The Preventive Cardiology Fellowship provides comprehensive teaching and self-guided learning opportunities in cardiovascular physiology, pathology, pharmacology and epidemiology with an emphasis on prevention.

Clinical training

Trainees spend the majority of their clinical time in three areas:

• Clinics including the Cardiovascular Health Clinic and its specialty clinics:
  • Primary and secondary cardiovascular risk reduction
  • Early atherosclerosis
  • Familial hypercholesterolemia
  • Statin intolerance
  • CV sports clinic
  • Atrial fibrillation risk reduction
  • CV genetics clinic
• Cardiovascular rehabilitation
• Stress-testing laboratory

Rotation schedule

A sample schedule showing the percentage of time spent on rotations:

Rotation descriptions

Cardiovascular Health Clinic

The Cardiovascular Health Clinic deals with coronary artery disease, risk stratification and diseases that have a significant impact on atherosclerosis, such as tobacco abuse, metabolic syndrome, insulin resistance, diabetes, obesity, exercise, dyslipidemia, platelet function and genetics.

You spend one month in the Cardiovascular Health Clinic early in your fellowship year, then have one day a week of clinic time for new and follow-up patients. During this rotation, you are exposed to noninvasive studies that evaluate CV risk.

Patients referred to the Cardiovascular Health Clinic for the management of dyslipidemia or hypertension are managed in collaboration with the referring physician so as to enhance the learning experience.

Training experiences include:

• Exercise testing — the mainstay of risk stratification in people with known or suspected coronary artery disease is exercise testing. Particular emphasis is focused on treadmill exercise ECG interpretation and O2 consumption. This is incorporated in the Cardiovascular Health Clinic rotation.
• Early Atherosclerosis Clinic
• Lipidology
• Diabetology, metabolic syndrome and management of insulin resistance
• Cardiac rehabilitation
• Nutritional counseling
• Behavior modification
• Healthy Living Rochester — a communitywide Mayo-based program to reduce cardiovascular disease burden in Olmsted County, Minnesota
• Outcomes research from a Cardiovascular Health Clinic database
• Familial Hypercholesterolemia Clinic
• Statin Intolerance Clinic

Cardiac Rehabilitation Program

You are involved in the diagnosis and management of people with a variety of lipid disorders, as well as in the design of programs for exercise and rehabilitative training, and risk factor modification in the Cardiac Rehabilitation Program.

The Cardiac Rehabilitation Program includes:

• Cardiopulmonary exercise testing
• Body composition analysis by using a Bod Pod
• Pulmonary function testing
• Six-minute walk testing
• Inpatient cardiac rehabilitation
• Outpatient cardiac rehabilitation
• Long-term management of cardiovascular risk factors
• Cardiovascular health consultations
• Individualized dietary consultations
• Individualized exercise prescriptions

Electives

Areas of special emphasis or electives possible during this fellowship include:

• Peripheral vascular disease
• Cardiovascular imaging — cardiac CT/CT angiography level I training and MRI
• Physiologic testing — endothelial function by peripheral arterial tonometry (EndoPAT) exercise tolerance testing and O2 consumption stress testing*
• Brachial artery reactivity testing
• Nutritional counseling*
• Behavioral science*
• Health services and outcomes research
• Epidemiology
• Clinical trials*
• Preventive cardiology and rehabilitation
• Mayo Clinic Health Solutions

*Can be carried out during the Cardiovascular Health Clinic rotation.

Call frequency

Hospital or clinic call is not required as part of this fellowship.

Research training

You identify a mentor with whom a career development plan is designed to meet your individual needs. You also identify two secondary research mentors.

Clinical research projects, with a goal of publication in a peer-reviewed journal, may be in the areas of:

• Subject reviews
• Original manuscripts utilizing the extensive Cardiovascular Health Clinic exercise treadmill and rehabilitation database (potential databases to access also include prior National Heart, Lung, and Blood Institute studies)
• Data available from mentor's ongoing research efforts
• Ongoing randomized clinical trials

Incoming fellows each submit a potential research project before beginning the Preventive Cardiology Fellowship. Timelines for achievement of milestones are developed before beginning the project to ensure completion and publication.

You have the option of enrolling in one year of didactic coursework on clinical research. Coursework can fulfill requirements for a master's degree in clinical research through the Mayo Clinic Center for Clinical and Translational Science. The theory and methods of preventive cardiology research, including epidemiology, biostatistics, health services and outcomes research, social and behavioral medicine, clinical trials, health informatics, and research ethics, are available through this program.

This didactic training is supplemented by a series of seminars, including instruction in the ethical and responsible conduct of research, recruitment and retention of research subjects, presentation and publication of scientific work, relationships with industry and technology transfer, research project management, and writing of competitive research proposals.

Didactic training

Clinical conferences, seminars, small discussion groups, journal clubs and one-on-one instruction are integral parts of the Preventive Cardiology Fellowship. A full, core curriculum is provided by the Cardiovascular Health Clinic that designates expectations for fellows in terms of didactic learning.

Conferences

You are expected to attend required educational conferences provided by the Department of Cardiovascular Medicine, including the Preventive Cardiology Conference held the second Monday of the month and Cardiovascular Grand Rounds held weekly. In addition, the Preventive Cardiology Journal Club is held the third Tuesday of the month.

Teaching opportunities

Opportunities are available for teaching rotating residents and medical students.

Evaluation

To ensure that you gain proficiency and develop the corresponding technical skills, your performance is monitored throughout the Preventive Cardiology Fellowship. You are formally evaluated 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 confirm that your educational goals are being met.