Fellowship Program Information
The goal of our Pediatric Cardiology Fellowship Program is to prepare physicians for careers in academic pediatric cardiology. We strive to create a training environment that will foster not only quality clinical training, but also rigorous inquiry and mentoring that will lead to development of the next generation of leaders in pediatric cardiology.
Pediatric Cardiology Fellowship Curriculum
The duration of the Fellowship Program is three years. The exact schedule is determined in part by the fellow's interest and previous experience, but an example is shown below. We follow a 4-week block system, so there are 13 blocks in one year.
| 1st Year | 2nd Year | 3rd Year | |
|---|---|---|---|
| Inpatient | 1.5 | 1 | 1 |
| Consults | 1 | 1 | 1.5 |
| CVICU | 1 | 1.5 | 1 |
| Heart Failure/Transplant | 1 | 1 | 1 |
| Imaging | 2.5 | 1 | 1 |
| Electrophysiology | 1 | 0 | 1 |
| Cardiac Catheterization | 1.5 | 1 | 0 |
| Adult Congenital | 0 | 1 | 0 |
| Research | 3 | 4.5 | 5.5 |
| Bootcamp | 0.5 | 0 | 0 |
| Elective | 0 | 1 | 1 |
| Total Blocks | 13 | 13 | 13 |
Description of Specific Clinical Rotations
Inpatient Floor
The fellow on inpatient service is responsible for following all cardiology inpatients alongside the attending cardiologist.
All fellows participate actively in teaching discussions with the residents and attending physician. During the fellowship, the fellow assumes increasing responsibility for patient management.
Consultation Service
The fellow on consult service works alongside advanced practice providers to provide consultation to all cardiac patients in the CVICU, the general pediatric services, the NICU and the emergency department. The fellows also provide consultation to the newborn nurseries and NICU at Parkland Hospital and Clements University Hospital. The fellows work under the supervision of the attending cardiologist. The fellow assumes increasing responsibility with each rotation.
Cardiac Intensive Care Unit
The fellow is responsible for managing critically ill patients in the cardiac intensive care unit and will work with the attending cardiac intensivist, the on-service consulting cardiologist, and the cardiac surgeons. During this rotation the fellow becomes skilled in caring for neonates with congenital heart disease, postoperative patients as well as heart failure and transplant patients, understanding their physiology and managing their various comorbidities and complications. In addition, the fellow will become familiar with cardiac anatomy, as visualized by the surgeon, and with techniques of cardiopulmonary bypass.
Imaging
The goal of this rotation is for the fellow to acquire skills necessary for performing and interpreting echocardiographic studies. More than 13,000 echocardiograms (including transthoracic, transesophageal, and fetal studies) are performed each year, which offers the opportunity for the trainee to be exposed to a wide variety of complex congenital/acquired heart diseases. Fellows have the opportunity to perform the initial scan. Education is available in twice-weekly echocardiographic conferences and on a daily basis by sonographers and readers. During the second and third years the fellow gains experience in specialized areas such as transesophageal, fetal, and exercise stress echocardiography. An advanced cardiac imaging elective, including cardiac MRI and cardiac CT, is also offered.
In partnership with the Department of Radiology, the UT Southwestern Pediatric Cardiology Program is a leader in the field of CMR in patients with acquired and congenital heart disease. Our program combines technology, physics, and clinical care to provide the most comprehensive cardiac evaluations for patients. We have a magnet in the Heart Center that is primarily dedicated to cardiac imaging and is physically located next to the catheterization lab, allowing hybrid procedures to be performed. As part of imaging training at UTSW, fellows will have extensive exposure to cardiac MRI and cardiac CT. With over 600 cardiac CTs and 1000 cardiac MR procedures, fellows will learn how cardiac MRI, CT, and echocardiography work together to answer critical questions for each cardiovascular lesion. They will also be exposed to image acquisition techniques, study interpretation, and quantitative analysis. Advanced techniques such as 3D reconstruction, including 3D printing, will also be covered.
Cardiac Catheterization
We offer a full range of interventional procedures with just over 700 total catheterizations were performed last year. The cardiac catheterization laboratories comprise of two angiographic suites which are hybrid capable. Both laboratories are state of the art and are in the interventional suite of the Heart Center. The catheterization laboratories have direct access to Pre-op and Recovery, Cardiac OR, MRI, and CVICU.
Electrophysiology
Our electrophysiology service is very active. During this rotation, the fellow is exposed to all aspects of clinical electrophysiology. The fellow will become proficient in interpreting electrocardiograms and 24-hour recordings, performing and interpreting transesophageal ECG recordings, and assessing pacemaker and implanted cardioverter defibrillator (ICD) function. About 20,000 electrocardiograms are performed each year. More than 250 pacemaker patients are currently in active follow-up and about 35 devices are implanted each year. In addition, the fellow participates in electrophysiologic studies and catheter ablation procedures. Typically, 150 electrophysiology studies and catheter ablations are performed annually.
Transplantation
We are a high-volume transplantation program with around 20 heart transplants per year. Additionally, we have a robust heart failure service with exposure to mechanical circulatory devices. Around 15 ventricular assist devices are placed each year with these patients being followed both in the inpatient and the outpatient setting. The fellow will attend transplant clinic and help manage the patients in the hospital who are being evaluated for transplantation, awaiting transplantation, or are status post-transplant.
