IM PGY2-3: Cardiovascular Medicine - Subspecialty Rotation(s)

Course Director: Robert C Bernstein, MD

Rotation Format: IM PGY2-3. One to four week inpatient rotation. No night call. No weekends. Designed to be 1, 2, 3 or 4 one week each subspecialty rotations to include

1. Advanced Heart Failure / Cardiac Transplant;
2. Cardiac Electrophysiology;
3. Interventional Cardiology; 
4. Structural Heart. Longer 2, 3, or 4 week single subspecialty rotations arranged on an individual basis.

Site Lead: Amit Badiye, MD

Course Location: Norfolk General Hospital

Course Description:

Busy predominantly inpatient service focusing on the clinical assessment, decision making, and acute care management of patients with refractory heart failure including shock, mechanical circulatory support, and cardiac transplant. Rotation includes significant Cardiac Intensive Care Unit and Cardiac Surgical Intensive Care Unit exposure as well as cardiac cath lab based procedures and cardiothoracic surgical operative procedures.

Learning Objectives:

1) Perform a targeted heart failure history and exam including pertinent negative and positive findings;
2) Develop a heart failure differential diagnosis, assessment, and plan;
3) Appropriate use specific heart failure and cardiac transplant lab, non-invasive, and invasive testing including study limitations;
4) Cardiac invasive hemodynamics associated with heart failure and shock, and how they correlate with exam findings and clinical presentations;
5) In depth pharmacology of intravenous and oral medications employed for management of cardiac transplant and rejection, cardiogenic shock, and acute and chronic heart failure including basic and advanced guideline directed medical and device therapies for advanced heart failure.

Rotation Format: IM PGY2-3. One week inpatient rotation. Longer 2, 3, or 4 week Advance Heart Failure/ Cardiac Transplant subspecialty rotation arranged on an individual basis. No night call. No weekends. Designed to be part of a 1, 2, 3 or 4 one week each multi-cardiac subspecialty rotation to include 1) Advanced Heart Failure / Cardiac Transplant; 2) Cardiac Electrophysiology; 3) Interventional Cardiology; and 4) Structural Heart.

Additional preceptors: Admit Badiye, MD; John Herre, MD; Wayne Old, MD; Edward Sawey, MD; Zachary Tushak, DO; Amin Yehya, MD

Site Lead: Erich Kiehl, MD

Course Location: Norfolk General Hospital and Careplex Hospital

Course Description:

Busy inpatient service focusing on the clinical assessment, decision making, and acute care management of patients with tachycardic or bradycardic heart rhythm abnormalities, syncope, and sudden death. Rotation includes significant observation and analysis of ECGs and cardiac electrophysiology procedures including a wide range of catheter ablations, pacemaker and implantable cardioverter defibrillator implantation, and device and lead extractions.

Learning Objectives:

1) Perform a targeted heart rhythm, syncope, or aborted sudden death history and exam including pertinent negative and positive findings
2) Develop a dysrhythmia, syncope, or aborted sudden death differential diagnosis, assessment, and plan
3) Appropriate use of specific cardiac rhythm abnormality targeted lab, non-invasive, and invasive testing including study limitations
4) Improve understanding of the variety of presentations associated with rhythm abnormalities including activity limitations, syncope, and sudden death
5) In depth pharmacology of intravenous and oral medications employed for management of cardiac rhythm disorders including basic and advanced guideline directed medical, device, and ablation therapies for patients with heart rhythm abnormalities
6) Improved skill ECG analysis of cardiac rhythm disorders.

Rotation Format: IM PGY2-3. One week inpatient rotation. Longer 2, 3, or 4 week Cardiac Electrophysiology subspecialty rotation arranged on an individual basis. No night call. No weekends. Designed to be part of a 1, 2, 3 or 4 one week each multi-cardiac subspecialty rotation to include 1) Advanced Heart Failure / Cardiac Transplant; 2) Cardiac Electrophysiology; 3) Interventional Cardiology; and 4) Structural Heart.

