General Cardiology Fellowship
The program recruits 7 fellows per year and provides a comprehensive training in general cardiology that leads to eligibility for certification by the American Board of Internal Medicine. The program includes 24 required months of inpatient rotations, a continuity outpatient clinic, dedicated research time and the opportunity to rotate on clinical services at University College London's (UCL) Heart Hospital and Great Ormond Street Hospitals. Interventional cardiology: The main objective of the Fellowship Training Program in Interventional Cardiology is to provide an academically and clinically rigorous training program for the cardiology trainee to obtain the necessary skills in cardiac interventional procedures. The fellowship program includes three trainees for the twelve month training program and offers unequaled opportunities in both peripheral vascular interventions as well as structural heart disease. A second year of training is available to select individuals with specific interests in peripheral or structural heart disease interventions.
Echo training during general cardiology fellowship provides a strong knowledge base and practical skills in echocardiography. Fellows have didactic teaching and case conferences and hands-on training to perform two-dimensional and Doppler transthoracic imaging, exercise and dobutamine stress echocardiographic testing, and contrast imaging using the most current ultrasound equipment is emphasized. Fellows also receive training in three-dimensional echo imaging as it is integrated into our routine transthoracic and transesophageal echocardiographic studies.
Advanced echo training to achieve level III emphasizes higher level of skills in 2D transesophageal echocardiography, the use of 3D transesophageal echo acquisition and analysis of 3D data in echo lab, interventional procedures and intraoperative echocardiography. Clinical echocardiographic research is highly encouraged with opportunities provided in the echo lab or core lab.
The primary goals of the Yale Clinical Cardiac Electrophysiology Fellowship Program (CCEP) are to train superb academic clinical cardiac electrophysiologists who understand and appreciate the basic mechanisms of normal and abnormal cardiac rhythms provide technically excellent and humane care to their patients and who advance the field through clinical practice, research and training. In addition to obtaining outpatient and inpatient consultative experience, CCEP fellows spend the majority of their time performing procedures in three state-of-the-art hybrid OR-EP laboratories. More than 1200 procedures are performed annually including device implants, complex ablations (atrial fibrillation, ventricular tachycardia, epicardial ablations), and laser lead extractions. Yale CCEP fellows are fluent in the use cutting-edge technology including intracardiac echo, three-dimensional mapping and robotics. A didactic EP curriculum is held weekly which focuses on complex intracardiac electrogram interpretation, presentation of novel science, and CCEP board review. Yale CCEP fellows are highly encouraged and expected to participate in ongoing research projects and scholarly activities.
All general cardiology fellows have the opportunity to obtain 4 months of dedicated training in nuclear cardiology, with hands-on training in radiotracer preparation and camera quality control, leading to level II certification. For those fellows pursuing advanced training in cardiac imaging, a physics course is provided that meets NRC requirements for level II certification. The clinical training in nuclear cardiology involves high volume clinical exposure with state-of-the-art solid-state detector systems, hybrid SPECT/64-slice CT scanner, and cardiac PET/64-slice CT imaging with integrated exposure to non-contrast and contrast cardiac CT imaging. Participation in clinical research during these elective months is available and strongly encouraged.
Advanced Cardiac Imaging
An additional 1 to 3 years training in advanced multimodality cardiovascular imaging is available to select candidates. This can lead to level III training in nuclear cardiology and/or echocardiography, and level II training in cardiac CT and MR imaging. For those interested in truly advanced training in cardiovascular imaging, funding is available for 2 to 3 years of research training in imaging technology, and molecular and translational imaging, through an NIH funded T32 training grant. This training can involve: hands-on research experience on clinical 1.5T and 3T MR magnets for pre-clinical or clinical research, pre-clinical experience with microCT, microSPECT/CT, and high-resolution mouse echocardiography, pre-clinical or clinical experience with PET/CT, SPECT/CT, or 3D ultrasound, or pre-clinical training in the ranostic multi-modality probe development.
Advanced Heart Failure
The Yale Center for Advanced Heart Failure and Heart Transplantation is in the process of ABIM certification as an approved center to offer Advanced Heart Failure and Transplant Cardiology Certification, as developed by the American Board of Internal Medicine (ABIM). This new cardiology sub-specialty is designed to recognize the qualifications of physicians who specialize in advanced heart failure and transplant cardiology. This certification encompasses the special knowledge and skills required of cardiologists for evaluating and optimally managing patients with heart failure, particularly those with advanced heart failure; those with devices, including ventricular assist devices; and those who have undergone or are awaiting transplantation. Training includes management of patients with advanced heart failure, including evaluating prognosis, performance and interpretation of cardiopulmonary stress testing, management of patients requiring invasive hemodynamic monitoring and intravenous inotropic/pressor agents and the assessment of candidacy for heart transplant. It also includes evaluation of the need for mechanical circulatory support using both short-term and long-term platforms and the management of patients on LVAD’s as bridge to transplant as well as the management of immediately post transplant and long-term post transplant patients including the use and monitoring of immunosuppression drugs, performance of endomyocardial biopsies, interpretation of cardiac pathology, management of rejection and common problems encountered in the post transplant population.
Research training is offered in all areas of clinical cardiology, basic investigations and outcomes research. Qualified individual may be eligible for support by NIH funded T32 training programs in vascular biology and molecular imaging. Other training options include a Department of Medicine Investigative Medicine PhD program that leads to a Yale PhD degree, Clinical Investigator Program offered by Yale CTSA leading to an MS degree in clinical research and a Robert Wood Johnson program leading to an MS degree in health service research.