Clinical Training Years 1 & 2
A central mission of the Cardiovascular Disease Fellowship Program is developing truly exceptional cardiovascular clinicians. Our curriculum focuses on fundamental concepts around cardiovascular physical diagnosis and clinical reasoning.
The first year curriculum will immerse fellows in general cardiology, echocardiography, cardiac catheterization, cardiovascular imaging, heart failure, consultative cardiology, and electrophysiology. The second year curriculum will build upon these skills and incorporate experiences in cardiac surgery, cardiac transplantation, mechanical circulatory support, vascular medicine, adult congenital heart disease and as the team leader in the cardiac step down unit and Cardiac Intensive Care Unit. Additionally, during the first two clinical years fellows have the opportunity to explore many of the unique clinical subspecialty programs during 6-8 weeks of elective time, in order to tailor their clinical training to their goals. Clinical fellows rotate primarily at Mass General with a weekly half-day continuity clinic on site, and also rotate at Brigham and Women’s Hospital as well as the West Roxbury VA Hospital.
After the first two clinical years are complete, the third and fourth year (if taken) of training is fully elective to achieve scholarly, academic and clinical goals individualized to each fellow's unique career path.
View sample schedule
|Rotation *||Site||First Year||Second Year|
|Cardiac step-down unit||MGH||3-5 weeks||3-4 weeks|
|Echocardiography||MGH||4 weeks||3-4 weeks|
|Cardiac catheterization||MGH||4 weeks||4 weeks|
|Cardiac catheterization||BWH||3-4 weeks|
|Cardiac Intensive Care Unit||BWH||3-4 weeks|
|Cardiac Intensive Care Unit||MGH||3-4 weeks|
|Electrophysiology||MGH||4 weeks||2 weeks|
|Heart Failure/Transplant||MGH||2 weeks||4 weeks|
|Nuclear cardiology||MGH||3-4 weeks||3-4 weeks|
|Prevention, Genetics & Women's Heart Health||MGH||4 weeks||3-4 weeks|
|Cardiovascular Imaging||MGH||4 weeks|
|Night float||MGH||3-4 weeks||3 weeks|
|Adult Congenital Heart Disease||MGH||4 weeks|
|Vascular medicine||MGH||2 weeks|
|Vascular medicine||BWH||2 weeks|
|Elective||MGH||2-3 weeks||4-5 weeks|
|Cardiothoracic surgery||MGH||2 weeks|
|Vacation||MGH||4 weeks||4 weeks|
* Please note these are estimates. We are continuously working to optimize our schedule to maximize clinical experiences.
- Rotation Director: Dr. Army Sarma and Dr. Varsha Tanguturi
- First year fellows develop proficiency in the performance of diagnostic ultrasound, understanding of basic principles and competence in study interpretation. A particular strength is the direct instruction fellows receive from senior sonographers in the performance of the echocardiographic examination during their first rotation.
- For second year fellows, emphasis is placed on interpretive skills and advanced procedures, such as stress echo studies and transesophageal echocardiography. Fellows developing interest in the research aspects of diagnostic cardiac ultrasound are encouraged to pursue projects under supervision of the laboratory staff. Level II training in transthoracic and transesophageal echocardiography imaging can be completed during elective time and/or during the later years of fellowship.
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Cardiac Consult Service
- Rotation Coordinator: Dr. Jonathan Salik
- One of the strengths of clinical training at Mass General is the remarkable variety and complexity of patients seen during this rotation. Fellows serve as the primary cardiologists on new hospital-wide cardiology consultations and admissions to the cardiac step-down unit. Although senior staff provide careful oversight and teaching, the fellow is the main provider and decision maker for patient care. The patients seen while on service are followed as outpatients and form the bulk of each fellow’s practice in the Paul Dudley White associates clinic.
Cardiac Catheterization Laboratory
- Rotation Director: Dr. Nilay Patel
- Fellows are lead operators on diagnostic procedures in the Knight Cardiac Catheterization Laboratory, a state-of-the-art suite of six rooms with high-resolution digital fluoroscopy units. A wide variety of diagnostic and interventional procedures are performed, with approximately 6,000 cases done per year, approximately 1,400 of which are coronary interventions. Since Mass General serves as the primary hospital for the local neighborhood as well as a tertiary referral center for high-risk patients from state, national and worldwide health centers, cases are varied and challenging. Fellows gain a strong foundation in appropriateness and indications for catheterization, protocols for venous and arterial access, the hemodynamic assessment of cardiac, valvular and coronary function, angiography of coronary and bypass vessels and post-procedural management. Furthermore, the laboratory is academically-based and has approximately 20 active research protocols. This provides ample opportunity for fellows to pursue their research interests.