Additional preceptors: Tanya Geronilla, MD; Phillip Gentlesk, MD; Jon Grammes, DO; Jeffrey Hedley, MD; Venkat Iyer, MD; Erich Kiehl, MD; Olusesi Olusegun, MD; Divyang Patel, MD; Ian Woollett, MD; Allen Ciuffo, MD; Maruthi Gottimukkala, MD

Site lead: Paul Lavigne, MD

Course Location: Norfolk General Hospital

Course Description:

Busy inpatient service focusing on the clinical assessment, decision making, and acute care management of patients with acute coronary syndromes. Rotation includes significant evaluation and analysis of coronary anatomy and risks for disease progression. There is a focus on the medical and procedure based treatments of coronary artery disease and medical and lifestyle measures for coronary disease risk reduction. There is extensive opportunity for observation of a variety of cath lab procedural interventions.

Learning Objectives:

1) Perform a targeted atherosclerotic disease history and exam including pertinent negative and positive findings as well as family and personal history;
2) Develop a differential diagnosis, assessment, and plan;
3) Appropriate use of specific coronary disease targeted lab, non-invasive, and invasive testing including study limitations;
4) Improve understanding of the variety of presentations associated with coronary abnormalities including activity limitations, gender and racial disparities, and sudden death;
5) In depth pharmacology of intravenous and oral medications employed for management of acute coronary syndromes and future risk reduction;
6) Improve skill ECG analysis of acute coronary syndromes.

Rotation Format: IM PGY2-3. One week inpatient rotation. Longer 2, 3, or 4 week Interventional Cardiology subspecialty rotation arranged on an individual basis. No night call. No weekends. Designed to be part of a 1, 2, 3 or 4 one week each multi-cardiac subspecialty rotation to include 1) Advanced Heart Failure / Cardiac Transplant; 2) Cardiac Electrophysiology; 3) Interventional Cardiology; and 4) Structural Heart.

Additional preceptors: David Adler, MD; Ramin Alimard, MD; Alan Banks, MD; Allen Ciuffo, MD; Maruthi Gottimukkala, MD; Justin Heizer, MD; Luke Kohan, MD; Paul Lavigne, MD; Petra Lynch, MD; Partha Manchikalapudi, MD; Ronald McKechnie, MD; Edward Miller, MD, James Miller, MD; Amol Raizada, MD; Scott Robertson, MD; Megan Sattler, MD; Ronald Stine, MD; Matthew Summers, MD; Deepak Talreja, MD

Site lead: Matthew Summers, MD

Course Location: Norfolk General Hospital

Course Description:

Busy inpatient service focusing on the clinical assessment, decision making, and acute care management of patients with structural heart abnormalities. Rotation includes the evaluation and analysis of heart valve pathology and septal defect anatomy as well as disease progression. There is a focus on the medical and procedure based treatments for valve regurgitation and stenosis including percutaneous valve repair and replacement and indication and procedures related to septal defect closure. There is extensive opportunity for observation of a variety of cath lab and operating room procedural interventions.

Learning Objectives:

1) Perform a targeted valve and septal defect based disease history and exam including pertinent negative and positive findings as well as family history;
2) Develop a targeted assessment and plan;
3) Appropriate use of specific structural heart disease targeted lab, non-invasive, and invasive testing including study limitations;
4) Improve understanding of the variety of presentations associated with valve and septal abnormalities including activity limitations;
5) In depth pharmacology of intravenous and oral medications employed for management.

Rotation Format: IM PGY2-3. One week inpatient rotation. Longer 2, 3, or 4 week Structural Heart subspecialty rotation arranged on an individual basis. No night call. No weekends. Designed to be part of a 1, 2, 3 or 4 one week each multi-cardiac subspecialty rotation to include 1) Advanced Heart Failure / Cardiac Transplant; 2) Cardiac Electrophysiology; 3) Interventional Cardiology; and 4) Structural Heart.

Additional preceptors: David Adler, MD; Matthew Summers, MD; Deepak Talreja, MD