Continuity Clinic and Other Clinical Activities
The fellow will be assigned to work with a faculty member in outpatient clinic one-half day per week. Patients in this clinic will consist of a wide variety of general cardiology problems including pre-operative, post-operative and new patient evaluations. The goal of this experience is to provide a continuum of patient contact so that the fellow can appreciate the natural history of selected clinical problems and work closely with an attending cardiologist to learn how to develop a good doctor/patient relationship.
The fellow will also participate in specialty clinics, such as preventative cardiology, arrhythmia, pulmonary hypertension, sports cardiology, and adult congenital heart disease.
Research/Scholarly Activity
Research may be performed in clinical or basic science areas. A fellow may choose a faculty mentor who has the skills and interests to help the fellow complete their research project. The experience should instill the culture and value of investigative work and lay the foundation for future contributions. The trainee will develop skills in experimental design, data analysis, and presentation of results through presentations at national meetings and publications of manuscripts in scientific journals.
Clinical Science Opportunities
All pediatric cardiology faculty members are active in clinical research and, as such, fellows may participate in a wide variety of projects. Fellows may also collaborate with investigators outside of pediatric cardiology, depending on interest.
Rotation in Research
All fellows are expected to show evidence of scholarly activity during their fellowship. Basic science, translational science and clinical science studies, a critical meta-analysis of the literature, a critical analysis of public policy relevant to the subspecialty, and a curriculum development project with an assessment component are all considered “evidence of scholarly activity.”
We do not expect fellows to have a project defined at the beginning of the fellowship. Research rotations during the first year allow the fellow time to explore possible areas of interest. Research may be performed in clinical or basic science areas. A fellow may choose a faculty mentor from inside or outside the pediatric cardiology division. The goal is to have each fellow present at national meetings and publish a manuscript in an academic journal prior to completion of fellowship. More importantly, the experience should instill the culture and value of investigative work and lay the foundation for future contributions. The trainee will develop skills in experimental design, data analysis and presentation of results. Fellows with previous research experience, or well-defined interests, may begin research during the first year.
Basic Science Opportunities
UT Southwestern has an international reputation as a leading research institution and supports more than 3500 research projects annually totaling more than $400 million dollars in funding. On the basis of federal individual research grant support for basic sciences, UT Southwestern is among the top 10 biomedical research institutions in the country, and the faculty are among the most distinguished in the world. There are over 500 graduate students earning their Ph.D. degrees and over 90 students obtaining combined M.D. and Ph.D. degrees.
A vast array of research opportunities is available in the area of cardiovascular biology, as UT Southwestern currently boasts one of the largest concentration of investigators in this exciting area of science, including: Eric Olson, Ph.D., Helen Hobbs, M.D., Masashi Yanagisawa, M.D., Ph.D., Joseph Hill, M.D., Ph.D., and Craig Malloy, M.D. This critical mass has allowed the institution to successfully compete for selection as the first recipient of a Reynolds Foundation Grant, headed by Dr. Helen Hobbs, for research in the cardiovascular sciences that was recently renewed bringing the total funding to $42 million. Additional post-doctoral fellows training in cardiac development, and graduate students obtaining their Ph.D. or M.D., and Ph.D. degrees in the laboratories, provide a rich and interactive training environment.
The research training that will be required of the fellow will depend upon his/her prior experience and interests. If you have a particular research interest, you can search for faculty interested in that area. In general, the majority of fellows focusing on basic science research will likely spend a total of four years in their training. Grants are available through the Physician Scientist Training Program (PSTP) at UT Southwestern or the Reynolds Foundation, to assist in funding for these additional years. Those pursuing more clinical research will have a rich exposure to state-of-the-art approaches in understanding the molecular basis of congenital heart disease and cardiac development through formal and informal conferences and discussion.
Clinical Science Opportunities
All of the Pediatric Cardiology faculty members are active in clinical research and as such, fellows may participate in a wide variety of projects. As indicated above, the fellows may also collaborate with investigators outside of pediatric cardiology depending on interests.
For further information on active research areas, please see Pediatric Cardiology Research.
Research Education
Training in clinical research involves more than the traditional apprenticeship with an established mentor and performing a research study. The clinician investigator must be trained in research methodology which should include techniques of patient-oriented research, hypothesis generation, study design, and statistical analysis.
UT Southwestern has made a major commitment to the development of clinical research at the medical school and has subsequently created the Department of Clinical Sciences. Additional extensive resources to support clinical research are available through the Clinical and Translational Science Awards (CTSA), which is a national consortium funded through the National Institutes of Health (NIH) National Center for Research Resources (NCRR) with the primary aim of creating a definable academic home for the disciplines of clinical and translational research.
The mission of the Department is to accelerate and enhance the training and career development of clinical investigators, promote the conduct of high-quality patient-oriented research, develop effective mechanisms to facilitate translational research, and provide a formal mechanism of institutional recognition for clinical scientists.
The following units and programs are supported by the Department of Clinical Sciences:
- Biomedical Informatics
- Biostatistics
- Epidemiology
- Outcomes and Health Services Research
- Research Ethics
The curriculum is well suited for candidates who possess both a working knowledge of clinical medicine and excellent scholastic aptitude. Required course work may include didactic courses in basic biostatistics, epidemiology, clinical research design, translational research, molecular genetics, grant-writing skills, and data analysis and management.
For further information, please see Pediatric Cardiology Research and UT Southwestern Research.
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