During the 12 months of clinical training in the Advanced Heart Failure and Transplant Cardiology Fellowship, 75% of your time includes experiences in inpatient heart failure, cardiac transplantation (including pretransplantation evaluation, acute postoperative care, and chronic maintenance care), mechanical circulatory device therapy (including pre-implantation evaluation, and post implantation management) as well as end-of-life care. Approximately 25% of your time is spent in the ambulatory practice, evaluating patients with stage B-D heart failure, pre- and post-cardiac transplantation, and mechanical circulatory support. Additional time is spent in a number of subspecialty cardiomyopathy clinics (Cardiac Amyloidosis Clinic, Cardiac Sarcoidosis Clinic, Cardio Oncology Clinic, Cardiomyopathy Clinic [HCM]).

You will gain experience in the interpretation of oxygen uptake treadmill results and sleep studies, right and left heart hemodynamic catheterizations, 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.

There is an opportunity for rotation at two of the other Mayo Clinic sites (Arizona and Florida) that both have busy advanced heart failure practices. This allows for a more diversified training experience.

The inclusion of the 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

A typical schedule for this fellowship includes:

Call frequency

Your call schedule is different for each rotation. Mayo Clinic College of Medicine and Science follows the recommendations of the Accreditation Council for Graduate Medical Education (ACGME) regarding duty-hour expectations. Generally speaking, on the Transplant and LVAD service, fellows perform home call. On ambulatory rotations, there is no mandatory call.

Research training

Although this fellowship is primarily a clinical fellowship, you will be expected to perform clinical research in the area of heart failure under the direction of supervising heart failure faculty. Dedicated blocked time is allocated throughout the year to allow for appropriate research training.

Didactic training

Clinical conferences, seminars, small discussion groups, journal clubs, and one-on-one instruction are integral parts of this fellowship. A full core curriculum is provided, which designates the expectation for you in terms of didactic learning.

Conferences

Educational conferences that you will be invited to include the weekly Multidisciplinary Transplant Selection Conference, Transplant Grand Rounds, Transplant Core Curriculum conferences, and Transplant Watchlist meetings. In addition, there is a weekly Cardiovascular Grand Rounds. Furthermore, we hold an Advanced Heart Failure and Transplant Cardiology Conference the first Tuesday of the month for all staff and fellows in the subspecialty field of heart failure cardiology and transplant cardiology, and there is an Advanced Heart Failure and Transplant Cardiology lecture series the second Friday of the month.

Teaching opportunities

Opportunities are available for you to teach rotating residents and medical students.

Evaluation

To ensure that you acquire adequate knowledge and develop the appropriate technical skills to meet program expectations, your performance is monitored carefully during the Advanced Heart Failure and Transplant Cardiology Fellowship. You are formally evaluated by your supervising faculty members on a quarterly basis and meet with the program director to review these evaluations.

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.