The Interventional Cardiology Fellowship at Massachusetts General Hospital is a one-year ACGME-approved program, organized under the directorship of Douglas Drachman, MD. The fellowship functions as an integral component of the subspecialty residency in cardiology and the categorical residency program in internal medicine. During the year of interventional training, fellows are expected to master the techniques involved in coronary intervention, while developing perspective on procedural risk and benefit, patient selection and clinical decision-making in cardiovascular patient care. At the end of the year, fellows should function as independent operators during interventional procedures. The program adheres to the tenets outlined in the ACC COCATS guidelines document and the AHA statement on clinical competency in interventional cardiology.
The primary goal of the Interventional Cardiology Fellowship is to provide comprehensive training in the diagnosis, care and endovascular treatment of patients with cardiovascular disease. Fellows graduating from Mass General's program will be poised to assume positions of leadership in the field of Interventional Cardiology. The fellowship program provides the opportunity to acquire procedural expertise including but not limited to:
In additional to learning techniques for percutaneous coronary intervention, fellows will be exposed to non-coronary cardiac interventions and management of peripheral vascular disease.
Non-coronary interventions include:
Peripheral evaluations and intervention include percutaneous treatment of arterial disease in the following distributions:
Clinical investigations include the use of novel devices for percutaneous treatment of coronary artery disease, non-coronary cardiac interventions such as percutaneous valve replacement, drug-eluting stent studies, stem cell and angiogenesis factor treatment for patients with end-stage coronary and peripheral arterial disease and novel imaging technologies.
The clinical fellows are responsible for seeing patients pre- and post-cath. They are involved in the daily care of these patients, including their pre-catheterization evaluation. The clinical fellow participates in daily rounds on these patients. All cases are discussed in the morning prior to the days procedures. There is a comprehensive core curriculum lecture series that includes didactic presentations, as well as a journal club and an intensive morbidity and mortality review.
Those graduating from the one-year program will easily exceed the minimum ACGME requirement of 250 coronary interventions, where a single coronary intervention is defined as all coronary interventions performed during one hospitalization. The ACC recommends a maximum participation level at 600 procedures per year. We anticipate that each fellow will perform between 300 to 350 coronary interventions during the one-year program. Fellows will be the primary operator on the majority of these cases. Our curriculum meets the requirements specified by the American College of Cardiology for interventionalists; our high volume and high level of case complexity provide an excellent foundation to develop expertise as an independent operator.
The Interventional Cardiology Fellowship Program allows fellows the opportunity to work with a variety of highly-qualified invasive cardiologists in the setting of an extremely active program which performs approximately 6,000 cases per year. The case material is varied and challenging, as Massachusetts General Hospital serves both as the primary hospital for the local neighborhood as well as a tertiary referral center which draws patients from affiliated hospitals and health centers throughout Massachusetts. Massachusetts General Hospital also attracts patients from across the United States and internationally. Furthermore, the Interventional Program is academically based and has approximately 20 active research protocols including multicenter and investigator-driven trials. This provides ample opportunity for fellows to pursue their research interests. Additionally, there is ample faculty mentorship and animal facility access for fellows who wish to focus on translational research.
The Knight Cardiac Catheterization Laboratory is located on the 9th floor of the Blake building on Mass General's main campus. The laboratory is comprised of six state-of-the-art, high-resolution digital fluoroscopy units, which are networked throughout the hospital. A wide variety of diagnostic and interventional procedures are performed in these laboratories, with approximately 6,000 cases done per year, approximately 1,400 of which are coronary interventions. While patients from throughout the hospital may be referred to the Cardiac Catheterization Laboratory for invasive assessment, the majority of patients with acute cardiovascular illness are managed on Ellison 9, Ellison 10 or Ellison 11. Ellison 9 is the Cardiac Intensive Care Unit (CICU); Ellison 10 is the Stepdown Unit (SDU); and Ellison 11 is the Access unit. Outpatient care for patients of the Interventional Cardiology Associates practice is provided on the 8th floor of the Gray-Bigelow building.
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Interventional Cardiology Fellowship - Massachusetts General Hospital ...
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