What’s New with the Cardiology Fellowship Program

Founded in 1949 by Alexander Nadas, MD, the Cardiology Fellowship Program at Boston Children’s Hospital is one of the oldest in the country, having graduated nearly 400 fellows. However, the program has remained a fertile training ground, preparing trainees to work at the forefront of their field.

David Brown, MD, director of the Fellowship Training Program, makes it a priority to keep the program current, by continually looking at ways to improve and innovate.

“Every year, we try to focus on two or three things we want to change, because I’m never happy with the status quo,” says Brown. “Just like the field of cardiology itself keeps rapidly moving and changing, so the way we train fellows should change as well.”

Boot camp for all trainees

One aspect of the program that sets it apart is the month-long boot camp for all first-year fellows. Now in its fifth year, the boot camp is the longest of any cardiology fellowship program in the country.

“Many programs have short boot camps that focus on anatomy or pathology or imaging. We have the only one I’m aware of that’s all-encompassing,” says Brown. He says the goal was to focus as much as possible on experiential learning. “We specifically didn’t want our new fellows in a classroom for a month. We wanted them immersed in a clinical learning environment as much as they could be, without being the primary fellow responsible for the patient’s care.”

Boot camp allows new fellows to learn about how care is delivered in the Heart Center, while acquiring practical skills, such as how to move cameras in the catheterization lab, using a passport-type checklist of skills. “We’ve reduced the number of didactic lecture sessions because they get more out of experiential learning,” says Brown. “We’ve also increased the simulation-based learning as much as possible.”

Brown leading a discussion with a class of fellows

Brown says the boot camp has made a big difference in the fellows’ confidence and skill level. “We’ve seen that the timing in their training at which they start to gain competence in a given skill, such as imaging, has been accelerated,” he says. “And the focus on anatomic knowledge has increased their confidence.”

Another benefit of the boot camp has been the fellow-to-fellow bonding. “It used to take a full year or two to see the class coalesce. But because they spend a month together, it’s all accelerated and they get to know one another very well. It’s been a wonderful, unexpected benefit of the boot camp.”

Focus on ICU training

Another area that sets the program apart is that the core requirements are generally longer than most other programs, including six cardiac intensive care unit (ICU) rotations instead of the usual four.

“We’re a little ICU-heavy,” says Brown. “I think it’s a huge strength for us because the ICU is really the nexus of program, where all of our sub-disciplines come together around acute patients’ care.”

New areas of focus

Over the past few years, the program has expanded the number of fourth-year training options offered to fellows. These include preventive cardiology with Sarah de Ferranti, MD, one of the few such programs in the country, as well as advanced training in electrophysiology with Dominic Abrams, MD.

The program also offers training in advanced cardiac therapies, which has replaced the Heart Failure Program. “Advanced cardiac therapies incorporates training in ventricular assist devices (VADs), an area that is really exploding now,” says Brown.

A class of fellows engages in a lively discussion

Another new focus of training has been the quality improvement (QI) curriculum. Fellows are encouraged to choose an area of interest within the Heart Center in which they can learn about.

“We’re always trying to think outside the box in terms of getting fellows individualized skills and expertise,” says Brown. “We try to think about each fellow’s training almost like a college major, and not only what training we can offer in the greater Longwood area, but also throughout the Harvard-wide system and beyond.”

Where are our fellows now?

We have graduated more than 390 trainees to date.

Of the 331 trainees who are more than 10 years out:

  • 91 attained rank of full professor
  • 20 have been department chairs
  • 42 have been pediatric cardiology division chiefs
  • 7 have been directors of research institutes
  • 16 have been leaders in the biopharmaceutical industry
  • 2 have directed foundations
  • 1 was federal assistant secretary of HHS
  • 1 was provost of Brandeis University