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Curriculum

Photo of Heidi M. Connolly, M.D., reviewing a transthoracic echocardiogram with Alexander C. Egbe, MBBS

Adult Congenital Heart Disease Clinic Director Heidi M. Connolly, M.D., reviews a transthoracic echocardiogram with fellow Alexander C. Egbe, MBBS.

Clinical training

As outlined by the American Board of Internal Medicine and in accordance with Core Cardiology Training Statement (COCATS 4) recommendations, the Adult Congenital Heart Disease Fellowship is a two-year program with two pathways, depending on whether a trainee's background is from adult or pediatric cardiology.

Pediatric cardiologists devote training time to areas of adult internal medicine and cardiology to fulfill requirements necessary to care for adults with congenital heart disease, while adult cardiologists complete additional training in pediatric cardiology to meet the same requirements.

The schedule has flexibility to allow fellows to customize their education, depending on their career plans. Electives can be arranged in advanced heart failure/transplant, pulmonary hypertension, electrophysiology, stress testing, or additional cardiac catheterization lab or imaging training.

Our program is unique in that we have patients in the Adult Congenital Heart Disease (ACHD) Clinic every day of the week, so on months when the fellow is assigned to ACHD Clinic, he or she is in the congenital echo lab for half a day and in the clinic for the other half of the day. This provides the unique opportunity to perform echocardiograms on the patients the fellow will see in clinic, which allows for correlation of physical exam findings to echo findings, as well as continuity of care.

Historically, our fellows have performed more than 300 transthoracic and more than 150 transesophageal echocardiograms during their fellowship, which previously was a one-year program. These numbers far exceed the COCATS 4 recommendations for the two-year program.

The fellow is responsible for following ACHD patients admitted to the hospital for procedures or operations and also for performing new consults on patients admitted to inpatient services.

Mayo Clinic is unique in that all patients with congenital heart disease, regardless of age, are cared for in the same geographic location. All inpatient procedures, including cardiac surgery, catheterization procedures and electrophysiology procedures, are performed at Mayo Clinic Hospital, Saint Marys Campus.

Rotation schedule

Internal medicine pathway
Rotation Length
ACHD Clinic 12-18 months (overlap with other rotations)
ACHD Inpatient/Consult Service 9-12 months (overlap with other rotations)
ACHD Cardiac Imaging 3 months
ACHD Cardiac Catheterization 2 months
Pediatric Cardiology 2 months
Cardiothoracic Surgery/ICU 1 month
Elective/Research 6 months
Pediatrics pathway
Rotation Length
ACHD Clinic 12-18 months (overlap with other rotations)
ACHD Inpatient/Consult Service 9-12 months (overlap with other rotations)
ACHD Cardiac Imaging 3 months
ACHD Cardiac Catheterization 2 months
Adult Cardiology 2 months
Cardiothoracic Surgery/ICU 1 month
Elective/Research 6 months

Didactic training

One-on-one instruction, clinical conferences and small discussion groups are integral parts of the Adult Congenital Heart Disease Fellowship. There is a full core curriculum provided electronically that designates the expectations for the fellow in terms of didactic learning.

Conferences

The fellow presents at our multidisciplinary congenital heart center conference once each quarter. Challenging or interesting cases are reviewed with faculty from multiple disciplines. When the fellow presents at this conference, he or she is responsible for reviewing the relevant literature on this topic and presenting to the group. The fellow has a faculty mentor for each of these presentations. Faculty members evaluate the fellow's ability to critically evaluate the literature, communication skills, effectiveness of presentation and interaction with attendees at the conference.

Weekly education opportunities for the fellow include:

  • Congenital Heart Center Conference
  • Congenital Heart Center Grand Rounds
  • Cardiovascular Diseases Grand Rounds
  • Cardiac Imaging Grand Rounds
  • Cardiac Catheterization Laboratory Conference

In addition, the Cardiovascular Diseases Fellowship has weekly teaching conferences (Core Curriculum Lecture Series and Clinical Exam Teaching Conference), and the echo lab has a weekly didactic conference and case conference.

Research training

While this is primarily a clinical fellowship, the fellow is expected to perform clinical research in the area of adult congenital heart disease under the direction of supervising faculty. Dedicated time is allocated throughout the fellowship to allow for appropriate research training.

Call frequency

The call schedule is different for each rotation. Mayo Clinic College of Medicine follows the recommendations of the Accreditation Council for Graduate Medical Education.

Teaching opportunities

The fellow works with adult and pediatric cardiology fellows rotating in the ACHD Clinic and congenital echocardiography lab, which provides opportunities for teaching.

Participation in the many educational conferences, including the case-based echo conferences, is another opportunity to teach the adult cardiology fellows about congenital heart disease. Presenting at conferences is another teaching opportunity.

Evaluation

Written evaluations are performed by the clinical faculty members who work with the fellow on each rotation. The results of these evaluations are provided to the fellow electronically and are reviewed in person with the program director on a quarterly basis. In these reviews, both clinical skills and academic productivity are reviewed.

  • May 18, 2016
  • ART387210