Pediatric Cardiology Fellowship Program Curriculum and Schedule
During UT Southwestern’s Pediatric Cardiology Fellowship, trainees gain comprehensive exposure to all areas of pediatric cardiology. Clinical and research rotations are thoughtfully integrated throughout the three years to ensure a balanced training experience.
We employ a night float system, with fellows providing in-house coverage during designated night rotations. The schedule also offers flexibility to accommodate individual goals, including extended research time for those pursuing basic science research and customized pathways for fellows on an accelerated track due to prior training.
Continuity Clinic
Throughout all three years, fellows participate in a weekly continuity clinic, working closely with a dedicated faculty cardiologist at either the Dallas or the Plano campus. This experience exposes them to a broad range of general cardiology conditions while fostering the development of longitudinal patient relationships, cost-conscious clinical decision-making, and continuity of care skills. It also allows fellows to better understand the natural and modified history of both congenital and acquired heart disease.
Curriculum
The program also includes a robust didactic and conference schedule. Our fellows are integral in the presentation of patient data at our weekly combined Cardiology/CT Surgery Conference. Fellows also present on different cardiac topics and facilitate Journal Club and the Morbidity and Mortality Conference as part of the weekly Heart Center Conference.
Multiple protected didactic sessions are held throughout the week and led by faculty, supplementing the education of our fellows in the different areas of cardiology.
Clinical Rotation Schedule
Below is an example of a typical three-year rotation schedule.
| 1st Year | 2nd Year | 3rd Year | |
|---|---|---|---|
| Acute Care Cardiology | 1 | 1 | 1 |
| Cardiology Consults | 1 | 1 | 1 |
| Cardiac Intensive Care | 1 | 1 | 1 |
| Heart Failure and Transplant | 0.5 | 0.5 | 0.5 |
| Imaging | 2 | 1 | 1 |
| Electrophysiology | 1 | 0 | 1 |
| Cardiac Catheterization | 1.5 | 1 | 0 |
| Adult Congenital Heart Disease | 0 | 1 | 0 |
| Research | 4 | 5 | 6 |
| Elective / Other | 1 | 1.5 | 1.5 |
| Total Blocks | 13 blocks | 13 blocks | 13 blocks |
Description of Specific Clinical Rotations
Acute Care Cardiology
The Acute Care Cardiology Unit houses 44 beds, which are divided into three teams. The Acute Care Cardiology Unit is referred to as the inpatient or step-down unit at some centers. The fellow on the acute care service is responsible for managing all of the cardiology patients on the teaching service. The other two teams are a primarily advanced practice provider-run cardiology team and the heart failure/transplant team.
During the three years of fellowship, the fellow assumes increasing responsibility for patient management and team education. This rotation focuses on caring for children with congenital and acquired heart disease postoperatively, as well as for those with medical conditions, and ultimately discharging them home.
Cardiology Consults
The consult service provides consultation and patient management recommendations to all cardiac patients throughout the hospital, including the intensive care units, the emergency department, the general pediatric wards, and other subspecialty units.
Additionally, the consult team provides consultation to the newborn nurseries and neonatal intensive care units at our partner hospitals, Parkland Memorial Hospital and William P. Clements Jr. University Hospital. The fellow on the consult service works alongside advanced practice providers to provide care to these patients under the supervision of an attending cardiologist.
Cardiac Intensive Care Unit
The Cardiac Intensive Care Unit consists of 32 beds, which are divided among three teams. During this rotation, the fellow becomes skilled at managing critically ill cardiac patients, including neonates with congenital heart disease, post-operative patients, patients with heart failure, mechanical circulatory support, and transplant patients. The fellows assume increasing responsibility each year, and by their final year of fellowship, they are managing one of the teams with the assistance of a cardiac intensive care faculty member.
Heart Failure, Mechanical Circulatory Support, and Heart Transplant
We are a high-volume transplantation program with around 20 heart transplants per year. Additionally, we have a robust heart failure service with around 15 ventricular support devices placed each year. During this rotation, the fellow receives exposure to all facets of heart failure and transplant management in both the inpatient and outpatient settings.
Imaging
The goal of this rotation is for fellows to acquire the skills necessary for performing and interpreting echocardiographic studies. With over 13,000 echocardiograms performed each year, our fellows have exposure to the imaging of a wide variety of congenital and acquired heart disease. During this rotation, the fellows work closely with experienced sonographers to optimize their image acquisition and with cardiology faculty to perfect their image interpretation.
The first year is primarily focused on transthoracic echocardiography. During the second and third years, many fellows choose to gain additional experience in specialized areas such as transesophageal, fetal, and stress echocardiography, as well as advanced imaging modalities, including cardiac CT and MRI. For fellows interested in advanced imaging modalities, the program offers robust exposure, with more than 600 cardiac CT scans and more than 1,000 cardiac MRI procedures performed each year.
Electrophysiology
During this rotation, the fellow is exposed to all aspects of clinical electrophysiology. The fellow becomes proficient in interpreting electrocardiograms and 24-hour recordings and assessing pacemakers and ICDs. The fellow also participates in invasive electrophysiologic studies and catheter ablation procedures.
- Around 20,000 electrocardiograms are performed each year.
- More than 250 patients with pacemakers are currently being followed by the electrophysiology team.
- Around 150 electrophysiology procedures are completed each year.
This provides ample experience for the fellows.
Cardiac Catheterization
The cardiac catheterization laboratories comprise two angiographic suites that are hybrid-capable, where more than 800 cases are performed each year. The fellow is able to participate in the full range of cardiac catheterization procedures, including hemodynamic evaluations, balloon valvuloplasty, device closures, and stent/angioplasties. During this rotation, the fellow is involved in the pre-procedure planning, the interpretation of the physiologic data and angiograms, and the post-procedure management for the patients.
Adult Congenital Heart Disease
During this rotation, our fellows are fortunate to receive education from our adult congenital cardiology colleagues. They are exposed to a wide variety of medical problems that arise in our patients as they enter adulthood. The fellows are able to see patients in the Adult Congenital Cardiac Clinic and through consults to cardiac patients admitted to Clements University Hospital.
Research
Our fellows are expected to actively participate in scholarly activity throughout their fellowship. The majority of our fellows participate in clinical research, though some choose to pursue translational or basic science research. Quality improvement and medical education projects are also possible.
We schedule our fellows to have research rotations starting in their first year so that they can focus on the foundational parts of their scholarly work. The goal is to perform the bulk of their scholarly work during their second-year blocks and present their findings at national meetings in their third year.