Interventional Cardiovascular Fellowship Homepage

Fellowship Program Goals and Objectives

Housed in the department of Cardiology, the Interventional Fellowship program admits three fellows, selected from hundreds of applications each year. Candidates are trained in cardiovascular and peripheral procedures with didactic teaching to prepare them for the interventional boards.

The interventional laboratory performs 4,800 procedures a year. The ongoing, up-to-date mastery of medical knowledge is necessary to performing interventional procedures and caring for patients in this specialized field. In addition to a mastery of medical knowledge, an in depth understanding of peripheral vascular disease and its ramifications is expected of both first and second year fellows.

When patients are evaluated in the clinical setting, all risk and benefit considerations must be clearly understood by the interventional fellow. The fellow should be able to develop a logical plan for both immediate and long-term management of this patient. Good clinical judgement is considered a necessity, as is a physician's ability to adapt to the scientific and technical changes in medicine as they occur.

It is expected that the Cardiology Fellow will enhance his/her clinical experience in the Catheterization (Cath) Laboratory with active involvement in academic research pursuits. This includes an intellectual curiosity regarding the interventional literature, as well as involvement in ongoing academic research protocols. A leadership role by the Interventional Fellows is expected in the Cath Lab Conferences and interventional presentations.

During both years of training, an emphasis is placed on humanistic qualities. Integrity, respect and compassion is demonstrated in care of patients, and above all, physicians are expected to be honest, involved and responsive to patient needs. Moral and ethical behavior is emphasized as one of the prerequisites to professionalism. Professionalism itself aspires to altruism, accountability, excellence, duty, service, honor and integrity, and respect for others.

Program Summary

The interventional fellow is expected to spend a majority of his/her time doing coronary evaluations and interventions. Approximately 30 weeks of the first year is spent in the cardiac catheterization laboratory performing coronary procedures. Ten weeks are allotted for clinical decision making, bedside clinical evaluation, and judgement and out patient care. Research comprises approximately 20% of his/her time (10 weeks). During the first year, approximately 5% of the fellow's time will involve exposure to peripheral interventions.

During these rotations, an emphasis is placed on clinical judgement and medical knowledge. After the first year of training, each interventional fellow is expected to have mastered the clinical judgement necessary to integrate medical facts and clinical data. He or she should be able to weigh alternative medical and/or interventional forms of therapy and understand the limits of this knowledge – recognizing any complications, diseases and side effects of treatment. He or she should be able to issue prompt measures to deal with serious or life-threatening clinical consequences of any intervention performed in the catheterization laboratory.

Necessary clinical skills include obtaining precise, logical, well thought out and appropriately directed patient interviews. This includes conducting an expertly focused physical examination and listing subtle findings directed toward the patient's problems. The fellow must demonstrate an understanding of and proficiency in minimizing risks and discomfort to the patient in the performance of certain diagnostic and therapeutic procedures.

The second year of training is heavily weighted on peripheral interventions. An interventional fellow will have completed this portion of his/her training with an expert understanding of peripheral vascular disease, indications for procedures and the therapeutic limitations for patients with cerebral vascular, subclavian, renal, iliac and SFA disease.

Each interventional fellow will be given one day per week for research interests and work. It is expected that there will be an ongoing project between an interventional fellow and interventional attending. At the beginning of the year, a realistic goal plan will need to be defined for each interventional fellow and progress will be monitored by the assigned attending on a regular basis throughout that year.

Thomas C. Piemonte, MD
Director
Interventional Fellowship Program