Fellowship program

The fellowship training program is broad in scope, covering the full spectrum of congenital and acquired heart disease in all age categories from the fetus to the adult. The program emphasizes a balance between clinical service, didactic learning and research. During the three years of training, 24 months are primarily for clinical training and 12 months are dedicated to research. Physicians should commit to self-directed and life-long learning and demonstrate competence to enter a practice in pediatric cardiology.

Clinical training:
Advocate Children’s Hospital is a premier pediatric cardiovascular center. Annually, we perform more than 400 cardiac surgeries, 350 cardiac catheterizations, and 180 electrophysiology procedures. We have more than 25 cardiologists with multiple representatives in each subspecialty. We have a highly ranked pediatric cardiovascular surgical program with four experienced full-time congenital cardiac surgeons. The Pediatric Cardiac Intensive Care Unit is a 16-bed unit dedicated to pediatric cardiac patients who require intensive care.

Inpatient/consult service:
During this rotation, the fellows provide cardiac care to all hospitalized primary cardiology patients and consultation services to the neonatal ICU, pediatric ICU, emergency department and general pediatric services. The fellows work closely with the pediatric house staff to provide supervision and education. The inpatient/consult service team includes full-time nurse practitioners and a supervising attending cardiologist.

Imaging:
The fellows perform and review echocardiograms with the faculty on a regular basis throughout the three years of training. The first year focuses on being able to perform and interpret transthoracic echocardiograms for normal and abnormal hearts. During the subsequent years, the fellows perfect these skills and gain significant exposure and skills in transesophageal echocardiography, fetal echocardiography, cardiac MRI and cardiac CT.

Cardiac catherization:
The cathterization rotation allows trainees to gain skills in the performance of cardiac catheterization and interventional techniques under direct supervision. The fellow on this rotation presents the clinical data during the weekly Combined Pediatric Cardiology-Surgical Conference.

Cardiac ICU:
Advocate Children’s Hospital has a dedicated 16-bed Pediatric Cardiac ICU (PCICU). During this rotation, fellows manage critically ill pre- and post-operative patients with supervision from the cardiac intensivists and cardiothoracic surgeons. This includes exposure to all modes of ventilation and ECMO. There is 24-hour in-house attending coverage in the unit. There are also full-time nurse practitioners who are dedicated to this unit.

Electrophysiology:
The fellows encounter a wide spectrum of arrhythmias and cardiac conduction abnormalities during their three years. The electrophysiology faculty work closely with the fellow to manage rhythm disturbances. They provide in-house consultation services as well as diagnostic and interventional procedures. During the first year, the fellows interpret electrocardiograms, ambulatory monitors (Holters and Event monitors), and exercise tests. In their second and third years, the fellows participate in invasive electrophysiology studies and procedures including device implantations, diagnostic EP studies and catheter ablations.

Cardiac pathology:
Cardiac pathology is taught monthly in sessions that include examining cardiac pathological specimens from our large library of congenital hearts. Fellows also have the option of spending additional time in the pathology library during lighter rotations or as an elective.

Research:
Academic research is an essential part of the fellowship and all fellows are required to be involved in a research project under the guidance of a faculty mentor. There is a longitudinal research curriculum that covers all aspects of research including: choosing the appropriate question and mentor, study design, data management, statistical analysis, writing a manuscript, and submission for publication. The Heart Institute has a dedicated research coordinator to assist with projects and navigating the IRB process. Projects may be in clinical research or basic science research. Our fellows have the opportunity to do research at our affiliated sites, including the University of Chicago. Fellows frequently present their research at regional or national meetings. In addition, fellows are instructed in quality improvement methods and are encouraged to participate in ongoing quality improvement projects throughout their fellowship.

Call schedule:
Fellows are on-call roughly once every six nights with approximately a quarter of the call being done from home. Overnight calls may be more frequent during some months in order to have periods of call-free each year.

Conferences and didactics

Fellows attend a large number of didactics and conferences throughout fellowship. These include but are not limited to:

Monday morning report: Weekly (1.5 hours)
Faculty lectures: Weekly (1-2 hours)
Moss and Adam's review: Monthly (2 hours)
Pediatric cardiology-surgery conference: Weekly (3 hours)
Morbidity and mortality conference: Monthly (1 hour)
Journal club: Monthly (1 hour)
Imaging review: Weekly (1 hour)