Training and Curriculum

A combination of clinical rotations, simulation, didactics, procedures, mentored research and self-directed learning prepare fellows to be future leaders in Cardiovascular Medicine. Fellows participate in the following activities during the cardiovascular fellowship program:

Clinical Rotations

Our clinical rotations emphasize fellow autonomy and clinical decision-making with direct faculty supervision. Fellows in our program gain independence in clinical judgment and procedural skills with this interaction, which is bolstered by outstanding clinical volume and diversity, as well as numerous core curriculum and sub-specialty conferences.

The clinical curriculum in our program is designed to meet COCATS 4 recommendations by the American College of Cardiology for both procedural volume and training time for competency in Cardiovascular Disease. Specific rotation requirements include:

  • Cardiac Catheterization Laboratory [PDF] (4 months)
  • Coronary Care Unit (4 months)
  • Valvular/Congenital Heart Disease (1-2 months)
  • Echocardiography (5-6 months)
  • Electrophysiology Inpatient and Consults (2 months)
  • Heart Failure/Transplant (1-2 months)
  • MRI (1 month)
  • Nuclear Cardiology (2 months)
  • Magnetic Resonance Imaging (1 month)
  • Vascular Medicine/Prevention Cardiology (1 month)
  • Outpatient Continuity Clinic (weekly for all 3 years of fellowship, at Duke Hospital or Durham VA Medical Center)

Procedures

Fellowship training at Duke meets training recommendations of the American College of Cardiology (COCATS). Procedural volume is tracked throughout training by the specific laboratories (Cardiac Catheterization, EchocardiographyElectrophysiologyNuclear CardiologyMRI) and by a self-reporting system.

  • Cardioversion
  • Insertion and management of temporary pacemakers including transvenous and transcutaneous
  • Programming and follow-up surveillance of ICDs and permanent pacemakers
  • Bedside right heart catheterization
  • Right and left heart catheterization including coronary arteriography (>200 cases)
  • Exercise stress testing 
  • Echocardiography (Perform 150, Interpret 150, TEE 50, Stress Echo 100)
  • Electrocardiograms (> 3500)
  • Ambulatory ECG recordings
  • Radionuclide studies of myocardial function and perfusion
  • Cardiac magnetic resonance imaging
  • Intra-aortic balloon counterpulsation (insertion and management)
  • Pericardiocentesis

Didactics

Weekly educational conferences throughout the Division of Cardiology and Heart Center are available for fellows. Conferences cover topics in general cardiology as well as sub-specialties. For fellows, three weekly conferences offer a core didactic curriculum: Cardiology Grand Rounds, Core Curriculum Conference, and Clinical Case Conference. Other conferences are optional but highly recommended, especially on specific rotations or based on the fellow's own interest, to increase knowledge in the sub-specialties. Here is an example of our weekly conference schedule:

The cardiology core curriculum presentations and conferences are archived for future review or for fellows who miss a conference.

Mentored Research and Training

Fellows will participate in mentored research projects throughout their clinical years as allowable given clinical demands, and will have 1-2 years of dedicated, protected and funded research time during their fellowship. Throughout the clinical years of training, fellows are encouraged to initiate and develop plans for research years, including specific mentors and research projects. Fellows, with the input of faculty members, develop their own individual plan for career development, including both clinical and research training, while completing clinical training requirements. Many of our fellows pursue coursework and advanced degrees in research skills, such as the Clinical Research Training Program, with a tuition benefit provided by NIH T32 training grants. 

We are proud of the outstanding academic productivity of our fellows.  Click here to view the Fellow's Publications PDF.

In 2015, the School of Medicine and Pratt School of Engineering, with support from the Office of the Provost, created MEDx. An initiative rather than an institute, MEDx is structured to enhance existing ties and encourage new collaborations among faculty from both schools as well as other schools, institutes and initiatives at Duke.

Evaluations

The Duke Cardiology Fellowship program uses many formats for assessment, most of which are collected and documented electronically through the trainee reporting system, MedHub. These include evaluations at the conclusion of each month’s rotation by faculty, peers, other health-care providers, and/or patients. For each clinical rotation/experience, fellows should receive a face-to-face meeting with a faculty member and a written evaluation from each faculty member with whom the fellow worked. In addition, there is a twice yearly program director summative evaluation: In this evaluation fellows meet individually with the program director to review their files, procedure logs, lecture attendance, research project progress and to develop individualized learning plans. Each fellow's progress toward clinical competency and independent practice is also reviewed every 6 months by our Clinical Competency Committee, with an assessment based on ACGME Milestones for the core competency domains. 

Evaluation of the research portion of the fellowship will be performed by the designated research mentors. This will include description of a research plan prior to initiation of research, as well as periodic evaluations of the progress in the research plan.

Travel

First- and second-year fellows are supported to attend one major, national scientific conference per academic year, such as the AHAACC Scientific SessionsHeart Failure Society of America, or Heart Rhythm Society. Fellows generally receive support from their faculty mentors to attend meetings during their research year(s) or advanced training.