Curriculum

The first two years of the UMass fellowship are devoted to training in all aspects of clinical cardiology. During this time, fellows serve as cardiology consultants for acutely ill medical and surgical patients; provide ongoing, outpatient care for their own patients; and perform and interpret both invasive and noninvasive diagnostic procedures. Time is set aside in the second year to enable fellows to initiate a research project under the guidance of a mentor.

The third year is designed for completion of research projects; advanced training in such areas as cardiac catheterization, echocardiography, and electrophysiology; and electives such as congenital heart disease and advanced imaging.

Fellows participate in many formal didactic conferences with faculty; the number of conferences per week ranges from five to nine, with an average of seven.

Clinical rotations are described below.
 

Rotation

Description

Ambulatory Clinic

Each fellow has a supervised ambulatory clinic one half-day per week at the Ambulatory Care Center. Some second and third year fellows opt to split their clinics between UMass and the Worcester Veterans Administration Outpatient facility. Fellows gain experience in caring for a wide range of adult patients with cardiac disease and learn to communicate well with referring physicians. All fellows take turns participating in the monthly Adult Congenital Heart Disease clinic.

Cardiac Catheterization Laboratory

The cardiac catheterization rotation allows for the performance of catheterizations in a highly supervised setting. Fellows spend several months on this rotation, becoming proficient in informed consent, radiation safety, gaining radial and femoral access, and performing right and left heart catheterization.

Vascular and Cardiac Surgery

This one month rotation immerses fellows in the care of patients with vascular disease. Fellows attend outpatient clinics, assist in the operating room and catheterization lab, and learn to perform and interpret noninvasive vascular testing. There is also exposure to cardiac surgery during this rotation.

Cardiac Care Unit

Fellows rotate in the 16-bed CCU for two or three months during their fellowship. Fellows take primary responsibility for patients with acute MI, shock, heart failure, cardiac arrest and arrhythmias. They are responsible for running rounds and making decisions under the guidance of experienced faculty members. Fellows learn to manage intra-aortic balloon pumps, temporary pacemakers and pulmonary arterial catheters.

Echocardiography/ Heart Station

Fellows spend several months on the echocardiography/heart station rotation. They become proficient in performing and interpreting transthoracic echocardiograms, stress echocardiograms (treadmill and pharmacologic), treadmill stress tests and electrocardiograms.

Transesophageal Echocardiography

Fellows spend two months on the TEE rotation. They become proficient in the following areas: understanding indications and contraindications for the procedure, managing moderate sedation, and performing and interpreting TEEs in multiple settings (echo lab, OR, ICU, EP lab).

Electrophysiology

Fellows spend two months on the EP rotation. They perform consultations, implant and program devices, assist with EP studies, and interpret Holter and event monitors.

Nuclear Cardiology

Fellows spend several months on the nuclear rotation. They become proficient in the performance and interpretation of nuclear stress testing, including dipyridamole, regadenoson and dobutamine stress. They become familiar with radiation safety and the QA procedures that are necessary for running a nuclear laboratory. Fellows are encouraged to participate in the performance and interpretation of coronary CT angiography during this rotation.

Consultation

Fellows spend two or three months on the consultation service. Each fellow takes charge of the busy service and supervises medical residents and students. The goal of the rotation is to become an excellent consultant, supervisor and communicator.

Inpatient

Fellows rotate on the inpatient  cardiology service for two or three months, evaluating and managing admitted patients. Fellows formulate their own assessments and plans and communicate with house staff, patients, families and referring physicians, under the guidance of the attending.

Health Alliance

Each first year fellow spends one month at Health Alliance, a community hospital located 20 miles north of Worcester. Fellows work closely with a small private cardiology group, performing inpatient and outpatient consultations and interpreting echocardiograms and nuclear perfusion scans. The goal of the rotation is to gain experience in a community hospital setting.

Heart Failure

Each fellow spends at least one month on the heart failure service. Fellows follow patients admitted to the service, perform consultations, and spend time in the heart failure clinic. Two weeks of the rotation are spent at Tufts Medical Center in Boston, gaining experience with advanced heart failure, ventricular assist devices and heart transplantation.

Electives

Fellows have participated in several types of electives at UMass and other nearby institutions, including - but not limited to - adult congenital heart disease, advanced imaging (MR/CT), cardio-oncology and ambulatory cardiology.