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Pediatric Cardiology fellows learn how to perform and interpret transthoracic echocardiography with some exposure to transesophageal and fetal echocardiography. Skills are refined in outpatient clinic, hospital wards, intensive care units and operative settings. Fellows who desire a focused experience in cardiac MRI, advanced transesophageal or fetal echocardiography may choose to do so.
Fellows learn to interpret catheterization data and angiograms, thereby gaining a solid understanding of physiology, as well as indications for these procedures. In the process, they train with the faculty operators to perform diagnostic procedures of complex disease, to obtain biopsy samples from children with heart transplants, for therapeutic interventions, and to palliate cardiac defects. Division faculty participate in multiple clinical trials, including those for various closure devices and transcatheter valves. Fellows are exposed to a wide range of cardiac defects, as well as interventional procedures involving the newest devices and techniques.
Fellows in the pediatric cardiology program at IU School of Medicine experience all aspects of electrophysiology, including invasive ablation procedures, ICD and defibrillator implants. They learn to interpret ECGs, Holter and event monitors and exercise stress testing and participate in pacemaker clinics to learn the nuances of managing patients with complex rhythm abnormalities.
Fellows are part of a collaborative team of cardiac intensivists, cardiologists, neonatologists and cardiac surgeons at IU School of Medicine who manage post-operative children on a dedicated cardiovascular intensive care unit. Annually more than 500 pediatric and adult congenital cardiac surgeries are performed by four dedicated pediatric cardiac surgeons.
Fellows learn to manage children with a variety of acquired, congenital and post-operative cardiac issues on the cardiac step-down unit. They provide consultative services to the neonatal and general pediatric intensive care units. This experience also allows fellows to direct patient care rounds, help educate residents and medical students, and hone leadership and organizational skills.
While not a mandatory rotation, pediatric cardiology fellows have the option of training with adult cardiology faculty in the inpatient and outpatient setting.
First-year fellows in the Pediatric Cardiology Fellowship program are exposed to a wide variety of cardiac conditions in this multidisciplinary rotation. Fellows spend time learning about pulmonary hypertension, cardiomyopathies and cardiac genetics. In addition, time is allotted for fellows to begin involvement in research projects.
Fellows spend approximately one year of their training in research endeavors. They have opportunity to become involved in clinical, bench and/or translational projects that fit their areas of interest. Fellows consistently present their research at regional and national conferences.
Clinical research opportunities exist by working with a faculty member and through the NIH-funded Pediatric Heart Network (PHN), of which Riley Hospital is a clinical site. Pediatric Cardiology faculty participate in numerous multi-center research studies, and fellows have the opportunity to gain experience in performance of clinical trials. Dedicated research coordinators are available to assist in submission of IRB and grant proposals.
Opportunities for basic science research are available at the Herman B Wells Center for Pediatric Research, where cardiac development biology and cardiovascular genetics are two of the primary areas of focus. Fellows have the opportunity to complete a Masters of Clinical Science degree during fellowship training.
Call Schedule and Responsibilities
Inpatient call is conducted in the hospital during weekdays and at home on weekends. Pediatric Cardiology fellows share call equally. Responsibilities include management of patients on the inpatient and ICU services, consultation services, and obtaining echocardiograms on requested patients. Taking call allows for continuity of care for post-operative patients and for skill development in image acquisition.
Lectures and Conferences
This component of the curriculum allows fellows to interact with one another and faculty from cardiology and other disciplines. Teaching conferences provide an intimate environment for fellows to learn about specific topics from clinical specialists and to present their own research and experiences with patient cases. Patient-centered conferences cover surgical cases, complex case, and morbidity and mortality topics.
The Interactive Conference Series includes a Catheterization Conference, Echocardiography Diagnostic Forum, MRI Conference, Electrophysiology Conference, Pathology Conference, Journal Club, Board Review series, and Heart Failure Conference. Didactic instruction includes a core lecture series, a cardiovascular intensive care unit lecture series, and an adult congenital heart disease echocardiography forum.