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Cardiovascular Disease


At A Glance

Program Type: Military Medical Center

Location: Bethesda, MD

Accredited: Yes, Accreditation Council for Graduate Medical Education (ACGME)

Program Length: 3 years

Required Pre-Requisite Training: Medical School Graduation, Completion of Internal Medicine Residency

Categorical Year in Specialty Required: No

Total Approved Complement: 12

Approved per Year (if applicable): N/A

Dedicated Research Year Offered: No

Medical Student Rotation Availability: 4th Year

Additional Degree Concurrent with Training (e.g. MPH): No

Program Description

The National Capital Consortium Cardiovascular Disease Fellowship Program is a premier training program for graduates of an Internal Medicine Residency. The program has a long history of developing superior cardiologists who are capable of working in varied settings to include austere environments during deployments, small military treatment facilities, or large academic medical centers. Graduates of the program acquire a diverse set of skills which prepare them to be successful in any of these settings. Our program has access to state-of-the-art technology in cardiac imaging to include advanced echocardiography, nuclear cardiac imaging, cardiovascular CT, and cardiac MRI and in invasive evaluation and treatment of cardiac disease to include invasive coronary physiology, percutaneous coronary intervention, transcatheter aortic valve replacement, transcatheter treatment of adult congenital heart disease, and cardiac electrophysiology. The program has collaborative relationship with multiple local institutions to include Washington Adventist Hospital, Inova Fairfax Medical Center, and the National Institutes of Health.

Mission, Vision and Aims

Mission

Our mission is to produce clinically excellent, independent cardiologists who provide high-quality, patient-centered, cost-effective care and who function as outstanding clinicians, teachers, and leaders within the military healthcare system.

Vision

We envision a Military Health System which is a leader in cardiovascular care and provides state-of-the-art evaluation and management of our patients with cardiovascular disease.

Aims

We aim to develop military cardiologists who have the skills needed to care for the patients in the Military Health System (services members, families, and retirees) which includes the full spectrum of cardiovascular disease from diagnostic evaluation, risk factor management, to care for patients with advanced heart disease. Our graduates will be knowledgeable and caring clinicians who are capable of caring for our patients with heart disease and able to collaborate across specialties to advance the cardiovascular capabilities of their military treatment facility.

Curriculum and Schedules

Each week there are multiple academic conferences led by either a faculty member or a fellow.

Tuesday Mornings

We have a cardiac imaging case conference with review of clinical imaging including electrocardiography, echocardiography, cardiac computed tomography, nuclear cardiac imaging, and invasive coronary angiography/hemodynamics.

Wednesday Mornings

We have our heart team conference to discuss clinical management of patients with complex coronary disease or structural heart disease.

Friday Afternoons

We have an academic half-day which is a 3-hour session dedicated to shared fellow and faculty learning with sessions including core didactics, clinical case conference, journal club, professional development, and quality improvement/morbidity & mortality conference.

Quarterly

We have a combined National Institutes of Health-Walter Reed Cardiology Ground Rounds where faculty and fellows have the opportunity to present interesting clinical cases or research.

Year 1 Year 2 Year 3
  • Orientation
  • Echocardiography
  • Cardiac Imaging
  • Ambulatory Cardiology
  • Cardiac Catheterization
  • Electrophysiology (EP)
  • Comprehensive Procedures
  • Research
  • Cardiac Care Unit
  • Echocardiography
  • Cardiac Imaging
  • Ambulatory Cardiology
  • Cardiac Catheterization
  • Electrophysiology (EP)
  • Advanced Heart Failure
  • Comprehensive Procedures
  • Research
  • Cardiac Care Unit
  • Echocardiography
  • Cardiac Imaging
  • Ambulatory Cardiology
  • Cardiac Catheterization
  • Adult Congenital Heart Disease
  • Comprehensive Procedures
  • Research

Elective option includes National Institutes of Health for Cardiac Imaging.

  • Fellows take call only at Walter Reed National Military Medical Center and overnight call is home call.
    • Each night during the work week, there are two fellows on call one of which is the current inpatient cardiology/CCU fellow who manages the cardiology patients admitted to the hospital.
    • The second fellow on call rotates amongst the other fellows, but typically is a first-year fellow, who takes calls on new consults or admissions.
    • On the weekends, there is typically a first-year fellow on call who will takes new calls and round on the inpatient service.
    • A fellow in their second or third year is on back-up call to help when the inpatient service is busy or to assist the first-year fellow when needed.
  • Each night a faculty member and an interventional cardiologist are on call for supervision of the fellows and to perform urgent/emergent care when needed.

