Nicklaus Children's Hospital is proud to have an ACGME accredited Pediatric Cardiology Fellowship Program. The fellowship is a three-year training program with two fellows per year. The Heart Institute at Nicklaus Children's Hospital has an outstanding faculty of 16 cardiologists, six cardiac intensivists, three dedicated pediatric cardiac anesthesiologists, two cardiac surgeons, three cardiac imaging physicians, two interventional cardiologists and 16 dedicated nurse practitioners that participate in training the fellows.
The cardiac catheterization program performs over 300 cardiac catheterizations a year with a strong emphasis on interventional procedures. The cardiac surgical program lead by Dr. Redmond Burke, Director of Cardiovascular Surgery, performs over 200 open-heart cases a year.
Nicklaus Children's Hospital prides itself in utilizing collaborative and innovative surgical and interventional strategies to achieve the best possible outcomes for patients with simple and complex congenital heart disease. US News and World Report recognizes Nicklaus Children's Hospital, among one of the top pediatric cardiology and heart surgery programs in the United States. Nicklaus Children's Hospital is the largest freestanding children’s hospital in Florida and the pediatric teaching hospital for the Florida International University Herbert Wertheim College of Medicine.
Curriculum
The goal of the fellowship program is to graduate well-rounded pediatric cardiologists able to provide the highest quality of care to patients from infancy through adulthood. The fellowship will be a three-year program divided into 24 months of clinical rotations and 12 months of research. In addition, fellows will enjoy a robust clinical experience rotating through our dedicated 34 bed cardiac-intensive care unit, inpatient floor, ambulatory offices, electrophysiology lab, non-invasive imaging lab and a new state-of-the art hybrid catheterization lab. Non-invasive imaging includes TTE (2D and 3D), TEE, fetal echo and cardiac MRI.
The objectives of the fellowship program are to train our fellows to:
- Be well-versed in all aspects of cardiology (cardiac anatomy, cardiac physiology, non-invasive cardiac imaging, cardiac catheterization, electrophysiology, cardiac critical care medicine, inpatient and outpatient cardiology)
- Be empathetic professionals that use a patient centered approach
- Find a career in cardiology that excites them and pushes them to innovate the field
The program’s educational content includes an extensive curriculum filled with interactive lectures and conferences as well as block rotations in non-invasive imaging (echocardiography and cardiac MR), cardiac critical care medicine, cardiac catheterization and electrophysiology, inpatient / outpatient cardiac service and research. In all of the clinical areas, the fellows are supervised by faculty which allows the fellows to have progressive autonomy through direct and indirect supervision. The faculty and fellows both regularly evaluate the program and each other to help improve the program, the faculty and the fellows. As a referral tertiary care center, the fellows are exposed to a large volume of cardiac patients with a varying mix of pathology, complexity, and volume. The Research Institute provides the infrastructure for research support including regulatory function and IRB. The GME provides the institutional support for the educational activities such as the common fellowship curriculum, faculty development, Grand Rounds and other hospital wide conferences that supplement the division-specific conferences.
Each fellow has five clinical rotations in the CICU over the course of the fellowship. (A senior CICU fellow and a critical care fellow share responsibilities and call while rotating in the CICU.) The fellow in the CICU is responsible for the cardiology and intensive care management of the cardiac surgical and cardiac medical patients. In addition, the fellow is responsible for presenting the CICU patients in the Wednesday morning CICU Grand rounds each week. The clinical commitment is less than 80 hours/week including call. One attending intensive care staff is responsible for providing direct supervision of patient care and teaching during daily rounds and while on call. Fellows receive training in cardiac pathophysiology, cardiology and intensive care management, and critical care monitoring and procedures.
Each fellow has seven clinical rotations in the non-invasive lab over the three year fellowship. Fellows learn echocardiography (mainly transthoracic and some tranesophageal / fetal echo) as well as some cardiac MR through hands-on experiences guided by cardiac sonographers, senior cardiology fellows, and cardiology attendings specializing in echocardiography and cardiac MR. In addition, a weekly didactic on echocardiography is presented by the senior fellows and attending cardiologists for the fellows’ education. The fellow takes an active role in the laboratory performing echocardiographic scanning and also echocardiographic interpretation of anatomic, doppler and ventricular function studies.
Each fellow has six clinical rotations on the cardiology service over the course of the fellowship. The fellow leads and teaches (informally and formally) a team of pediatric residents and medical students in the management of patients on 2 Bed Tower (cardiac inpatient floor) and the ambulatory cardiology clinic. The fellow also assists the surgical team (including nurse practitioners) in the preoperative ambulatory visit and the postoperative care of the cardiac patients convalescing on the floor by assuming the role of the consulting cardiologist and/or the primary medical doctor. Additional clinical responsibilities include cardiology consults throughout the hospital, interpreting EKGs and 24 hour holter monitors, and assisting in cardiopulmonary and exercise stress tests. Supervision of all clinical responsibilities is provided by the attending cardiologist assigned to the particular area of the cardiology service.
