Cardiovascular Disease

At A Glance

Program Type: Military Medical Center

Location: San Antonio, TX

Accredited: Accreditation Council for Graduate Medical Education (ACGME)

Program Length: 3 years

Required Pre-Requisite Training: Medical School Graduation, Completion of Internal Medicine Residency. All applicants must be active duty members of the U.S. Military.

Categorical Year in Specialty Required: No

Total Approved Complement: 21

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

Our Fellows in Action

A group of doctors standing together with comical clips of other doctors edited into the picture.

A doctor presenting a lecture on valvular heart disease.

A group of smiling people standing on a stage after their program won the national cardiology knowledge bowl.

Six men standing shoulder to shoulder in golf attire.

A doctor standing in the front of a room reading an enlarged ECG while a supervising doctor provides instruction.

A collage of pictures showing doctors standing in front of poster presentations.

A group of people sitting a picnic table smiling at the camera.

Program Description

The SAUSHEC Cardiovascular Disease Fellowship is the largest Department of Defense and joint cardiology training platform, supporting a 425-bed tertiary facility and the only military Level 1 Trauma and Burn Center. The fellowship program has a long-standing outstanding history of training proficient and competent cardiovascular specialists in delivering high-quality and contemporary cardiovascular care to support the operational requirements of the DOD. Graduates of the fellowship are well prepared to care for active-duty personnel, dependents, retirees, and diverse civilian populations based on the breadth of their fellowship experience.

Our 3-year program starts with an introductory “Boot Camp” where trainees are gain critical performing and interpretation echocardiogram skills, solidify vascular access abilities, and receive hands on training with cardiac implantable electronic device interrogation and reprogramming. This introductory period allows for a smooth introduction for the coming rigors of fellowship training and patient care.

Fellows rotate through the following block rotations: Cardiovascular Critical Care Unit, Cardiovascular Consults (inpatient and outpatient), Nuclear Cardiology, Cardiac Computed Tomography, Echocardiography, Cardiac Catheterization, Cardiac Magnetic Resonance Imaging (MRI), Cardiac Electrophysiology These rotations are completed at SAUSHEC. The fellowship training experience is supplemented with external rotations at University of Texas San Antonio, the San Antonio Veterans’ Administration to provide rotations in adult congenital heart disease and catheterization. Fellows also rotate at Methodist Hospital to provide additional experience in critical care, mechanical circulatory support, and advanced heart failure therapy. Rotations in vascular medicine/ultrasound are available for those interested in seeking specific competencies.

Every fellow graduates proficient in cardiac catheterization, echocardiography, nuclear cardiology, cardiac CT and well prepared to support the entire DOD population.

Mission, Vision, and Aims

Mission

The mission of the SAUSHEC Cardiovascular Fellowship Program is to train competent general cardiovascular specialists to meet the operational requirements of the DOD and provide high-quality, modern cardiovascular care.

Vision

We envision a fellowship that produces well rounded, innovative, and inquisitive military officers who will continue to improve cardiovascular care delivery within the DOD.

Aims

Provide intensive training encompassing various aspects of general cardiology, such as cardiac catheterization, echocardiography, cardiac CT and Magnetic Resonance Imaging, nuclear cardiology, electrophysiology, critical care, vascular medicine, and adult congenital heart disease.
Immerse fellows in specialized areas of cardiology, emphasizing hands-on experience in cardiac catheterization, imaging technologies (echocardiography, cardiac CT, MRI), nuclear cardiology techniques, electrophysiology procedures, critical care management, and the intricacies of adult congenital heart disease.
Prepare cardiologists for service in the U.S. Army and U.S. Air Force by providing comprehensive training that aligns with the specific medical needs and challenges faced in a military health care setting.
Offer additional and unique educational opportunities tailored to the distinct responsibilities and roles of a cardiologist within the armed forces, ensuring that fellows are well-prepared and equipped for their military service.

Curriculum and Schedules

Academics consist of 30 minutes of Electrocardiogram lecture review Monday–Thursday followed by a 45-minute lecture delivered by an attending or fellow. We strive to focus on high yield topics that are relevant for routine patient care and Cardiovascular boards. Our curriculum also includes lectures targeting Morbidity and Mortality, quality improvement, journal club, and industry supported hands-on training. We have cardiothoracic surgery and heart team conference every second Friday.

Cardiovascular Disease fellowship rotation schedule per year.

