The overall purpose of the first year of training is to provide new fellows with a broad exposure to all aspects of clinical cardiology as well as ample introductory experience to a wide variety of invasive and non-invasive cardiac procedures. Fellows will also be introduced to both clinical and basic science research. By the end of the first year, fellows will be able to evaluate cardiac patients and to initiate care appropriate for a wide variety of acute and chronic cardiac conditions but will not be expected to be experts in either clinical care or procedural skills. The goals for the first year of training are for fellows to be introduced to the full range of cardiovascular disease clinical and research opportunities, identify a specific area of interest and a projected career path, be paired with an appropriate mentor, and to select a research project.
Clinical Judgment and Skills:
By the end of the first year of fellowship training, fellows should be able to obtain an accurate and complete cardiac history and to perform a thorough but directed cardiac physical examination for patients being evaluated for a wide variety of cardiovascular diseases. During their first year of training, fellows will learn the proper role of the various invasive and non-invasive cardiac procedures and tests. Using the information available from the history, physical examination, and test results, first year fellows should be expected to be able to develop a differential diagnosis and a plan of care for common acute and chronic cardiovascular disease states. Additionally, first year fellows will be expected to identify life-threatening cardiovascular conditions and emergencies and to be able to initiate prompt therapy. First year fellows will gain experience in understanding the pathophysiologic basis of cardiac conditions. First year fellows should be able to contribute to patient management discussions on rounds in conjunction with the staff physician
First year fellows will begin to build the critical knowledge base that will permit them to function as competent well-rounded cardiologists. This knowledge will be acquired by reading current cardiology literature sources and standard textbooks as well as via didactic lecture sessions. Clinical knowledge will be gained in the following areas: coronary artery disease, myocardial diseases and heart failure, congenital heart disease, valvular heart disease, peripheral vascular disease and diseases of the aorta, cardiovascular prevention, hypertension, pericardial diseases, cardiac dysrhythmias and clinical electrophysiology, cardiothoracic surgery, cardiac rehabilitation, and pulmonary hypertension. First year fellows will begin to learn the basic literature related to cardiovascular testing and procedures and will begin to develop interpretive skills.
First year fellows will learn the indications, contraindications, and potential complications related to each major cardiovascular procedure. First year fellows will also begin to develop a working knowledge of the risk/benefit assessment that must take place prior to performing an invasive cardiac procedure. First year fellows will begin to learn how to safely perform procedures and to interpret the data obtained. These procedures will include electrocardiograms, ambulatory ECG monitoring, transthoracic and transesophageal echocardiograms, cardiac catheterization (hemodynamic and angiographic studies), exercise and pharmacologic stress testing, cardiac CT and MRI, electrical and chemical cardioversion, temporary pacemaker placement, and nuclear cardiac imaging. First year fellows will be instructed in how to properly document procedure findings and will be expected to document a thorough and accurate report on any procedure performed. By the end of the first year, fellows should be expert in the pre-procedural and post-procedural assessment of patients referred for cardiac testing and should participate in the performance of invasive procedures only under the direct supervision of an attending cardiologist.
First year fellows will be expected to provide teaching to medical students and residents on the basics of common cardiovascular conditions and routine bedside invasive procedures especially on the UIHC consult service, VA inpatient service, UIHC CVICU service and UIHC heart failure / transplant service. Teaching methods should include actively participating in case discussions on rounds, conducting brief teaching sessions, and introducing house staff to common cardiology literature sources (journal articles, textbooks, etc).
First year fellows are expected to conduct themselves with exemplary professionalism at all times, as evidenced by the display of honesty, integrity, respect, and compassion when caring for patients and interacting with patient families, referring providers, and other members of the health care team. First year fellows will accept responsibility for the care of cardiac patients and will be held accountable for conducting themselves with the highest of ethical standards at all times.
First year fellows will learn how to write a thorough, informative, and instructive cardiac consultation note as well as accurate and detailed procedure notes. First year fellows will learn to verbally communicate effectively with patients, families, and all members of the health care team. Fellows will learn the importance of maintaining complete and accurate medical records easily accessible to referring providers.
First year fellows should be able to provide guidance for medical students and residents as it relates to routine patient care. First year fellows should be able to participate in management discussions on teaching rounds in conjunction with the service attending.
First year fellows will be expected to develop a reading program that will build the foundation of basic cardiology knowledge necessary to become a competent clinical cardiologist. Fellows will learn the significance of keeping current with the literature in order to be able to adapt their clinical practice as new advances are made. Attendance at journal club will allow the fellows to keep abreast of the current literature. Fellows will improve their ability to critically review the cardiovascular literature and to correctly apply the literature in their clinical practice. Fellows will be introduced to both clinical and basic science research as it applies to cardiovascular diseases in order to help them select their fellowship research project.