Below we have included an example of what a schedule looks like over the three years on average. First and second year fellows are on call approximately one weekday a week and one weekend a month. After each weekend call, fellows have the following Monday off from clinical duties. Call in the third year is reduced to allow greater flexibility and exploration of career interests. Clinic runs throughout the year and you will get that time off from your clinical rotation.
Most of your clinical duties will be based at our main campus (2425 Geary Boulevard in the center of San Francisco). The heart failure/transplant and electrophysiology rotations are based at our Santa Clara campus that is approximately 45 minutes south of San Francisco. During rotations at Santa Clara, you will not take week day call at San Francisco.
The fellows run a weekly case conference that is broadcast to the cardiology departments across the Kaiser facilities in Northern California. This a lively and interactive event with fascinating cases with numerous learning opportunities.
All fellows are expected to participate in research and quality improvement projects. The research is largely retrospective in nature, although prospective trials are also in progress. We have a huge database with over 4.5 million patients in the Northern California region, many of whom who have spent their medical life within the Kaiser Permanente system. This makes for one of the strongest research databases in North America. Additionally, we have a strong Division of Research with graduate medical education funding for programmers and statisticians to facilitate in research projects. We have great mentorship from our faculty, under the leadership of Dr. Drew Ambrosy who works two days per week at the Kaiser Permanente Northern California Division of Research.
| Rotation/Activity | Year 1 | Year 2 | Year 3 |
|---|---|---|---|
| Adult Congenital Heart Disease | 1 month | ||
| Advanced Imaging / CT, MR | 1 month | 1 month | |
| Nuclear Cardiology | 1 month | 1 month | |
| Cardiac Catheterization Laboratory | 2 months | 2 months | 1 month |
| Cardiovascular Surgery / CVICU | 1 month | ||
| Congestive Heart Failure at Santa Clara | 1 month | ||
| Echocardiography | 2 months | 2 months | |
| Electives | 2 months | 2 months | |
| Advanced Echocardiography (optional) | 1-2 months | ||
| Cardiovascular Implantable Electronic Device (CIED) (optional) | 0.5-1 month | ||
| Electrocardiogrphy (ETT / Holter / EKG / Pacers)/ Res | 1 month | ||
| Electrophysiology at Santa Clara | 1 month | 1 month | |
| Intensive Care / A-Call | 2 months | 1 month | 1 month |
| Research | 1 month | 1 month | 1 month |
| Structural Heart Disease | 1 month | ||
| Vascular Medicine/ Prevention/ Rehabilitation/ Res | 1 month | ||
| Wards / B-Call | 2 months | 1 month | 1 month |
| Total | 12 months | 12 months | 12 months |
*First-year fellows now go to either HF or EP in Santa Clara.
Specialized Tracks
Advanced Imaging
For fellows who aim to become non-invasive Cardiologists with advanced imaging skills in one or more modalities, our program offers the opportunity to modify the third-year training schedule in order to develop advanced skills and acquire larger volume experiences in:
Advanced Echocardiography
Though all graduates of our program acquire COCATS level 2 proficiency in Echocardiography (and are eligible for National Board of Echocardiography certification), third year fellows may opt to do one or more months of advanced ECHO training. These months will focus on complex TTE interpretation (valve/structural, Impella/VAD) and increasing their experience with complex TEE cases (valve/structural).
Interventional Echocardiography
For fellows who wish to perform TEE and TTE in support of transcatheter interventions, one or month months of dedicated time are available. Fellows seeking advanced training in interventional echo will obtain primary operator experience in TTE for TAVR and TEE for transcatheter mitral and tricuspid valve interventions, ASD/PFO closures, and left atrial appendage occlusion device procedures.
Cardiac CT
All fellows experience two dedicated months of advanced imaging training and much of this time (plus elective time if desired) can be used for cardiac CT training. Comprehensive experiences in CT coronary angiography and structural cardiac CT (prior to transcatheter interventional procedures) are provided in order to prepare the fellow to achieve certification with the Board of Cardiovascular Computed Tomography.
Cardiac MRI
All fellows receive basic exposure to CMRI protocols for image acquisition and gain experience in study interpretation. For fellows wishing to achieve level 2 CMR training and certification with the Society for Cardiovascular Magnetic Resonance, it is possible to prioritize the advanced imaging and elective months to support the required training requirements.
Women’s Heart Health
For fellows who wish to develop focused expertise in Cardio-Obstetrics and disease processes such as spontaneous coronary artery dissection (SCAD), stress cardiomyopathy, and myocardial infarction with non-obstructive coronary arteries (MINOCA), our program offers a specialized outpatient clinic experience with longitudinal management of these conditions. In addition, there are a broad range of research opportunities in Women’s Heart Health with mentorship from both clinical faculty and research scientists at the KP Division of Research. Fellows working in the Women’s Heart Health track are expected to assume leadership roles in Quality Improvement projects and medical education and participate in national conferences.