Interaction with Other Disciplines. The Division of Cardiology works closely with the Cardiothoracic and Vascular Surgery Divisions as well as the Departments of Internal Medicine, Emergency Medicine, Nuclear Medicine, and Radiology. Joint conferences are often held and fellows and attendings from the division are often invited as expert speakers. Some cardiology fellows pursue additional training or collaborate on research projects with faculty members from other departments. In addition, several other subspecialty training programs and a residency in internal medicine allow trainees to interact with other disciplines through the availability of collaborating consultants and suitable patients.
Teaching and Educational Experience. Acknowledging the important role that cardiology fellows play in the education of medical students and housestaff, each fellow is appointed to the rank of Clinical Instructor in Medicine at Harvard Medical School. The cardiology teaching experience is directed by Dr. Eli Gelfand, and begins with a daily Core Curriculum lecture series in July and August. The lectures then continue weekly, and cover all key aspects of clinical and consultative cardiology, electrophysiology, imaging and interventional cardiology. The educational experience also includes weekly conferences in clinical cardiology, nuclear cardiology, echocardiography, electrocardiography, electrophysiology, angiography, advanced noninvasive imaging (cardiovascular magnetic resonance, cardiac CT, nuclear cardiology) and interventional cardiology. Attempts are made to incorporate basic biomedical information with the clinical aspects of cardiology, including integration of clinical management principles. Fellows have regularly scheduled experiences in teaching and are encouraged to attend and participate in national cardiology meetings. Funds are available for each fellow to attend one conference per year.
Evaluation and Documentation of Competence. Fellows are evaluated monthly throughout their training, consistent with criteria set forth by the American Board of Internal Medicine. Fellows review their evaluations and in turn, evaluate the faculty members who oversee their rotations. The program codirectors and representative section heads review these evaluations biannually. Upon discovery of a problem, the directors take immediate action to rectify as appropriate. Records are maintained of all evaluations and of the number and type of all laboratory procedures performed by each trainee.
Calls and Schedules. The call schedule for fellows starting in July is created by the upcoming second year class and approved by the program directors. The first year fellows who are on the three clinical rotations take most night and weekend coverage. In an approximately "every fourth night rotation" during their clinical service months, fellows take night and weekend coverage. (Fellows take minimal call while on the exercise, catheterization laboratory, and echocardiography rotations.) Fellows generally spend four to six months during their first year and one to two months during their second year on this "every-fourth" call rotation. Staff attendings are kept informed of all changes in the status of patients under their care and expect to be called at any hour.
Two weeks of vacation may be taken during the first year of the program, and three weeks during the second and third years. During the first year, the two weeks are taken during the Echocardiography or Exercise Lab rotation as arranged between the fellow and the appropriate attending. (Vacations are not taken, in either the first or second year, during a rotation when a fellow is the only covering fellow for a clinical activity or laboratory.)