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- Rotation Director: Dr. Ahmed Tawakol
- Nuclear cardiology at Mass General is a joint effort between the cardiology and radiology departments and provides various types of cardiac stress tests that help to identify and diagnose heart disease. The laboratory has six SPECT cameras and two PET cameras and performs over 7,500 imaging procedures per year. Fellows learn the integral role of cardiac stress testing in the practice of clinical cardiology, as well as its limitations, by performing and interpreting studies. The second year rotation focuses on multimodality imaging techniques. From a research perspective, the laboratory is involved in several multi- and single-center trials, including, for example, the evaluation of new myocardial tracers, the usage of PET for quantitative coronary physiology and nuclear studies of peripheral vascular disease and plaque inflammation.
Cardiac Intensive Care Unit
- Rotation Director: Dr. David Dudzinski
- The Cardiac Intensive Care Unit is a 16-bed unit serving critically-ill patients requiring acute care for advanced heart failure (including those awaiting transplant), periprocedural management of high-risk coronary disease, malignant arrhythmias and cardiac arrest and mechanical ventricular support. Fellows are involved in management of complex cases and play a primary leadership role on the team.
Advanced Cardiac Imaging
- Rotation Directors: Dr. Albree Tower-Rader and Dr. Nina Meyersohn
- Fellows spend a month rotating through the cardiac CT and cardiac MRI facilities at Mass General. Fellows also spend a full day of cardiac imaging with Dr. Marcelo DiCarli at Brigham and Women’s Hospital. The second is a half day in the vascular laboratory at Brigham and Women’s Hospital with Dr. Marie Gerhard-Herman.
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Preventive Cardiology, Genetics and Women's Heart Health
- Rotation Director: Dr. Michael Honigberg
- Preventive cardiology and cardiac rehabilitation was an innovation at Mass General in 2002. The primary goal of the Preventive Cardiology rotation is to provide the knowledge and skills necessary to successfully initiate and maintain long-term preventive therapies, characterize the inherited basis of cardiovascular disease, and recognize cardiovascular genetic conditions in general clinical cardiology practice. Fellows participate in intake sessions, exercise sessions, nutrition visits and team meetings.
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Heart Failure and Transplant
- Rotation Director: Dr. Dan Zlotoff
- The management of patients with advanced heart failure at Mass General is a multidisciplinary effort with input from physicians and non-physicians alike. Fellows are integrated into a team consisting of members of the heart failure and cardiac surgery services by caring for patients with advanced disease and participating in meetings discussing transplant status. Fellows should gain a solid grasp of management of chronic severe heart failure and pulmonary hypertension, assessment of candidates for transplantation and left ventricular mechanical circulatory support.
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Adult Congenital Heart Disease
- Rotation Director: Dr. Chris Learn
- Fellows become familiar with the anatomy and physiology and current therapies of patients with congenital heart disease or pulmonary hypertension. The multidisciplinary group at Mass General is dedicated to the advancement of care for adolescents and adults born with heart disease. Fellows participate in the weekly Multidisciplinary ACHD Meeting, rotate in pediatric cardiology, genetics aortopathy clinic, as well as Pulmonary Hypertension Clinic in our Pulmonary Unit. Additionally there are several weekly conferences including ACHD Echo Review as well as ACHD Radiology Review and monthly review of pregnant patients with cardiovascular disease.
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- Rotation Director: Dr. Ido Weinberg
- Second-year fellows spend one month becoming familiar with the evaluation and management of patients with peripheral vascular disease, including cerebrovascular disease, peripheral arterial disease, renal artery stenosis, complications of venous thromboembolism, and others, 2 weeks at Mass General and 2 weeks at BWH.
- Rotation Director: Dr. Bill Hucker
- The Mass General Telemachus & Irene Demoulas Family Foundation Center for Cardiac Arrhythmias was founded in 1978 and was one of the first clinical subspecialty services in United States. The cardiac electrophysiology laboratory comprises a state-of-the-art facility constructed in 2000 and is currently undergoing an expansion and renovation to keep with the newest technologies, needs and volume. Second-year fellows on this rotation gain competence in the interpretation of commonly performed electrophysiology studies, manage inpatients with arrhythmias or dyssynchrony, learn indications for pacemaker and ICD implementation and become experienced in programming and interrogation of devices.
