Clinical training

Trainees spend four days a week in the electrophysiology (EP) and pacing and clinical electrophysiology (PACE) laboratories performing a variety of procedures that include complex ablation, atrial fibrillation, ventricular tachycardia and ventricular fibrillation, and advanced device procedures including resynchronization therapy, lead extraction, and ablation and devices in patients with congenital heart disease.

A half-day continuity clinic may be combined with extra time in EP procedures or outpatient device troubleshooting, or research.

Call frequency

Clinical electrophysiology fellows serve as second call (with cardiology fellows being first call) for the service for one week out of six. Timely evaluations are done by the general cardiology fellow on call and supervised directly by the consultant.

The clinical cardiac EP fellow covers post-procedure patients including those that they would have done procedures on personally and the device troubleshooting and programming services on weeknights or the week they are on second call. In addition, the clinical cardiac EP fellow covers a primary call for the hospital service one Saturday per month.

Research training

During the clinical training year, time is available one afternoon a week to complete research projects and undertake smaller projects including case reports. Our fellows typically publish two to three peer-reviewed publications during their clinical year and complete prior research projects. We encourage individuals without significant electrophysiology experience in their cardiology fellowship to participate in a comprehensive program that involves research and extended clinical training for two to three years.

An optional funded year of research training is possible where translational animal laboratory or basis clinical electrophysiology experience is available.

Didactic training

Clinical conferences, seminars, small group discussions, journal clubs, and one-on-one instruction are integral parts of this fellowship. You will have many resources including:

• A core curriculum grand rounds conference (Monday mornings)
• Case conference (Tuesday evenings)
• Device tracings review on (Wednesday mornings)
• EP and device tracings review (Thursday mornings)
• Heart Rhythm Service Grand Rounds (Friday mornings)
• Journal club

Teaching opportunities

Extensive teaching opportunities are available including leading the discussion at conferences and teaching the junior cardiology fellows and residents, as well as allied staff.

Evaluation

To ensure that fellows acquire adequate knowledge and develop their technical skills, individual performance is monitored carefully during the program. Fellows are evaluated quarterly by supervising faculty members and meet with the program director to review these evaluations. This is accomplished through an electronic process called MedHub, available through any Mayo Clinic workstation or via remote access.

MedHub is linked to the six core competencies identified by the Accreditation Council for Graduate Medical Education (ACGME):

• Patient care
• Medical knowledge
• Interpersonal and communication skills
• Professionalism
• Practice-based learning and improvement
• Systems-based practice

Completed faculty evaluations are reviewed by the program director who assigns a pass-fail grade based on the scores and comments by the faculty members. Upon approval of the evaluation by the program director, the evaluation immediately becomes available electronically to fellows in the MedHub system.

Trainees also have an opportunity to complete an evaluation of faculty following each quarter, as well as an evaluation of the program on an annual basis.