac electrophysiology and heart failure/transplantation.
Completion of an ACGME-accredited three-year training program is required prior to entry into advanced clinical programs. Programs in basic/translational research and molecular cardiology can be developed before, during or after clinical training depending on individual goals.
A night float system was developed to replace traditional call. This week long rotation runs Sunday thru Friday. Fellows rotate through this during their 2nd and 3rd years. Responsibilities include management of the CICU patients, oversight of IM residents providing care on the ward floor teams, carrying the STEMI pager, and providing emergent consultative cardiac services. There is a 24 hour Saturday CICU rotation that uses a “drop-in” rotation of all the general fellows.
Core curriculum lectures are delivered to our cardiovascular disease sub-specialty fellows during the months of July-August and part of September. Structured didactics have been delegated to both fellows and faculty in areas identified as core concepts from ACC In-service Training exams and feedback from current trainees. The organization of all lecturers follow a fundamental format of: board review questions, followed by 30 minute lecture of core knowledge, and ends with discussion of the current ACC/AHA guidelines relevant to that particular topic.
- Simple Congenital Heart Disease
- Pharmacological Therapies in ACS
- Basic Cellular & Genetics of Atherosclerotic Vascular Disease
- Mitral Valve Disease
- Evaluation & Management of Patients with Hypertension
- Aortic Valve Disease
- Pregnancy in the Cardiovascular System
- Hypertrophic Cardiomyopathy
- STEMI Pathophysiology, Lytics, & Mechanism Complications
- Atrial Arrhythmias
- Rare Inflammatory Cardiomyopathies, & Transplant
- Diagnosis & Management of Hypertensive Cases
- Long QT, Ventricular Pre-Excitation & Brugada
- NSTE ACS
- Testing for Coronary Artery Disease
- Anticoagulation in AF
- Aneurysms of Thoracic/ABD Aorta & Genetic Syndromes
- Chronic Stable Angina
- Antiplatelet Therapy
- Peripheral Arterial Disease
- Ventricular arrhythmias
- Indications for PPM, CRT, & ICD
- Complex Congenital Heart Disease
- Carotid Disease & Inflammatory Diseases of the Aorta
There are numerous conferences that offer important educational opportunities for our fellows.
Cardiovascular Grand Rounds, our most formal conference, is delivered by faculty, senior fellows, and leaders in cardiology from all over the country. Presentations are on a variety of pertinent topics in cardiovascular medicine every other week.
There are also interactive conferences designed specifically for fellow education, including:
- ECG Conference – A weekly interactive review of basic and complex ECG reading and coding, led by one of the EP faculty
- Cath Conference – General and interventional fellows present recent interesting cath cases for discussion with the interventional attendings weekly
- EP Conference – EP faculty and subspecialty fellows present on a variety of EP topics, ranging from antiarrhythmic therapies to complex ablations
- Imaging Conference – Interesting nuclear scans, CTs, and MRIs are discussed with our department’s cardiovascular imaging specialist
- Echo Conference – Review of interesting echocardiograms
Additionally, there are fellow-led conferences, such as:
- Journal Club
- Morbidity & Mortality Conference
- Fellow Research Updates
If you have any questions, please feel free to contact Jennifer.Delacruz@unchealth.unc.edu.