Clinical training

As outlined by the American Board of Internal Medicine and in accordance with Core Cardiology Training Statement (COCATS 4) recommendations, the Adult Congenital Heart Disease Fellowship is a two-year program with two pathways, depending on whether your background is from adult or pediatric cardiology.

Pediatric cardiologists devote training time to areas of adult internal medicine and cardiology to fulfill requirements necessary to care for adults with congenital heart disease, while adult cardiologists complete additional training in pediatric cardiology to meet the same requirements.

The schedule has flexibility that allows you to customize your education, depending on your career plans. Electives can be arranged in advanced heart failure and transplant, pulmonary hypertension, electrophysiology, stress testing, or additional cardiac catheterization lab or imaging training.

Our program is unique in that we have patients in the Adult Congenital Heart Disease (ACHD) Clinic every day of the week. During months in which you are assigned to the ACHD Clinic, you are in the congenital echo lab for half a day and in the clinic the other half day. This provides you the unique opportunity to perform echocardiograms on the patients you see in clinic, allowing for the correlation of physical exam findings to echo findings as well as continuity of care.

Historically, our fellows have performed more than 300 transthoracic and more than 150 transesophageal echocardiograms during the fellowship, which previously was a one-year program. These numbers far exceed the COCATS 4 recommendations for the two-year program.

You are responsible for following ACHD patients admitted to the hospital for procedures or operations and performing new consults on patients admitted to inpatient services.

Mayo Clinic is unique in that all patients with congenital heart disease, regardless of age, are cared for in the same geographic location. All inpatient procedures, including cardiac surgery, catheterization procedures, and electrophysiology procedures, are performed at Mayo Clinic Hospital, Saint Marys Campus.

Rotation schedule

Call frequency

Your call schedule is different for each rotation. Mayo Clinic follows the recommendations of the Accreditation Council for Graduate Medical Education (ACGME).

Didactic training

One-on-one instruction, clinical conferences, and small discussion groups are integral parts of the Adult Congenital Heart Disease Fellowship. A full core curriculum is provided electronically that designates our expectations for you in terms of didactic learning.

Conferences

You present at our multidisciplinary congenital heart center conference once each quarter. Challenging or interesting cases are reviewed with faculty from multiple disciplines. When you present at this conference, you are responsible for reviewing the relevant literature on this topic and presenting to the group.

You have a faculty mentor for each of these presentations. Faculty members assess your ability to critically evaluate the literature and assess your communication skills, effectiveness of presentation, and interaction with attendees at the conference.

Weekly educational opportunities include:

• Congenital Heart Center Conference
• Congenital Heart Center Grand Rounds
• Cardiovascular Diseases Grand Rounds
• Cardiac Imaging Grand Rounds
• Cardiac Catheterization Laboratory Conference

In addition, the Cardiovascular Diseases Fellowship has weekly teaching conferences (Core Curriculum Lecture Series and Clinical Exam Teaching Conference), and the Echocardiography Laboratory has a weekly didactic conference and case conference.

Research training

While this is primarily a clinical fellowship, we expect you to perform clinical research in the area of adult congenital heart disease under the direction of supervising faculty. We allocate dedicated time throughout the fellowship to allow for appropriate research training.

Teaching opportunities

You work with adult and pediatric cardiology fellows rotating in the ACHD Clinic and congenital echocardiography lab, which provides opportunities for teaching.

Participation in the many educational conferences, including the case-based echocardiography conferences, offers opportunities to teach the adult cardiology fellows about congenital heart disease. Presenting at conferences is another teaching opportunity.

Evaluation

We carefully monitor your performance during the Adult Congenital Heart Disease Fellowship to ensure that you acquire adequate knowledge and develop the appropriate technical skills to meet program expectations. Supervising faculty members formally evaluate you on a regular basis, and the program director meets with you to review these evaluations. In addition, you regularly evaluate the faculty to confirm that your educational needs are being met.