Cardiovascular Disease Fellowship Program

Mission Statement

The HCA Florida Citrus Hospital Cardiovascular Disease Fellowship Program's mission is to develop the next generation of physicians and physician leaders.

As a part of HCA Healthcare, we are driven by a single mission: Above all else, we are committed to the care and improvement of human life.

This program is designed to offer fellows a rewarding, educational environment where residents are provided individualized learning opportunities by faculty and staff who support and sustain one another throughout quality care delivery. Our faculty are committed to ensuring the fellows’ clinical experience and educational needs are fulfilled while expanding fellows’ perspectives to be inclusive of cultures, values and ideals.

Program Overview

The Cardiovascular Disease Fellowship Program at HCA Florida Citrus Hospital, a part of HCA Healthcare/USF Morsani College of Medicine's GME Program has the following aims:

• Develop and maintain high-quality clinical and curricular studies in Cardiovascular Disease that prepare fellows to cultivate the sound judgments required to be successful, independent cardiologists.
• Provide fellows and faculty with opportunities and resources to pursue and complete quality improvement and scholarly activities, instilling a culture of quality care and life-long learning.
• Encourage and support faculty development opportunities with the goal of providing excellent education, role-modeling, and mentorship to the Cardiovascular Disease fellows.
• Instill the habits of self-reflection and self-improvement for fellows to evaluate their own knowledge, skills, and behaviors throughout the fellowship program and after entering autonomous practice.

During the training program, the fellow will be expected to select a mentor from the Cardiovascular Faculty at HCA Florida Citrus Hospital to guide them through their selected tracks. The fellow will also work closely with the mentor to come up with a research idea in their first year, finish the project in their second year and publish their findings in a peer-reviewed journal or present their findings in one of the national meetings such as the American College of Cardiology (ACC) or the American Heart Association (AHA).

In conjunction with the American Board of Internal Medicine (ABIM) training requirements, a clinic consisting of continuous patient care exposure will be part of the fellowship training program. We offer three clinic locations, at our Inverness and Crystal River offices.

Curriculum and Rotation Schedule

Rotations

Fellows can expect a vigorous clinical experience with exposure to a range of patient settings each year, including:

First-year rotations

Fellows rotate on the consult service, noninvasive service and cardiac catheterization lab. On the cardiology consult service and cardiac intensive care unit (ICU) services, the fellows are exposed to an extremely busy and active service.

Fellows will be trained in a multitude of cardiovascular problems in extremely complex patients with multiple co-morbidities due to the advanced age of the local population. They will be taking care of cardiovascular patients with conditions, including acute heart failure, cardiogenic shock, arrhythmias, acute coronary syndrome and valvular heart disease. Fellows will be trained in various procedures including placement of temporary venous pacemakers, cardioversion and right heart catheterization.

On the non-invasive services, the fellows will be taught how to perform and interpret electrocardiographs (ECGs), Holter monitors, stress tests, 2D echo, motion-mode (M-mode) echocardiography (EKG), color Doppler, and contrast EKG examinations. During the first year, fellows will rotate on the cardiac catheterization service to gain an introduction into the cardiac catheterization laboratory and learn about cardiovascular hemodynamics.

Second-year rotations

Fellows rotate on clinical, non-invasive, and invasive services. During the second year, the major emphasis is on the development of skills in the cardiac catheterization laboratory and in the electrophysiology laboratory. Fellows are responsible for helping to perform, interpret and report diagnostic coronary angiography, left heart catheterization, insertion of permanent pacemakers and implantable cardioverter defibrillators.

On the non-invasive services, they will be expected to interpret and perform transesophageal echocardiography in the outpatient, inpatient, and surgical arenas. They will also perform pharmacologic, contrast and stress echo procedures. Fellows will also have increasing exposure to structural heart planning (CT) and management post-procedure.

Third-year rotations

During the third year, fellows will be expected to have selected a pathway to which they would like further exposure. This year will involve further training and experience in either a clinical sub-specialty or research. Although the primary emphasis will be on developing and completing that pathway, they will also continue to be exposed to both outpatient and inpatient clinical responsibilities. The amount of time devoted to research, cardiac cath lab, EP lab, or clinical exposure will vary considerably depending on the fellow’s interests and career goals.

During the training program, the fellow will be expected to select a mentor from the Cardiovascular division faculty at HCA Florida Citrus Hospital to guide them through their selected tracks. The fellow will also work closely with the mentor to come up with a research idea in their first year, finish the project in their second year and publish their findings in a peer-reviewed journal or present their findings in one of the national meetings such as ACC or AHA.

Curriculum

Our curriculum gives fellows exposure to a variety of sub-specialties that strengthen their cardiovascular training, including:

PGY 4 rotation duration

We offer first-year fellows training in core cardiac specialties such as:

• Cardiology Consultations 4 months
• Cardiac Intensive Care Unit 2 months
• Nuclear Cardiology 1 month
• Echocardiography 1 month
• Electrophysiology 1 month
• Cardiac Catheterization Laboratory 2 months

PGY 5 rotation duration

Fellows can expect to build on experienced developed during their first year through advanced study, including:

• Cardiology Consultations 3 months
• Cardiac Intensive Care Unit 1 month
• Nuclear Cardiology 1 month
• Echocardiography 2 months
• Electrophysiology 1 month
• Cardiac Surgery 1 month
• Cardiac Catheterization Laboratory 2 months
• Elective 1 month

PGY 6 rotation duration

During the last fellowship year, our physicians continue to hone core cardiac skills plus gain exposure to sub-specialties. Rotation includes:

• Cardiology Consultations 3 months
• Nuclear Cardiology 1 month
• Echocardiography 2 months
• Electrophysiology 1 month
• Peripheral Vascular Management 1 month
• Cardiac Catheterization Laboratory 1 month
• Elective 3 months

Elective Rotations

Elective rotations expose fellows to additional cardiac sub-specialties, including:

• Advanced Heart Failure
• Cardiac computerized tomography (CT)
• Cardiac magnetic resonance imaging (MRI)
• Electrocardiography
• Electrophysiology
• Nuclear Cardiology

Vacation

There will be four weeks of vacation per PGY year. Vacation should not be more than two weeks at a time. Vacation will not be considered during Cardiac Intensive Care Unit rotations.

Salary & Benefits

Salary

Benefits

Program budgets include the following additional benefits:

• Professional Memberships
• Conference and Travel Expense
• Cell Phone
• Laptop/iPad
• Other Board Prep and Educational Expense
• Step 3 Reimbursement