The outpatient clinical cardiology experience is directed by Eli V. Gelfand, MD, FACC, Section Chief of General Cardiology, and spans the three years of the Cardiovascular Fellowship.
At the beginning of the first fellowship year, each fellow is assigned an outpatient faculty preceptor. These are selected faculty members who have large, diverse and active patient panels, with diagnoses spanning the entire spectrum of cardiovascular medicine. Trainees attend weekly ambulatory sessions with their preceptor, where preference is given to new patient visits and consultations. Each case is reviewed with the preceptor, who then verifies the salient portions of the history and physical examination, and provides immediate feedback on the fellow's assessment and plan. The fellow takes leadership in following up on the results of the ordered tests and procedures, as well as communicating with the patient and referring physicians. If a return visit is indicated, the trainee follows the patient longitudinally, thus preparing them for postgraduate experience as skilled and busy independent clinicians.
Advance-level fellows (PGY 6-7) spend the last two years of their fellowship within a subspecialty clinic, such as the Arrhythmia and Device Center or the Vascular Medicine clinic.
Frequent feedback, informal and formal, is an integral part of the Ambulatory Cardiology experience, and includes evaluations completed by the preceptors, clinic nurses and patients.
Cardiovascular Health and Lipid Center
The Cardiovascular Health and Lipid Center is a multidisciplinary outpatient program that holds five sessions per week at BIDMC. The primary focus is on risk reduction and the diagnosis and management of complex lipid disorders. In addition to faculty, fellows and senior medical residents, a registered dietitian and a lipid nurse specialist staff the Lipid Center, which oversees approximately 1,000 patients.
The Lipid Center is also a forum for clinical research. All clinical information and laboratory results are incorporated into a longitudinal database that tracks patient responses to dietary and pharmacologic strategies. In addition, the Lipid Center's patient population serves as a resource for basic metabolic and genetic studies and provides fellows an opportunity to become familiar with the diagnosis and management of hyperlipidemia as it pertains to cardiovascular disease.