1st Year	2nd Year	3rd Year
Echocardiogram Boot Camp (8 weeks) Cardiac Care Unit Cardiac Imaging Cardiology Outpatient Continuity Clinic Catheterization Echocardiography Electrophysiology Inpatient Cardiovascular Consultation Night Float Nuclear Cardiology Vascular Medicine	Adult Congenital Heart Disease Cardiac Care Unit Cardiac Imaging Cardiology Outpatient Continuity Clinic Cardiovascular Intensive Care Unit Catheterization Echocardiography Electrophysiology Heart Failure and Transplant Inpatient Cardiovascular Consultation Night Float Nuclear Cardiology Research Vascular Medicine	Adult Congenital Heart Disease Cardiac Care Unit Cardiac Imaging Cardiac Magnetic Resonance Imaging Cardiology Outpatient Continuity Clinic Cardiothoracic Surgery Cardiovascular Intensive Care Unit Catheterization Echocardiography Electrophysiology Heart Failure and Transplant Inpatient Cardiovascular Consultation Night Float Nuclear Cardiology Research Vascular Medicine

Once fellows meet their Core Cardiology Training Symposium and competency requirements, fellows are afforded additional time on rotations they are particularly interested in (Catheterization, Electrophysiology, Magnetic Resonance Imaging) and many have pursued additional certifications such as vascular ultrasound or device implantation.

We have a night float system that covers every night except Friday. First year fellows cover four weeks of night float. Second and third years cover about two weeks. The Cardiac Care Unit fellow covers Friday nights.

We teach fellows how to evaluate active duty for readiness and the process of returning them to duty. Many cardiologists deploy jointly as cardiologists and critical care physicians and our curriculum provides excellent critical care training to support deployment trauma missions. Air Force cardiologists are commonly tasked to support Critical Care Air Transport Team missions. Many deployed service members have risk factors (age, family history, occupational stressors) that predispose them to cardiovascular disease manifestations. This highlights the role of the military cardiologist within the austere and forward deployed environments.

Initial bootcamp (first eight weeks of fellowship)
Recertification in Advanced Life Support, Basic Life Support, and Opioid Training
80-hour Nuclear Regulatory required course
Cardiovascular Disease Board Review

We offer transthoracic and transesophageal echocardiography simulation. We also have cardiac catheterization and central line access simulation. There is also simulation available for cardiac device interrogation learning.

We have a week of military specific leadership lectures as part of our didactics.

Scholarly and Professional Development Opportunities

All fellows must generate high-quality manuscript submission as a graduation requirement in the form of a case report or original scholarly research. There are several active research endeavors ranging from evaluating genetic causes of sudden cardiac death to researching the incidence of COVID-related myocarditis in the active-duty population.

There are several ongoing quality improvement projects involving topics such as Extracorporeal Membrane Oxygenation (ECMO), virtual heart failure clinic, atrial fibrillation management in military members and there are many opportunities to initiate Quality Improvement (QI) projects mentored by a faculty member.

We sponsor all fellows to become Assistant Professors with the University Services University of Health Sciences. All fellows are invited to our faculty development sessions which earn credit towards USUHS academic certificates. Fellows are encouraged to attend local, regional, national conferences regularly.

Participating Sites

Audie L. Murphy Memorial Veteran’s Hospital, San Antonio
Methodist Hospital, San Antonio
University Hospital, San Antonio

Applicant Information, Rotation and Interview Opportunities

Our program offers SAUSHEC residents elective rotations on the inpatient consult service and in the echocardiography laboratory as part of their Point of Care Ultrasound (POCUS) elective.

If you would like to schedule an interview with our program, please contact dha.jbsa.brooke-amc.list.saushec-cards@health.mil.

Program graduates take the American Board of Internal Medicine (ABIM) Cardiovascular Disease exam. This exam is offered annually. To become fully board certified, applicants must take and pass the exam. To be eligible to take specialty board exams, graduates must complete all pre-requisites required by the ABIM by October 31st of the year they wish to take the exam. Board information can be found at the ABIM Cardiovascular Disease exam website.

Teaching Opportunities

Fellows are expected to teach residents and junior fellows with increasing levels of responsibility as their training progresses. Fellows routinely take part in Internal Medicine didactics, learning labs and bedside teaching.

Fellows are offered opportunities to teach Physician Assistant (PA) students. In addition, they are supported to attend regional and national meetings for teaching opportunities.

Faculty and Mentorship

Our faculty have subspecialty training in:

Interventional Cardiology
Structural Interventional Cardiology
Electrophysiology
Cardiac Imaging
Heart Failure

All fellows are assigned both a staff and fellow mentor to ensure support from all sides.

Well-Being

The fellowship meets monthly to discuss wellness issues. We have a social chair who sets up recuring events for the fellows and several times a year we meet as fellowship to promote comradery.

Contact Us