The internal medicine residency provides opportunities to work directly with cardiology attendings and fellows on the inpatient cardiology wards (Zoll rotation) and in the cardiac care unit (CCU) with a focus on management of patients with cardiovascular issues. The cardiology educational experience includes caring for patients on the heart failure, electrophysiology and interventional cardiology services. Residents and interns have the opportunity to work with numerous experts in cardiology who are fantastic teachers such that the CCU rotation is one of the residents' most highly ranked rotations. The cardiology rotations are all staffed by residents, interns and fellows.
The Zoll rotation was named after the famous The Zoll service is our
inpatient cardiology service.
Dr. Paul Zoll
was a Beth Israel Cardiologist who pioneered the development of heart
monitors, pacemakers and defibrillators in a career that spanned the 1950s
until his retirement in 1993.The cardiology service is located below the
cardiac catheterization lab and cardiac ICU. Patients with unstable
angina/NSTEMI, advanced heart failure, significant valvular diseases,
electrical disturbances, or patients requiring higher level of cardiac care
are admitted to this service.
The cardiology service is staffed by three teams of 1 resident and 2
interns. A supervising fellow and attending help care for the patients and
oversee clinical management. A separate interventional cardiology, heart
failure and electrophysiology service exist within the Zoll service which
have associated supervising attendings and fellows that work closely with
housestaff. Cardiology call is every 3rd night with an individual team
census cap of 20 and intern cap of 10. A general cardiology service lecture
series occurs on Wednesdays directed for housestaff; in addition, Zoll
housestaff are expected to attend cardiology department conferences.
The CCU is an 8 bed intensive care unit. It is staffed by a cardiology
attending, fellow, 3 residents and 3 interns. This rotation is typically
one of the highest rated rotations for several reasons including the
notable teaching opportunities and complex physiology. Patients are
admitted to the CCU for complications of MI, cardiogenic shock, significant
valvular disease (acute MR, critical AS), large territory ST elevation
myocardial infarctions, arrhythmias and high grade conduction disturbances.
It provides an opportunity to experience first-hand, hemodynamics using
Swan-Ganz catheters and intra-aortic balloon pumps. Residents take
overnight call every third night while are in the CCU in a weekly staggered
day-night schedule. The average census is 6 CCU patients with additional
floor patients who unlike most ICUs continue to be followed by the critical
care team after leaving the unit to allow for longitudinal care. The CCU
team attends both general cardiology conferences with the general
cardiology service in addition to a specific CCU based teaching