Fellows participate in the MEGA clinic which is a rapid evaluation pathway for low acuity consults in young and middle-aged patients, most of whom are active-duty service members. After the initial consultation, they are scheduled for cardiac testing, generally within one week of the initial consultation. Research from this clinic has demonstrated that it provides a rapid assessment and is able to complete the evaluation and return more than 90% of service members to full duty within 30 days of the initial consultation. As part of this, fellows are educated on the application of DOD and service specific instructions for accession and retention for service members.

Simulation is incorporated into the cardiology bootcamp which is a city-wide course which includes case and procedure simulation.

Within the fellowship curriculum, case simulation is used for cardiac device interrogation and for cardiac hemodynamics with clinical cases and pressure/volume loops with an online patient simulator.

Leadership courses are offered through the Hospital Education and Training department and through Uniformed Services University. Fellows are encouraged to seek out courses which align with their career goals.

Scholarly and Professional Development Opportunities

Scholarly activity is a requirement of fellowship training which can include intramural or extramural presentations or various publication types (e.g. textbook chapters, case reports/series, or retrospective/prospective clinical research).

It is expected that each fellow will submit some level of research to a regional or national meeting or to a journal for publication prior to graduation. Generally, presentations accepted for research will have funded travel to national meetings.

A quality improvement/patient safety fair is generally held at the beginning of the academic year to bring together fellows and faculty to develop one or more projects which can be performed during the academic year. Completed projects are encouraged to be presented at the hospital quality improvement fair.

Patient safety events unfortunately occur as part of routine patient care. Fellows are expected to present serious adverse events or near misses at the department Quality Improvement/Patient Safety Conference (M&M). Additionally, fellows are encouraged to use the Patient Safety Reporting System for patient safety events they witness.

Professional development for clinical, academic, and military professional development are built into the program academics. Additionally, multiple professional development courses are offered through the hospital’s Staff Education and Training Department and through Uniformed Services University. Fellows are encouraged but not expected to take the Stanford Faculty Development Course offered through Uniformed Services University to enhance their educational skills and prepare them to be teaching faculty members.

Participating Sites

  • Washington Adventist Hospital
  • Inova Fairfax Medical Campus

Applicant Information, Rotation and Interview Opportunities

  • Outpatient and Inpatient Cardiology rotation are available to medical students.
  • At present, rotations for residents are only routinely offered to Internal Medicine Resident in the National Capital Consortium.
  • On a case-by-case basis, rotations for Internal Medicine Residents from other programs may be considered.

The program offers options for virtual, or in-person interviews based on applicant preference. Interviews are typically performed between August 15th and October 1st. Applicants will have the opportunity to interview with the program director and a faculty member. Additionally, applicants will have the opportunity to meet with current fellows to hear about the program from the perspective of a trainee. Interested applicants should contact the program through the available program email group to coordinate an interview.

Program graduates take the American Board of Internal Medicine (ABIM) Cardiovascular Diseases Examination. This exam is offered annually. To become fully board certified, applicants are eligible to take board certification exam upon graduation. To be eligible to take specialty board exams, graduates must complete all pre-requisites required by the ABIM by October 31st. The exam is not taken concurrently during fellowship.

Teaching Opportunities

Fellows are expected to: 

  • Deliver multiple didactic or case presentations each year as part of the academic curriculum. Additionally, fellows will supervise trainees (medical students, interns, residents) from a variety of programs during their inpatient and ambulatory rotations.
  • Participate in the didactic and case presentations of the Internal Medicine Residency Program.
  • Participate in the Cardio/Pulmonary/Renal module for pre-clerkship medical students at Uniformed Services University.
  • Apply for a faculty appointment at Uniformed Services University, and generally are given appointments as an Assistant Professor of Medicine.

Faculty and Mentorship

Within the faculty at Walter Reed Military Medical Center, there are faculty with subspecialty training in Interventional Cardiology, Structural Intervention, and Clinical Cardiac Electrophysiology. At Inova Fairfax, there are additional faculty with subspecialty training in Advanced Heart Failure/Transplant Cardiology.

Fellows are encouraged to identify a mentor within the faculty who through a longitudinal relationship and help foster long-term growth as a cardiologist.

Well-Being

The program has an annual retreat which offers faculty and fellows a dedicated time to review the program and provide feedback and solutions to improve the program which includes any issues with well-being. As part of this, annually we assess the call and rotation schedules and structure to optimize well-being. The program leadership has an open door policy to discuss any issues which may be impacting the well-being of trainees.

Contact Us

Cardiovascular Disease Fellowship Program

Location: Walter Reed National Military Medical Center, Building 9/9A, 2nd Floor, Cardiology Clinic

Hours of Operation:

Monday–Friday
7 a.m. to 4 p.m.

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