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FELLOWSHIP IN PEDIATRIC CARDIOLOGY
I. DURATION OF TRAINING AND PREREQUISITES
The Division of Pediatric Cardiology of the Department of Pediatrics at the Medical
College of Virginia is an approved training program for fellowship in Pediatric Cardiology.
We require a three year program which emphasizes both clinical and research preparation
for an academic career. This training program exists in conjunction with an accredited
three-year pediatric residency program. We require that the resident applying for
fellowship complete three years of training in an accredited pediatric residency
prior to beginning the program.
II. GENERAL SCOPE OF PROGRAM
Our training program in pediatric cardiology provides a properly balanced, well-organized
program with progressive responsibility for care and study of patients on the ward
and outpatient services. The program encompasses all age groups from the fetus to
the newborn, including premature infants, through adolescence. The fellow is exposed
to pathologic conditions ranging from moderate to those found in the seriously ill
child needing intensive care. There is experience for the broad spectrum of congenital
and acquired heart disease, both surgical and medical, and chronic as well as acute
and emergency situations. There are opportunities to develop teaching skills. These
opportunities include both formal and informal experiences including rounds, outpatient
clinics, conferences, grand rounds, and formal lectures. There are opportunities
to participate in and learn the fundamentals of administration of the pediatric cardiology
program, including organizations of clinics and the function of the cardiac team;
interaction with support agencies in the community such as the Children's Specialty
Services Clinics, third party insurance companies, and school nurses; and training
in the basic medical sciences as well as in the clinical laboratory, public health,
and community aspects of pediatric cardiology.
III. CONTENT AREAS
A. Basic Sciences
The program offers instruction through courses, seminars, workshops, or laboratory
experience in basic fundamental disciplines related to the heart and cardiovascular
systems such as anatomy, physiology, biochemistry, embryology, pathology, pharmacology,
genetics, bioelectronics and biostatistics.
B. Clinical Practice
Our program prepares the fellow to provide optimal care and consultation for children
with cardiovascular disease. The clinical experience is broad and includes inpatient
and outpatient experience and encompasses age groups from the newborn through adolescence
(birth to 21 years) with the opportunity to observe heart disease in adults, particularly
congenital and rheumatic.
C. Cardiac Catheterization
The fellow participates in all cardiac catheterization procedures including hemodynamic,
electrophysiologic, and angiographic studies. MCV has an active interventional catheterization
program which provides the fellow with the skills necessary to perform balloon dilations
and vessel occlusion procedures.
D. Aftercare
The fellow participates in consultation or conferences in which the medical and surgical
staff evaluate the results of surgery and the patient's cardiac status prior to discharge
from the hospital. The fellow has an opportunity to arrange for follow-up visits
and send information to the referring physician and assist him or her in the future
management of the patient.
This program offers broad and inclusive training in the specialty including the fundamentals
of clinical diagnosis with special emphasis on auscultation and physical examination,
roentgenology, electrocardiography, 2-D and M-mode echocardiography, radio-nuclear
cardiography, exercise stress testing, Holter monitoring and such other lab tests
that may become established to facilitate diagnosis and management. Experience and
instruction in techniques and understanding of the limitations of cardiac catheterization
and selective angiocardiography are provided. The fellow has the opportunity to participate
in at least one hundred cardiac catheterizations in infants and children over the
three year period. The fellow has an opportunity to master the use of relevant electronic
equipment, recording devices, and angiographic equipment necessary to perform cardiac
catheterization. In addition, the fellow is provided with the opportunity to learn
the fundamentals of radiation safety.
We provide experience with pre- and postoperative care of patients having cardiac
surgery, both by closed and open methods, in close cooperation with the cardiothoracic
surgical staff. The fellows acquire a basic understanding of current surgical techniques,
methods of cardiopulmonary bypass and hypothermia. They understand and learn to manage
postoperative complications, both immediate and delayed. There is opportunity for
long term follow-up of observations of both preoperative and postoperative patients.
The program provides the fellow with the opportunity for the study of rheumatic fever,
collagen diseases, infective endocarditis and other infections and metabolic conditions.
The fellow is made aware of the etiologic and risk factors in hypertensive and atherosclerotic
heart disease, including hyperlipidemic states, and gains experience in the diagnosis
and management of patients with these cardiovascular problems.
E. Conferences
Conferences are held on a regular basis in areas of clinical diagnosis, including
weekly surgical conferences and monthly combined internal medicine-pediatric noninvasive
conferences. Weekly cardiovascular research and journal clubs are held. Conferences
with other disciplines such as physiology, pharmacology, pathology, neonatology,
and cardiovascular radiology are held regularly.
F. Research
A critical aspect of the training program is its research environment. The fellow
is exposed to and takes part in research programs which provide an environment conducive
to a questioning attitude, to protocol development, and to critical analysis. The
fellow must design, conduct, evaluate and prepare for publication, a clinical or
laboratory research project in the area of cardiology. The completion of a research
project during the training program is mandatory. The fellow learns to communicate
knowledge to others both orally and in written form, conduct lectures, seminars and
clinical conferences and prepare a written report of the research activities for
faculty review and publication.
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