Fellowship - Trainee Rotations
- Daily Outpatient Clinics - The fellow first evaluates the patient, including the interpretation of laboratory data, then presents the findings and interpretations to one of the full-time staff who in turn examines the patient for final discussion and approval of the fellow's examination. The length of the outpatient service varies with the clinical experience and the needs of the trainee, but is usually one month in the first year and longitudinal follow-up of patients in two clinic days per month over the remainder of fellowship. These longitudinal clinics will consist of both “new” patients along with patients the fellow has previously managed.
- Echocardiography Laboratory - Instruction and experience are provided in the use of ultrasonic diagnostic techniques. With staff supervision, the fellow performs and interprets the studies. Four months are spent on this rotation in the first year. By the end of the first year, fellows will be able to do a complete transthoracic echocardiogram on any type of heart defect. Fellows may develop additional expertise in fetal echocardiography, transesophageal echocardiography, ventricular function assessment, and MRI in the third year of training.
- Inpatient Service - The fellow has the responsibility, with staff supervision, for the clinical management of the hospitalized patient. The fellow supervises the pediatric residents in the inpatient care of the patients. Approximately 50 of the 456 beds in Texas Children's Hospital are occupied by cardiac patients. The medical care of the preoperative and postoperative patients includes responsibility for the patients in the dedicated cardiac intensive care unit as well as the neonatal/pediatric intensive care units. Four months during the first year and two months during the second and third year are spent on this service.
- Cardiac Catheterization Laboratory (note to make link)- The fellow initially assists and learns the use of the equipment, then, with supervision, performs cardiac catheterizations, angiocardiograms, electrophysiologic studies and related procedures. The fellow presents the catheterization data and angiographic material as well as the features of the case at catheterization conference. Two months during the first year and three to four months during the second and third year are spent in this rotation.
- Electrophysiology - One month during the first year of fellowship and at least one month during the second year are usually spent on this rotation. The fellow interprets each ECG and 24-hour ambulatory ECG and reviews with one of the faculty electrophysiologists. During this period the trainee also participates in management of patients with arrhythmias, performing and interpreting intracardiac electrophysiologic studies, participating in pacemaker implantations for the cath lab performing radiofrequency ablations, using investigational antiarrhythmic agents and assisting in operating room mapping for ablation of arrhythmia.
- Exercise Laboratory - The trainee participates in exercise testing and reviews results with staff and the exercise physiologist during outpatient or catheterization rotations.
- Research - Investigative studies are encouraged and expected of the trainee during clinical rotations and, in addition, various periods are set aside each year (for a total of 12 months during the three years of training). The fellows will have published a manuscript in a peer review journal during their fellowship.
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