Cardiovascular Disease Fellowship Program Structure
The University of Vermont Cardiovascular Fellowship program includes didactic and interactive conferences that complement the intensive clinical learning experience. Fellows attend weekly interventional, electrophysiology and imaging conferences, as well as case discussions, hemodynamic sessions, ECG hours, congenital series, journal clubs and many more. Interdisciplinary conferences include CT surgery, Critical Care and Vascular Surgery. The curriculum is dynamic and ever-changing, and it is characteristic of the UVM environment that our fellows are always involved in shaping it.
All fellows complete their core clinical training during the first 24 months. Every clinical rotation takes place at the University of Vermont Medical Center, the academic center of the University of Vermont Health Network. In addition, fellows complete an advanced heart failure / transplant rotation at Massachusetts General Hospital. Each fellow has two continuity clinics, one in the UVM Medical Center Cardiology outpatient practice and one at the Burlington VA clinic. The clinical experience is designed to satisfy all COCATS and ACGME training requirements.
Fellows engage in bench, translational and clinical research under the guidance of nationally acclaimed faculty. The Cardiovascular Research Institute of Vermont provides additional mentorship and resources such as project support, networking events and travel awards to trainees. Quality projects are supported with divisional and departmental resources, including High Value Care awards.
Learning and Teaching
Didactic and interactive conferences complement the intensive clinical learning experience. Fellows attend weekly interventional, electrophysiology and imaging conferences, as well as case discussions, hemodynamic sessions, ECG hours, congenital series, journal clubs and many more. Interdisciplinary conferences include CT surgery, Critical Care and Vascular Surgery. The curriculum is dynamic and ever-changing, and it is characteristic of the UVM environment that our fellows are always involved in shaping it. Fellows become teachers, contributing to medical student, resident and peer education not only during clinical rotations but also as instructors in the Sim Lab, lecturers at the Medical School, and teachers of didactic and interactive fellow conferences.
Fellows are assigned an academic advisor at the beginning of their fellowship. That faculty member will serve as a general resource to guide integration into fellowship and academic development during the first year. Thereafter, fellow subspecialty interests will drive the choice of a mentor. Faculty mentors represent a broad spectrum of academic physicians with interests ranging from bench research to innovation.
Cardiac Catheterization: Our cardiac catheterization laboratory is the quarternary referral center for the region. First and Second Year Fellows are trained to independently perform diagnostic coronary angiography and in left and right heart catheterization with hemodynamics. They are also exposed to percutaneous coronary interventions, structural procedures, intracoronary diagnostics (FFR, IVUS, OCT), and complex interventions (CTO, atherectomy etc). Fellows who intend to subspecialize in Interventional Cardiology begin their training in interventional procedures during their Third Year. Overall, 2500 diagnostic coronary angiographies are performed at UVMMC per year, 1200 PCI, and 270 structural procedures, including 210 TAVR.
CCU Rotation: The inpatient Cardiology service is fellow-driven at UVMMC and comprises all levels of acuity, from acute STEMI care to chest pain. Fellows drive the care of all patients admitted to the cardiology service, from ED to discharge. Teams include a cardiology faculty member, two fellows, four residents, a midlevel provider, and medical students. Fellows become comfortable managing and directing the care of patients with coronary syndromes, acute valvular disease, heart failure, pericardial disease, pulmonary hypertension, and adult congenital heart disease.
Inpatient Consultation: Fellows provide consultative services in conjunction with select faculty members, residents and students. A focus of this rotation is the care of the critically ill patient with a primary or secondary cardiac diagnosis in the Medical Intensive Care Unit. At UVMMC, patients with a primary cardiac diagnosis who require mechanical ventilation are treated in the medical or surgical (CT) Intensive Care Units and co-managed by Intensivists and Cardiologists.
Electrophysiology: Fellows evaluate and treat patients with the whole range of arrhythmia problems both on the electrophysiology inpatient service and as in-hospital consultants. Throughout fellowship, they are responsible for reading assigned ECGs and long-term arrhythmia monitoring. Fellows also take part in ambulatory device clinics. Our electrophysiology laboratory performs more than 1500 procedures a year, including ablations, diagnostic procedures, and devices
Echocardiography: During dedicated echo rotations, fellows are trained in the performance and interpretation of transthoracic and transesophageal echocardiography. Technology and training is continually updated to reflect the most recent innovations, including 3D and strain imaging. This is a particularly high-volume service, offering our fellows ample opportunity to achieve COCATS Level 2 competency. Third-year fellows wishing to focus on noninvasive cardiology or imaging can obtain Level 3 training.
Cardiac Imaging: First-year fellows are initially trained in stress testing and nuclear myocardial perfusion imaging. Subsequent rotations add Cardiac CT and Cardiac MR exposure. At UVM, 75% to 80% of all nuclear studies are co-read by a nuclear cardiologist and a nuclear radiologist. A collaborative environment between Cardiolgy and Radiology creates optimal training conditions in all advanced cardiac imaging modalities. A dedicated Nuclear Physics curriculum is offered biennially to fulfill Nuclear Cardiology Board eligibility requirements. Fellows can choose to become COCATS Level 2 certified in Nuclear Cardiology during their training.
Night Float: Fellows direct the night resident on the inpatient cardiology service and direct care of admissions throughout the night. This 2-week rotation runs Monday through Thursday from 7 pm to 7 am.
Continuity Clinics: All Fellows participate in two continuity clinics during alternating weeks: one half-day outpatient clinic at the Burlington VA outpatient center, and one 3-hour session at the UVM Cardiology outpatient practice. In addition, Fellows in their third year can choose to participate in specialized outpatient clinics in electrophysiology, heart failure, interventional/structural cardiology, women's cardiac health, adult congenital heart disease, and preventive cardiology.
Research/Reading: Two weeks are set aside in each of the first 2 years of fellowship to explore and initiate research projects or focus on review and reading.
Please contact us with any questions!
Fellowship Coordinator: Roberta Frohock, 802-847-2005
Email: Roberta [dot] Frohockuvmhealth [dot] org (subject: Cardiology%20Fellowship)
Address: Department of Medicine, UVM College of Medicine/UVM Medical Center
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