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Curriculum

Heart Failure and Transplant Cardiology fellow and faculty member talking in the hall at Mayo Clinic in Jacksonville, Florida.

Clinical training

During the 12 months of clinical training in the Advanced Heart Failure and Transplant Cardiology Fellowship, all your rotations will be performed at Mayo Clinic Florida Hospital. This will include experience in outpatient and inpatient heart failure, cardiac transplantation (including pre-transplantation evaluation, acute postoperative care, and chronic maintenance care), mechanical circulatory device therapy (including pre-implantation evaluation, acute postoperative care, and chronic maintenance care), end-of-life care, and advanced echocardiography. You will also have the chance to participate in dual solid organ transplants (heart-kidney, heart-lung, heart-liver).

You will gain experience in the interpretation of cardiopulmonary stress tests, right and left heart hemodynamics, evaluation and treatment of pulmonary hypertension, and performance and interpretation of endomyocardial biopsy. You are exposed to a wide variety of conditions leading to heart failure, including ischemic heart diseases, idiopathic dilated cardiomyopathy, hypertrophic cardiomyopathy, congenital heart disease, valvular heart disease, and pulmonary hypertension.

The inclusion of the additional focused cardiac transplantation training allows this fellowship to meet requirements for United Network for Organ Sharing (UNOS) certification as a transplant cardiologist.

It is expected that you will function at the level of a senior cardiovascular fellow.

Rotation schedule

The Advanced Heart Failure and Transplant Cardiology Fellowship includes 12 months of clinical rotations:

RotationLength
Heart failure transplant service 8 months
Elective 1 month
Outpatient/Ambulatory 1 month
Transplant infectious diseases 1 month
HLA Laboratory 1 month

The fellow must be available for any new heart transplant or ventricular assist device (VAD) implant for the perioperative period and subsequent 72 hours, regardless of service obligation.

There are also individual opportunities that can be arranged to participate in the care of patients at the Pulmonary Hypertension clinic, Myocarditis clinic, Congenital Heart Disease, and Amyloidosis Clinic.

A typical week's schedule on the primary heart failure transplant service includes:

Monday

  • 8-11 a.m. — hospital rounds
  • 11 a.m.-noon — outpatient congestive heart failure and transplant
  • 1-5 p.m. — outpatient congestive heart failure and transplant

Tuesday

  • 7-8 a.m. — advanced heart failure/joint cardiology conference/Journal Club
  • 8-10 a.m. — biopsies and right-heart catheterizations
  • 10 a.m.-noon — hospital rounds
  • 1-5 p.m. — outpatient congestive heart failure and transplant; pulmonary hypertension clinic (monthly)

Wednesday

  • 8-11 a.m. — hospital rounds
  • 11 a.m.-noon — outpatient congestive heart failure and transplant
  • Noon-1 p.m. — staff meeting/morbidity and mortality meeting (once monthly)
  • 1-3:30 p.m. — outpatient congestive heart failure and transplant
  • 3:30-5 p.m.— multidisciplinary selection conference (weekly), meeting with OPO (monthly)

Thursday

  • 7-8 a.m. — cardiology conference
  • 8-10 a.m. — annual left- and right-heart catheterizations
  • 10 a.m.-noon — hospital rounds
  • 1-3:30 p.m. — outpatient congestive heart failure and transplant
  • 3:30-4 p.m. — pathology/biopsy review conference
  • 4-5:30 p.m. — transplant selection committee

Friday

  • 8-11 a.m. — hospital rounds
  • 11 a.m.-noon — outpatient congestive heart failure and transplant
  • 1-5 p.m. — outpatient congestive heart failure and transplant

Didactic training

Clinical conferences, seminars, small discussion groups, journal clubs and one-on-one instruction are integral parts of this fellowship. There is a full core curriculum that designates expectations for the fellow in terms of didactic learning.

Simulation Center

The J. Wayne and Delores Barr Weaver Simulation Center at Mayo Clinic's campus in Jacksonville, Florida, provides team and individual skills training for Mayo physicians, residents, students, nurses, and allied health professionals and for learners from other organizations. The Society for Simulation in Healthcare-accredited center comprises approximately 9,500 square feet of multidisciplinary simulation training space, complemented by an additional 2,500-square-foot expansion of the center's Procedural Skills Lab.  Many of the Advanced Heart Failure and Transplant fellow hands-on training regarding temporary mechanical circulatory support, as well as recertification in BLS/ACLS is held in this location.  View a virtual tour.

Research training

Although this fellowship is primarily a clinical fellowship, you are expected to complete one clinical project during your fellowship year. A research mentor is assigned at the outset of the year.

Call frequency

The fellow will take call no more than 1 in 7 nights, and 1 in 4 weekends. The fellow can take call from home and is not required to be “on-site”.  During call, the fellow will be responsible for coverage only at Mayo Clinic Florida Hospital.

Teaching opportunities

Opportunities are available for teaching rotating general cardiology fellows, internal medicine residents and medical students, as well as international observers.

Conferences

The fellow is expected to attend required educational conferences, specifically the Advanced Heart Failure and Transplant Journal Club held every Tuesday for all staff and fellows in the subspecialty field of Transplant Cardiology. Prospective fellows are welcome to view past Tuesday weekly lecture series; topics covered include heart failure, mechanical circulatory support, and cardiac transplantation.

Other conferences available for current fellows include the weekly online Transplant Grand Rounds, the Cardiovascular Grand Rounds, and Internal Medicine Grand Rounds. You will also have available a specific library with bibliography related to your specialty, as well as full access to the Mayo intranet Library that includes all the videos from the Mayo Clinic Board Review Annual Courses in General Cardiology, Echocardiography, Electrophysiology and Interventional Cardiology.

Evaluation

To ensure that you acquire adequate knowledge and develop your technical skills, your performance is monitored carefully during the course of the Advanced Heart Failure and Transplant Cardiology Fellowship.

You are evaluated formally by your supervising faculty member after each clinical rotation and meet with the program director to review these evaluations. In addition, you regularly evaluate the faculty to ensure that your educational needs are being met.

The fellow is evaluated on a quarterly basis with review of written evaluations from all key clinical faculty who have had contact with the fellow during the previous quarter. The fellow also meets with the program director on a biannual basis. There is also a mid-year in-training examination that will aid in preparation for the future ABIM Heart Failure Board Examination.

Completed faculty evaluations are reviewed by the program director and are immediately available electronically to you in the MedHub system. In addition, you have the opportunity to complete an evaluation of faculty following each rotation, as well as an evaluation of the program on an annual basis, to confirm that your educational needs are being met.