ACGME Fellowship Program - Clinical Training

The clinical training program provides Cardiology fellows an excellent subspecialty education in cardiology. The program is organized to provide the Fellow competency in the specialty in three years in accordance with national guidelines. This educational program provides training and experience in the evaluation and management of a wide variety of patients with acute and chronic cardiovascular conditions including coronary heart disease, congestive heart disease, arrhythmias, acute myocardial infarction and other acute ischemic syndromes, lipid disorders, hypertension, cardiomyopathy, valvular heart disease, pulmonary heart disease, peripheral vascular disease, infections and inflammatory heart disease, and adult congenital heart disease.

In the Cardiology training program, most of the training occurs at The University of Chicago Hospitals in various settings. In the core clinical training period, Fellows typically spend all but 2 months at the Medical Center. Clinical training is provided in various settings. These settings include:

  • General Cardiology Wards
  • Cardiac Care Unit
  • Cardiac Surgery ICU
  • Inpatient Consult Service
  • Outpatient Clinic
  • Cardiac Catherization Laboratory
  • Noninvasive Cardiac Imaging Laboratory
  • Cardiac Exercise Physiology
  • Nuclear Cardiology
  • Pediatric Cardiology
  • Vascular Laboratory
  • MR Imaging

An extensive laboratory experience provides education in various cardiovascular testing and procedures such as electrocardiography, ambulatory ECG recording, exercise testing (nuclear and echo), echocardiography (including Doppler, transthoracic, transesophageal, and 3-D echo studies), radionuclide techniques, cardiac hemodynamics, cardiac catherization procedures, invasive electrophysiologic studies, assessment of peripheral vascular disease, pacemaker, and automatic cardioverter/defibrillator implantation and follow up.

In addition to the above clinical experiences, the Cardiology section directs active clinical programs in Heart Failure, Arrhythmia Control, and Preventative Cardiology and Rehabilitation.

The clinical rotations of the first two years are programmatic and are summarized below:

Heart Station, Exercise Testing, Nuclear Medicine. The purpose is to provide theoretical, practical and research skills in electrocardiology, clinical electrophysiology and pacemakers, signal averaging techniques (eg., first-pass RNA, SPECT, gated SPECT, and PET) and gas exchange as well as outpatient experience in the management of patients with arrhythmias, conduction disturbances and heart failure. Additional specialized training in Nuclear Cardiology is encouraged as elective time in the third year. This has been designed so that each fellow has the opportunity to obtain the COCATS Level II and/or Nuclear Cardiology Board certification needed for Nuclear Regulatory Commission (NRC) licensure upon completion of the program.

Cardiac Catherization Laboratory

The purpose is to provide theoretical, practical and research skills in the physiology of cardiac function and coronary blood flow, the use and interpretation of data obtained from cardiac catherization and related techniques, and the assessment of candidates for cardiac catherization and other types of interventional cardiology procedures. Specialized techniques include: PTCA, valvoplasty, atherectomy, stents, thrombectomy, intravascular ultrasoundlaser and physiologic assessments, peripheral interventions, endomyocardial biopsy, brachytherapy and distal protection devices.

Noninvasive Imaging

The purpose is to provide theoretical, practical and research skills relevant to noninvasive imaging of cardiovascular structures. Interpretation of data is founded in physiological and pathophysiological teaching and concepts. This includes instruction in transthoracic and transesopohageal echocardiography and Doppler, the use of echogenic contrast materials for imaging and the assessment of myocardial perfusion and instruction in dobutamine, stress echocardiographic testing, and exercise stress echocardiographic testing. Also, instruction in 3-D echo imaging is provided.

Consultative Service

The purpose is to provide the training cardiologist practical skills in general medicine and surgical consultation.

Clinical Electrophysiology

Fellows obtain dedicated experience in arrhythmia evaluation including participation in the Arrhythmia and Implantable Cardiac Device Clinics, the Clinical Electrophysiology Laboratory and the Arrhythmia Consultation Service. Broad area of expertise include risk assessment and sudden death prevention, standard and experimental antiarrhythmic drug therapy and nonpharmacological control of ventricular and supraventricular arrhythmias. The service has extensive experience in the evaluation and management of cardiac pacemakers, catheter ablation of all types of cardiac arrhythmias and pacemaker and antitachycardia device implantation. The program emphasizes the development and application of new catheter ablation techniques, new antiarrhythmic drug evaluation and new device implantation. Important research opportunities span basic and clinical electrophysiology.

Cardiac Care Unit

The purpose is to provide theoretical, practical and research skills in intensive medical and surgical Cardiology. The CCU is fully equipped for all types of cardiology care.

Congestive Heart Failure

The purpose is to provide the trainee with exposure to cardiac transplantation, mechanical devices for the treatment of heart failure, selection of transplant candidates and clinical management of heart failure.

Outpatient Cardiology

The purpose is to provide a 2-3 year longitudinal experience in the outpatient management of all varieties of cardiac disease that are physician or self-referred. The ongoing management of these patients becomes the joint responsibility of the Cardiology Fellow and the Attending Physician with whom a Fellow works. This clinic meets one half-day weekly.

Subspecialty Clinics

Fellows spend a 1-2 months gaining experience in a number of subspecialty clinics including Lipid, Heart Failure, Arrhythmia Control, Preventive Cardiology and Rehabilitation.

Typical Fellow Rotation

First Year

  • Cardiac Cath Lab - 3 months
  • Echocardiography Lab - 2 months
  • Cardiac Consults - 2 months
  • Heart Station/Nuclear - 2 months
  • CCU - 2 months
  • Vacation - 1 months

Second Year

  • Cardiac Cath Lab - 3 months
  • Echocardiography Lab - 2 months
  • Cardiac Consults - 2 months
  • Heart Station/Nuclear - 2 months
  • CCU - 2 months
  • Vacation - 1 months

Third Year
Clinical or Research Rotations tailored to the individual needs of the trainee.