Each Cardiovascular Disease fellow will rotate on the Cardiac CT/MRI rotation for at least one month during the course of his/her fellowship.

During this rotation, fellows will be introduced to the acquisition and interpretation of cardiovascular CT and MRI imaging studies. At present, this rotation is conducted mostly at the University of Cincinnati Medical Center. Additional learning opportunities activities may take place at The Christ Hospital.

The Electrophysiology (EP) rotation through UCMC provides fellows with a general overview of all aspects of cardiac electrophysiology and ensures fellows acquire the necessary expertise required to manage the electrophysiology disorders routinely encountered in the general practice of cardiology.

Each cardiology fellow will rotate on the EP service for at least two months during the 3 years of cardiovascular disease fellowship.

On this rotation, the fellow will learn how to evaluate and manage patients with electrophysiologic disorders in both the inpatient and outpatient setting. The fellow will also be introduced to the performance of a variety of EP procedures and will be taught the basics of pacemaker/ICD management and device interrogation.

The purpose of the CCHMC Adult Congenital Heart Disease rotation is to provide exposure to congenital heart disease in adolescents and adults, genetic cardiovascular syndromes and acquired/idiopathic conditions in pediatric cardiology.

The fellow will primarily see outpatients within the adult congenital heart disease clinic with focus on reviewing past surgical and interventional history, interviewing and physical examination, reviewing current imaging and other testing.

The echocardiography rotation through both the University of Cincinnati Medical Center and Cincinnati VA Medical Center, provides fellows with a general overview of all aspects of cardiac echocardiography and ensures fellows acquire the necessary expertise to perform and interpret transthoracic, transesophageal, and stress echocardiography studies which are routinely encountered in the practice of general cardiology.

Each cardiology fellow will complete at least six months of echocardiography during the three years of the cardiovascular disease fellowship training. 

During these rotations the fellow will learn principles of echocardiography as pertains to the evaluation and management of patients with general cardiac disorders such as heart failure, coronary artery disease, valvular disorders, pericardial diseases and cardiac masses.

All fellows will complete their cardiovascular disease training with Level II certification in cardiac echocardiography if they meet the rotation and competency requirements as outlined by ACC COCATs 4 and the American Society of Echocardiography.  An additional year of training may be required for Level 3.

The UCMC float/nuclear rotation provides additional training in the nuclear cardiology lab.
This rotation also gives a designated fellow the responsibility for cross-coverage when other fellows assigned to UCMC rotations are on vacation, at meetings or absent due to an illness or emergency.

This rotation provides 0.5 time for the month towards level 2 nuclear cardiology rotation requirement. 

The UCMC Night Float rotation is conducted in conjunction with the UCMC nuclear cardiology rotation. During this one-month rotation, two fellows share the night float duties and cover the UCMC nuclear cardiology service. Services are covered in two intervals.

The primary purpose of the night float rotation is for fellows to learn to cover a variety of acute cardiac issues in the on-call setting.

This rotation counts towards 0.5 month credit each in nuclear and inpatient cardiology.

Each cardiology fellow will have the opportunity to rotate on the Nuclear cardiology service for at least four months during the course of the cardiovascular disease fellowship.

On this rotation, fellows will learn the strengths and limitations of nuclear stress testing modalities, optimal stress test selection, how to safely and effectively conduct stress testing and how to accurately interpret stress studies. 

In order for fellows to achieve Level 2 certification requirements and competencies outlined by ACC COCATs 4 and the Certification Board of Nuclear Cardiography, fellows will need to complete nuclear cardiology requirements.  Fellows are required to attend nuclear cath correlaton conferences held each month, nuclear physics course provided free by the division to all fellows and pass the required examination, and complete/document additional on-line educational assessments.

Each cardiology fellow will rotate on the Cardiology Consult service for at least 2 months during the course of his/her fellowship. Typically this rotation is scheduled to first year cardiovascular disease fellows.

The purpose of the Cardiology Consultation rotation is for the fellow to learn to evaluate patients, recommend treatment plans, and follow the clinical progress of inpatients with a wide range of cardiac problems. The rotation will also emphasize electrocardiographic interpretation.

The overall purpose of the UCMC CVICU-A rotation is to provide trainees with a comprehensive training experience in the evaluation and management of common cardiac disorders as well as disease states that mimic cardiac disorders. This intensive training experience is designed to expose the trainee to both acute and subacute presentations of cardiac dysfunction and ensure that the fellow acquires the necessary clinical and procedural skills to care for cardiac disorders routinely encountered in the practice of general cardiology.

Each cardiovascular disease fellow will rotate on the UCMC CVICU-A service a minimum of four months (increments of 2-week blocks) during the course of his/her fellowship. On this rotation, the fellow will learn how to evaluate and manage patients with acute coronary syndromes, including cardiac arrest and cardiogenic shock, cardiac dysrhythmias, congestive heart failure, valvular heart disease, myocardial and pericardial heart disease, and aortic and hypertensive emergencies. Additionally, evaluation and management of peripheral vascular and extracranial cerebrovascular disease are incorporated into the training experience. A primary goal of this rotation is to build a strong foundation for the practice of evidence-based and cost-effective medicine with a focus on primary and secondary prevention strategies.

