Curriculum

Our program provides comprehensive teaching and self-guided learning opportunities in cardiovascular physiology, pathology, pharmacology and epidemiology related to the following diseases with emphasis on prevention. 

The following is a sample of how time is spent during the one-year program:

Clinical Training

Cardiovascular Health Clinic (CVHC)
This clinic deals with coronary artery disease, risk stratification and diseases which have significant impact on atherosclerosis such as tobacco abuse, metabolic syndrome, insulin resistance, diabetes, obesity, exercise, dyslipidemia, platelet function and genetics.

You will spend one month in the CVHC early in their year, then have one day per week clinic for new and follow-up patients.  During this rotation the fellow will be exposed to EndoPAT and will become proficient at reading these noninvasive studies which evaluate endothelial function.

Patients referred to 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.

Your experiences will include:

• Exercise testing
  The mainstay of risk stratification in patients 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 CVHC Rotation.
• Premature Atherosclerosis Clinic
• Behavior modification
• Lipidology
• Diabetology, Metabolic Syndrome and Management of Insulin Resistance
• Cardiac rehabilitation
• Nutritional counseling
• Behavior modification
• Cardiovision 2020 – a community-wide Mayo-based program to reduce cardiovascular disease burden in Olmsted County, Minn.
• Outcomes research from a CVHC database

Cardiac Rehabilitation Program
You will be involved in the diagnosis and management of patients with a variety of lipid disorders, as well 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
• 6 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
• Hydro Therapy

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

• Peripheral Vascular Disease
• CV Imaging - Cardiac CT/CT angio- level I training and MRI
• Physiologic testing – Endo PAT, exercise tolerance testing and 02 consumption stress testing*
• Brachial artery reactivity testing
• Nutritional Counseling*
• Behavioral Science*
• Health Services and Outcomes Research
• Epidemiology
• Clinical Trials*
• Preventive cardiology/rehabilitation
• Mayo Health Solutions

*Can be carried out during CVHC rotation

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 provided by the Heart Failure Clinic, which designates the expectation for the Fellow in terms of didactic learning.

While on this rotation, you are expected to attend required educational conferences provided by the Cardiovascular Division, including weekly Cardiac Catheterization Conference, Echocardiography Laboratory Conference and Cardiovascular Grand Rounds. In addition, there is a Heart Failure Journal Club, which is held the first Tuesday of the month for all Staff and Fellows in the subspecialty field of Heart Failure Cardiology.

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

Teaching Opportunities
Opportunities are available for teaching rotating residents and medical students.

Evaluation
The heart failure Fellow is evaluated on a quarterly basis with review of written evaluations from all key clinical faculty who have had contact with the heart failure Fellow during the previous quarter. In addition, the fellow meets with the Cardiovascular Disease Training Program director on a biannual basis. In these reviews, both clinical skills and academic productivity are emphasized.

Research Training
You will identify a mentor with whom a career development plan will be designed to meet your individual needs. You also will identify two secondary research mentors. Clinical research projects with a goal will be publication in a peer-reviewed journal, may be in the areas of:

• Subject reviews
• Original manuscripts utilizing the extensive CVHC exercise treadmill and rehabilitation database.  Potential databases to access also include prior NIH/NHLBI studies.
• Data available from mentor’s ongoing research efforts.
• Ongoing randomized clinical trials (i.e. NIH Funded AIM HIGH study).

As an incoming fellow, you will submit a potential research project before beginning the Preventive Cardiology Fellowship. Timelines for achievement of milestones will be developed before beginning the project to ensure completion and publication. 

You will have the option of enrolling in one year of didactic coursework on clinical research. Coursework can fulfill requirements for a Masters in Clinical Research through the Mayo Clinic Center for Translational Science Activities. 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 is available through this program.

This didactic training will be 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.