Each fellow is assigned to a weekly half day clinic, which is supervised by at least one attending cardiologist. Fellows evaluate, treat and plan the medical care of patients referred to the clinic for outpatient evaluation. The fellow also provides continuity of care to those patients with simple to serious cardiac problems that necessitate further follow up in the ambulatory cardiology clinic. Fellows see patients assigned to their clinic day and/or patients that they assumed from a previous inpatient clinical rotations. The follow up appointments are scheduled by the fellow in the EMR with the assistance of the physician support staff. The fellow accomplishes this task by looking at their schedule to see what day that he or she has clinic during a particular month and having the physician support staff mark the appointment in the EMR and contact the fellow upon the patients return to clinic.
Each fellow has four rotations in catheterization/electrophysiology. The responsibilities of the fellow include preparation of the case, review of informed consent with the patient's family on the day of the procedure or the day prior to the procedure, presentation of the case at morning conference, performance of the catheterization with a staff physician, and analysis and review of the data at the end of the day. As the rotation progresses, the fellow learns to obtain a complete set of hemodynamics, saturations and angiographic data in a safe and expedient manner. Training in catheterization of the newborn infant and interventional procedures will also be taught throughout the rotations. One day a week, the fellow will also be responsible for assisting the attending electrophysiologist in intracardiac electrophysiology studies, ablations and intraoperative procedures. In addition, the fellow will assist the EP attending with consults on inpatients and selected outpatients with arrhythmias.
The Division of Cardiology maintains that experience in cardiovascular research is an essential component of fellowship training in cardiology. Fellows have 12 months of research over the course of their fellowship. Fellows are expected to get involved in a research project during their fellowship, under the guidance of one of the faculty. Such projects, either new or ongoing, will often be of the chart review type, and may form the basis for a future prospective study for those fellows interested in clinical research. Fellows need to identify a research mentor from among the faculty by the end of their first year. The faculty assists the fellows in identifying projects, resources, and mentors. A scholarship oversight committee (SOC) is assigned to each fellow to biannually monitor and review the fellow’s progress throughout fellowship training. During the first half of the second year, the fellow is expected, with appropriate guidance, to write and submit an IRB proposal for a research project which: (1) addresses an important question; (2) applies available state-of-the-art techniques to answering that question; and (3) is practical within the time and other constraints of the fellowship. By the end of the fellowship, each fellow should have been intimately involved with a research study such that has given the fellow an opportunity to produce a meaningful research product as determined by their individual SOC. Preferably each fellow produces a meaningful product like a manuscript that is either ready for submission or has been submitted and accepted for publication in a peer review journal.
In addition, the research fellow is responsible for reviewing and presenting a current or relevant journal article in the monthly fellow journal club.
How to Apply
Applications should be submitted through the ERAS system.
For questions or more information contact:
Jason C. Katz, MD (jason.katz@nicklaushealth.org)
Director, Pediatric Cardiology Fellowship Program
Attending Pediatric Cardiologist and Cardiac Intensivist
Nicklaus Children's Hospital
3100 SW 62nd Avenue
Miami, Florida 33155-3009
Office: 305-662-8301
Fax: 305-662-8304
Odalys Orellana (Odalys.orellana@nicklaushealth.org)
Program Coordinator
Pediatric Cardiology Fellowship Program
Nicklaus Children's Hospital
3100 SW 62nd Avenue
Miami, Florida 33155-3009
Office: 786-624-4348
Fax: 305-662-8304
In accordance with the ACGME requirements, each training program is expected to form a Clinical Competency Committee (CCC). The program director appoints the CCC. The CCC must have at least three program core faculty (excluding the program director) who have the opportunity to observe and evaluate the residents. The CCC meets at least semi-annually to review and discuss each individual residents’ performance data and make a consensus decision on the progress of each resident by applying assessment data to the milestones. The CCC serves as an early warning system/ early identification if a resident fails to progress in the educational program and make recommendations to the program director for resident progress including promotion, remediation, and dismissal. The program director meets with each resident semi-annually to review the CCC report and design an individualized learning plan for the resident. To learn more about the CCC, click here.
Below are the faculty members who serve on the CCC committee (in addition to the Program Director) for the Pediatric Cardiology Fellowship Program:
- Sherrie J. Baysa, MD
- Juan Bolivar, MD
- Danyal Khan, MD
- Michael M. Lopez, MD
- Yadira Martinez, MD
- Juan Carlos Muniz, MD
- Madalsa Patel, MD
- Lourdes Prieto, MD