Fellows will be introduced to and become proficient in the performance and interpretation of a number of cardiac procedures including, but not limited to, pulmonary artery catheter placement, temporary venous pacemaker insertion, intra-aortic balloon pumps management, and elective cardioversion. Review and integration of laboratory, radiographic, hemodynamic, and cardiac diagnostic studies will be emphasized during this clinical rotation. The ultimate goal is for fellows to be deemed capable of functioning at the attending level, and this development will be fostered through a strong mentoring relationship with clinical faculty.

The overall purpose of the CVICU-B (Heart Failure/Transplant) rotation is to provide trainees with extensive experience in the diagnosis and management of patients with acute and chronic congestive heart failure and to provide an introductory experience with cardiac transplantation.

Each cardiology fellow will rotate on the Heart Failure/Transplant service for at least 4 months (increments of 2-week blocks) during the course of his/her fellowship.

On this rotation, the fellow will learn how to evaluate and manage patients with heart failure related disorders in both the inpatient and outpatient setting. The fellow will also be introduced to the indications for common procedures performed on heart failure and cardiac transplant patients, such as right heart catheterization and RV biopsy.

The overall purpose of the VA Float/Procedure rotation is to provide a designated fellow responsible for cross-coverage at the VA when the assigned fellows are on vacation, in clinic, at meetings or absent due to an illness or emergency.  This rotation will also provide time for first year fellows to acquire basic experience in echocardiography, in particular an introduction to scanning echocardiograms and beginning interpretation skills.  Third year fellows will have time to complete procedures needed to achieve the fellow’s desired level 2 certifications, such as Holter/Event monitor interpretation, ECGs, TTE scanning, TEEs and LHCs.

Cardiovascular Disease Fellow (PGY4-6) will serve as Consult Fellow at VAMC Consult Rotations.This rotation is primarily covered by PGY4 level fellows.Fellows training during PGY 4 year will be assigned VAMC Consult rotation 2 months during 12 month training period.Fellow will also serve “on-call” for assigned coverage during 12 month period.Fellows training during PGY 5/6 year will be assigned to VAMC Consult rotation as requested during 12 month academic year.Fellow during PGY5/6 will be assigned “on-call” as requested.

The primary goal of the VA Echo/CT Rotation is to provide the fellow with a general overview of all aspects of cardiac echocardiography and cardiac CT.  Fellows will work to acquire the necessary expertise required to perform and interpret transthoracic, transesophageal and stress echocardiography studies which are routinely encountered in the practice of general cardiology.  During this rotation, fellows will also be introduced to the acquisition and interpretation of cardiovascular CT imaging studies. 

Each fellow will complete 2-3 months on this rotation during the second and third years of training.  On this rotation, the fellow will learn principles of cardiac imaging as it pertains to the evaluation and management of patients with general cardiac disorders such as heart failure, coronary artery disease, valvular disorders, pericardial diseases and cardiac masses.

The primary goal of the VA Outpatient Rotation is to provide the fellow with experience in a wide range of non-invasive procedures as well as in cardiac consultation in the outpatient setting.  Each fellow will complete 2-3 months on this rotation during the first year of training.   

In addition, twice each week, the fellow will evaluate patients referred for outpatient cardiology consultation in New Patient Clinic.

Cardiac Catheterization Rotations take place at the Cincinnati VA Medical Center during the first year with rotations second and third year at the University of Cincinnati Medical Center.

The rotation at the Cincinnati VA Medical Center introduces trainees to heart catheterization and angiography. It also provides the experience necessary to achieve the skills required to independently and safely perform cardiac catheterization and to correctly interpret the hemodynamic and angiographic data obtained.

Each cardiology fellow will complete at least four months in the cardiac catheterization laboratories during the three years of the cardiovascular disease fellowship training.

Fellows desiring Level II certification in cardiac catheterization will need to meet rotation and competency requirements as outlined by ACC COCATS 4 .

Level II certification permits trainees to independently perform cardiac catheterization after completion of fellowship training. An additional year of training is required to practice interventional cardiology.  

In addition to technical procedure instruction, this rotation teaches fellows the indications and contraindications for cardiac catheterization, appropriate pre-procedure and post-procedure care, common complications of heart catheterization and interpretation of angiography.

In the UCMC and VAMC cardiac catherization laboratories, fellows will be instructed in vascular access, left and right heart catheterization, coronary and peripheral angiography, endomyocardial biopsy, intra-aortic balloon pump placement, temporary pacemaker placement and pericardiocentesis. Fellows will also be introduced to percutaneous coronary and peripheral intervention.