Advanced Echocardiography Fellowship

Overview

The Mass General Advanced Echocardiography Fellowship Program is a two-year non-ACGME training program. The focus is on the clinical and research application of Echocardiography, which includes performing and reporting all modes of echocardiography and dedicated time for ongoing and new translational and clinical research.

Mission Statement

The Advanced Echocardiography Fellowship Program is designed to train independent investigators and directors of echocardiography laboratories. The program includes the requisite clinical training required to perform, interpret and teach echocardiography at an academic level, and to engage in clinical and experimental research studies.

The clinical training program includes supervised performance of sufficient echocardiograms to satisfy professional certification requirements for laboratory director; interpretation of routine clinical studies; and performance of transesophageal, contrast, stress echo and emergency studies. The fellow will be familiar with the latest cardiac ultrasound technologies and develop an integrated appreciation of cardiac pathophysiology from the combined clinical and research aspects of the program and the wide-ranging expertise of its faculty. Cross modality exposure to Cardiac CT and MRI is available during this fellowship for interested individuals.

Objectives of Training

• Develop clinical expertise in the performance and interpretation of echocardiograms (transthoracic (rest and stress) and transesophageal
• Achieve level III training in echocardiography
• Develop research skills for clinical and experimental investigation with implementation and completion of a successful research plan
• Learn to effectively communicate results of investigations in echocardiography through publications and invited presentations
• Learn basics of grant writing

Requirements

To apply to the Advanced Echocardiography Fellowship, the following is required:

• Completion and passing of all three USMLE steps
• Completion of previous cardiology fellowship training
• Level I training in echocardiography
• ABIM board certified or board eligible
• The accepted applicant must obtain a full Massachusetts license (limited license if on visa)
• A valid ECFMG certificate for all foreign medical graduates
• Only J1 visas accepted

Curriculum

Transthoracic Echo (TTE)

The fellow will develop expertise in all areas of transthoracic echocardiography, including 2D, M-mode, Doppler and color Doppler. This includes contrast imaging, harmonic imaging, tissue Doppler, strain imaging and three-dimensional imaging.

Transesophageal Echo (TEE)

The fellow will develop expertise in performing and evaluating TEE studies with focus on:

• Native valve disease, including evaluation for potential transcatheter intervention
• Prosthetic valve function/dysfunction
• Infective endocarditis and its complications
• Aortic pathology, including aortic dissection, ulceration, hematoma and aortic trauma
• Cardiac source of embolus
• Complex congenital heart disease
• Intraoperative TEE evaluation
• Intraprocedural TEE imaging (transcatheter aortic, mitral and tricuspid intervention; Watchman; ASD closure)

Stress Echocardiography

The fellow will become proficient in performing and reporting exercise and pharmacological stress echocardiography including preoperative, coronary artery disease and valve disease evaluation.

Contrast Echocardiography

The fellow will become experienced in the use of contrast echocardiography for LV opacification, myocardial perfusion and as a diagnostic adjunct in patients undergoing stress echocardiography.

Core Clinical Competencies

• Transthoracic echocardiogram
• Transesophageal echocardiogram
• Stress echocardiograms

Ability to Interpret:

• Transthoracic echocardiogram
• Transesophageal echocardiogram
• Stress echocardiogram
• Contrast echocardiogram

Benchmarks of Clinical Competence

• Achieving level III training as outlined by the CoCATS
• Passing of National Board of Echocardiography examination
• Achieving comprehensive or transthoracic/transesophageal certification from the National Board of Echocardiography

Core Research Competencies

• Ability to design and carry out research project(s)
• Publication results of investigation(s)
• Ability to present and defend results of investigations
• Basic ability to write a grant proposal

Benchmarks of Research Competence

• Complete research study
• Present abstracts at national cardiology meetings
• Publish results of work in peer reviewed journals
• Submit proposal for funding

Duration

The Advanced Echocardiography Fellowship is two years in duration.

Conferences

• Clinical echocardiography conference: Weekly conference with fellows, sonographers and faculty where fellows present important echocardiographic topics with a mix of lecture and case interpretation
• Research echocardiography conference: Weekly conference where fellows present and discuss their research ideas and progress with co-fellows and faculty
• Congenital heart disease
• Combined Echo-cMR-cCT conference: Case-based conference discussing various clinical applications of the 3 noninvasive cardiac imaging modalities. Staff and fellows of all three services attend

Clinical Experience

The fellow is expected to spend approximately 50% of time in clinical activities within the echo lab including performance and interpreting all modes of echocardiography. In addition, on-call responsibilities will include performance of emergency TEEs and initial review of complicated TTEs performed by on-call cardiovascular disease fellow.

Research Experience

Approximately 50% of the fellow's time will be spent doing clinical and/or translational research including design, implementation and publication of new echocardiographic research.

Research Resources

The inpatient and outpatient echocardiography laboratories have an annual volume of approximately 40,000 echocardiograms. There is a combined working space of approximately 10,000 square ft, which includes all the necessary computers for data base analysis, offline review of images, image processing and analysis of studies.

• Three-dimensional echo research via commercial and in house developed software
• Cardiac Surgery/Cardiology Animal Research Center, a space with approximately 500 square foot animal laboratory and staff experienced in the creation of small and large animal models of cardiac disease, open-heart surgery and cardiopulmonary bypass.
• Cardiology Laboratory in Integrative Physiology
• Collaborations with Molecular Genetics, Cardiac Gene Therapy Center and Molecular Cardiology groups at the CVRC in Charlestown
• Cardiac Computer Center (Laboratory of Computer Sciences), including staff available for echo database searches

How to Apply

Positions are filled at least one year in advance, and prior cardiology fellowship training is required.

Interested applicants should send their CV, personal statement, and three letters of recommendation by e-mail to mghechofellowship@partners.org.