Training and Curriculum

training_and_curriculum_cardio fellowship
A combination of clinical rotations, simulation, didactics, procedures, mentored research and self-directed learning prepare fellows to be future leaders in Cardiovascular health. 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:

Duke Cardiovascular Disease Fellowship Years 1 and 2 Clinical Rotations
Cardiac Intensive Care Unit 4.5 months
Cardiac Catheterization  4 months
Electrophysiology  2-3 months
Imaging (Echo, Nuclear, Cardiac MRI, Cardiac CT) 7-9 months
Heart Failure/Transplant  1-2 months
Valvular/Congenital 1-2 months
Vascular/Prevention  1 month
Outpatient Clinic 1/2 day per week
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Sample Schedules for Duke Cardiovascular Disease Fellowship Year 3
Sample Schedule 1: Clinical Focus Sample Schedule 2: Advanced Imaging Focus Sample Schedule 3: Research Focus Sample Schedule 4: Research and Clinical Focus
Echo - 3 months Echo - 6 months Research - 12 months Research - 12 months
Nuclear Cardiology - 3 months CT - 3 months Outpatient Clinic - 1/2 per week Echo - 1 day per week
Consultative Cardiology - 1 month Nuclear Cardiology - 3 months Elective - varies Outpatient Clinic - 1/2 day per week
General Cardiology Inpatient - 2 weeks OR Vacation - 1 month Vacation - 1 month
Heart Failure Inpatient - 2 weeks Echo - 6 months
Elective - 2 months Cardiac MRI - 6 months
Outpatient Clinic - 2 months Outpatient Clinic - 1/2 per week
Vacation - 1 month Vacation - 1 month
Duke Subspecialty Fellowship Training Programs (Optional):
  • Advanced Heart Failure and Transplantation (ACGME) - 1 year
  • Adult Congenital Heart Disease (ACGME) - 2 years
  • Clinical Cardiac Electrophysiology (ACGME) - 2 years
  • Interventional Cardiology (ACGME) - 1 year
  • Critical Care Medicine (ACGME) - 1 year
  • Clinical Informatics (ACGME) - 2 years
  • Cardiology Research Pathway (non-ACGME) - 1 year
  • Structural Heart Disease (non-ACGME) - 1 year 

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, Echocardiography, Electrophysiology, Nuclear Cardiology, MRI) and by a self-reporting system.

procedures cardio fellowship
  • 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

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.