The clinical training program at Phoenix Children’s Hospital will provide each fellow with the academic knowledge and procedural skills necessary to care for patients throughout his or her career. Inpatient service time during the first year will focus on the care of patients on the cardiology medical ward and consult service, with the second year spent primarily in the Cardiovascular Intensive Care Unit. These experiences will be complimented by rotations in the echo lab & MRI suite, cardiac catheterization laboratory, and electrophysiology lab. The procedural skills and knowledge gained in these experiences will enable each fellow to become proficient in integrating imaging, hemodynamic, and electrophysiologic data into the management plan of each patient.
Call responsibilities during the first year of fellowship will consist primarily of home call, averaging 1 in 4 nights. Weekend responsibilities will also average 1 in 4. First year fellows will be supported by an on-call cardiologist, on-call cardiac subspecialists, an in-house cardiac intensivist, senior fellows, and ancillary staff. First year fellows will help to guide management of all patients admitted to the cardiology ward, and field calls from the Emergency Department, consulting services, outside hospitals, and parents/patients. Fellows will be present for floor admissions up until 9pm, with overnight admission coverage provided by an in-house nurse practitioner.
Second year call responsibilities will entail the care of patients admitted to the Cardiovascular Intensive Care Unit. These patients will consist of medically fragile infants and children with congenital heart disease (both pre-operative and post-operative), adults with palliated congenital heart disease, patients requiring aggressive arrhythmia management, and patients undergoing advanced heart failure management. By necessity, call will be in-house and will be shared with fellows from the separate Pediatric Intensive Care and CVICU Fellowships. Call responsibilities will average 1 in 5 weeknights and 1 in 5 weekend days throughout the year. As with the first year, each fellow will be supported by an in-house CVICU intensivist, on-call cardiac subspecialists, CVICU nurse practitioners, and ancillary staff.
Call responsibilities during the third year will again be primarily home call, and will average 1 in 3 weeknights and 1 in 4 weekends. These senior fellows will be available to advise and assist first year fellows in the management of complex patients, will perform after-hours echocardiograms, and will assist in after-hours procedures in the cardiac cath lab and electrophysiology suites.
Fellows will gain experience in the outpatient management of cardiac disease through weekly continuity clinics. These weekly half-day clinics will commence during the first month of fellowship and continue through all three years of training. Fellows will be expected to truly take ownership of the care of his or her clinic patients, and along with a faculty mentor, will guide all aspects of disease management. Additional rotations in subspecialty clinics (transplant/heart failure, Fontan, inter-stage, ACHD, etc.) will allow for exposure to these facets of cardiology, with additional opportunities for engagement in these subspecialties available for interested trainees. Near-daily didactic learning sessions, patient management discussions, imaging and electrogram reviews, or research progress meetings will ensure that fellows are well versed in both the theory and application of cardiology principals.
In addition to developing outstanding clinical skills, advancing the field of pediatric cardiology will be a focus of the fellowship. A full one-third of the 36 months spent in fellowship training will focus on research – both its performance and support. Fellows will receive instruction in study design, statistics, grant writing, regulatory considerations, manuscript preparation, and the review process. It is expected that Fellows will have the opportunity to present the results of their research endeavors at a regional or national meeting during the third year. While it is likely that the majority of projects will focus on clinical and translational research, basic research opportunities are available through many of our affiliated partners.
Staff at Phoenix Children’s Hospital, and the Division of Cardiology in particular, have close affiliations with and hold appointments at the University of Arizona College of Medicine - Phoenix, Arizona State University, Creighton University School of Medicine, and the Mayo Clinic. These affiliations provide opportunities for research engagement at each of these institutions. In particular, ongoing collaborations between Center for Heart Care staff and Arizona State University’s Ira Fulton Schools of Engineering provide opportunity for trainees to engage in the development and application of new protocols and devices to our unique population. It is expected that this partnership will continue to grow with time, and will become a significant focus of the research efforts of the Division well into the future.