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Cardiac Surgery and the Surgical Intensive Care Unit
- Rotation Director: Dr. Mark Wong and Dr. Jordan Bloom
- Fellows rotating on the cardiac surgical intensive care unit gain further experience in the postoperative care of cardiac surgical patients. Patients on the surgical service often undergo complex procedures with significant comorbidities, so fellows learn the ramifications of the technical and anatomic problems tackled during the operation. Fellows participate in daily morning rounds with cardiac anesthesiologists, heart failure specialists and cardiac intensivists. They attend surgical cases in the operating room, to gain an appreciation of the complexity of cardiac bypass pump physiology and intraoperative management.
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Subspecialty Program Selectives
- Rotation Director: Dr. Doreen DeFaria Yeh
- Fellows have dedicated time to rotate through three subspecialty programs of their choosing including: Women’s Heart Health Program, Thoracic Aortic Program, The Cardiac Performance Program (Sports Cardiology), CardioOncology, as well as the Heart Valve Program.
- Rotation Director: Dr. Colleen Harrington
- In addition to dedicated subspecialty program selective blocks, two to three additional weeks each clinical year are set aside for elective, spent either at Mass General or BWH. These have proven to be popular and educationally valuable experiences for fellows in past years. The third year and beyond function as unrestricted elective time to pursue research, academic endeavors and/or complete level II imaging training.
Outpatient Paul Dudley White Clinic
One of the most valuable aspects of the fellowship program is the opportunity to serve as the primary outpatient cardiologist for patients across three years of training. Many of the first encounters a fellow has with their clinic patients will be during the initial inpatient presentation. In the second year, fellows will also evaluate and care for ambulatory patients referred to the clinic by other providers.
The Paul Dudley White (PDW) Clinic provides opportunities to learn the fundamentals, nuances, challenges, and rewards of longitudinal cardiac care across a range of pathologies. Fellows are integrated into the dynamic and bustling ambulatory cardiology center in the Yawkey building, which is fully staffed with nursing and administrative support, ECG technicians, and phlebotomists. It is housed alongside the outpatient echocardiography and nuclear cardiology departments, and is also home to the outpatient arrhythmia, heart failure, and interventional cardiology clinics. During clinic, fellows work closely with faculty preceptors who provide individualized supervision, guidance, and teaching.
- Clinical Director: Dr. Danita Sanborn
Our program core conferences deliver a structured didactic curriculum to supplement clinical experiences in a variety of learning formats, including traditional lectures, hands-on workshops or bootcamps, fellow case presentations, and chalk talks.
These conferences include:
- Boot Camp for 1st year fellows (over the summer)
- Friday Core Conference – weekly
- Morning Report – twice a week
- ECG lecture: twice a month
- Cardiology Grand Rounds – weekly
- Fellow’s Leadership Meetings – quarterly
- Journal Club – monthly
- CCU M&M Conference – monthly
- ICU Grand Rounds – bi-monthly
- Cardiology M&M Conference – monthly
- Cath Lab Conference – weekly
- Multidisciplinary ACHD Conference – weekly
- Multidisciplinary Heart Failure & Transplant Conference – weekly
- Clinical Cardiovascular Imaging Conference – Weekly
- Echo Clinical Conference – Weekly
- Thoracic Aortic Center Rounds – Weekly
Innovations to fundamental cardiovascular teaching with advanced auscultation using Eko electronic stethoscopes as well as ECG case based software have been newly incorporated into the curriculum.
In addition to the clinical topic content, we have a robust non-clinical curriculum that also spans the academic year to highlight topics including: finding a job, negotiating a contract, financial considerations, basics of grant writing, introduction to biostatistics, fire-side chats for faculty, and informal mentorship. This curriculum is created by the fellows and tailored to their interests and needs. Starting in the fall of 2022, we will welcome mentorship with both large and small group sessions by James McKenna, internationally recognized physician leadership coach.
Clinical Opportunities and Electives
- Women’s Heart Health Program
- Adult Congenital Heart Disease Program
- Director: Dr. Chris Learn
- Cardiovascular Disease and Pregnancy Program (this program is a collaborative effort between the Women’s Heart Health Program and ACHD Program)
- Cardiac Performance Center (Sports Cardiology)
- Director: Dr. Aaron Baggish
- Thoracic Aortic Center
- Director: Dr. Eric Isselbacher
- Heart Valve Program
- Medical Director: Dr. Jon Passeri
- Cardio-Oncology Program
- Director: Dr. Tomas Neilan
- Cardiovascular Disease Prevention Center
- Director: Dr. Pradeep Natarajan
- Cardiovascular Genetics Program
- Complex Coronary and Chronic Total Occlusion Program
- Director: Dr. Farouc Jaffer