Fellowship description

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Length of training
The fellowship is designed for three years of training with an optional fourth year of additional research experience.

Content of training
During the first two years of subspecialty training, the resident will receive extensive, focused training in all aspects of clinical pediatric cardiology. The residents will have one rotation during the first year that will provide an introduction to investigative research where they will have an opportunity to interact with research mentors and begin to develop a program of investigative study with that mentor. Two additional months of research will be provided during the second year to further establish a program of investigative research in anticipation of focused research during the third and potential fourth years of the fellowship. During the third year, two elective clinical rotations in the subspecialty area of the resident's choice will be offered, and one rotation in the inpatient/ICU service will be required as the attending cardiologist, functioning as the team leader and director of rounds and clinical decision-making. The remainder of the year will be designed for focused research in a research mentored laboratory. Those who elect to participate in a fourth year will continue to develop an area of focused basic or clinical research.

Research opportunity
This program is designed to provide meaningful research experience and to train academic pediatric cardiologists capable of independent investigation. Supervised research experience begins in the first year and extends throughout the training. During the first year, the subspecialty resident will focus on understanding the pathophysiology of cardiac disease in children through the critical evaluation of the clinical and relevant basic science literature. The second year of the fellowship will again focus on understanding the pathophysiology of cardiac disease with two months research time where a specific mentor in the Cardiovascular Research Center at the Medical College of Wisconsin will be identified and initial groundwork started for focused basic/clinical research during the third year of training. A core curriculum of basic research instruction will be provided during the third year with the opportunity to participate in a fourth year of fellowship that would continue the basic/clinical research program. During the third and fourth years, course work on cardiovascular physiology, advanced renal physiology, introduction to molecular genetics, experimental design, cardiovascular pharmacology, membrane cell and tissue transport physiology, and mathematical biology will all be available. Those who elect to participate in a fourth year of research will be candidates through the Medical College of Wisconsin Graduate School for a master's of science degree.

Qualifications and recruitment of trainees
Fellow applicants will be required to have a medical degree and have completed a pediatric residency in a US-accreditated training program. The program participates in the NRMP pediatric cardiology match program.

Each rotation is 4 weeks with 24 total clinical months and 12 total research months.

Call will be every fourth night - First as a first and second year fellow and back-up call as a third and fourth year fellow.

Rotation Schedule

1st Year	Rotations
Echo/Noninvasive imaging Cardiac Catherization ICU/Wards EP/Prevention/Transplant/Adult Congenital Research	3 3 3 2 2 13 Total
2nd Year	Rotations
Echo/Noninvasive imaging Cardiac Catherization ICU/Wards EP/Prevention/Transplant/Adult Congenital Research Elective	2.5 2.5 2.5 2 3 0.5 13 Total
3rd Year	Rotations
Research ICU (Attending) Elective	10 1 2 13 Total

From home, call will be required during the first two years of training every fourth night. During the third and fourth years, the call will be at home as a resource for the junior fellow and as a back-up to assist in complicated cases every fourth night. This schedule will result in only two weekend days/nights of coverage for every four-week cycle (on Monday/Friday of week 1=off Sat and Sun; on Tues and Sat of week 2=off Sun; on Wed and Sun of week 3=off Sat; on Wed of week 4=off Sat and Sun). Inhouse call will be required during the inpatient/ICU rotation. Fellows on inhouse call will be released from clinical duties by noon the following day.

For the first and second year residents, at home call will involve first call responsibilities for all outpt parent/referring MD calls as well as first call responsibilities for all inpt cardiology and cardiothoracic surgery concerns. For third year residents, call will be taken from home as back-up support for the first year and second year resident on call. In house call during the ICU rotation will require primary management of inpatient post-operative surgical patients as well as the duties outlined above. The first and second year residents will have no call during their research rotations.

Clinical rotation

• Attend pediatric cardiology conferences and teaching sessions.
• Attend daily echo review session of the previous day's studies with echo attending.
• Participate in all TEE intraoperative and interventional studies.
• Evaluate need for and method of sedation in all uncooperative children proposed for echo study with echo attending.
• Observe and perform routine transthoracic echo studies on inpatients and outpatients with echo technical staff.
• Write preliminary reports on all studies performed by the fellow.
• Review all echo studies to be shown at conferences and present them.
• Take night call every fourth night from home for all pediatric cardiology and cardiovascular surgery patients.

Cardiac catheterization rotation:

• Attend pediatric cardiology conferences and teaching sessions.
• Perform H & P on all cardiac cath patients prior to the procedure.
• Participate in all cardiac cath procedures.
• Complete post-cath orders on patients following cath.
• Admit and write follow-up notes on all post cath interventional patients.
• Complete diagrams and hemodynamics on all cath patients and dictate the procedure.
• Review all cath studies to be shown at conferences and present them.
• Take night call every fourth night from home for all pediatric cardiology and cardiovascular surgery pts.

Inpatient/ICU rotation:

• Attend pediatric cardiology conferences and teaching sessions.
• Attend daily ICU and intermediate care rounds on cardiology and cardiovascular surgery patients.
• Perform H & P on all patients admitted to cardiology/cardiovascular surgery service.
• Write daily notes on all ICU cardiology and cardiovascular surgery patients.
• Perform all inpatient consults in the hospital.
• Participate in all patient interventions performed in the ICU.
• Review all inpatient histories to be discussed at conferences and present them.
• Take night call every fourth night in house for all pediatric cardiology and cardiovascular surgery patients.

EPS/Adult congenital heart disease/Preventative cardiology rotation:

• Attend pediatric cardiology conferences and teaching sessions.
• Perform H & P on all EPS patients prior to the procedure.
• Participate in all EPS procedures.
• Complete post cath orders on patients following EPS procedures.
• Admit and write F/U notes on all post EPS interventional patients.
• Reviw electrophysiology tracings on all EPS patients and dictate the procedure.
• Read all non-clinic inpatient and outpatient ECG's and Holters.
• Attend all exercise treadmill and tilt table tests.
• Attend all pacemaker clinics.
• Attend all adult congenital heart disease clinics.
• Attend all preventative cardiology clinics.
• Take night call every fourth night from home for all pediatric cardiology and cardiovascular surgery patients.