Program overview

Our mission is to train leaders in academic cardiovascular medicine for the twenty-first century and prepare our fellows to become nationally recognized as leaders and innovators – who will play a prominent and important role in the health care delivery systems of the future, and become role models for future generations of physicians. We strive to mentor fellows in developing a fellowship and career paths that are tailored to the unique goals of our fellows.

Our fellowship requires a minimum three years of general CVM fellowship training (ACGME) which includes a two-year clinical core curriculum (based on COCATS guidelines). It can also include one to three years of subspecialty/research training tailored to the needs of an individual fellow. The total length of training varies from three to six years depending on research and subspecialty training. We have an unparalleled number of training grants to support training across the full spectrum of basic, translational, clinical, and health services research.

Penn’s extremely competitive cardiovascular fellowship program, a leader in training heart specialists of tomorrow for more than 30 years, attracts more than 950 applicants for twelve fellowship positions annually.

Rotations

Our fellowship training program has a well-developed range of rotations to ensure each trainee receives a complete cardiovascular disease education in a variety of practice environments.

View a block schedule of our rotations

Our three primary training sites (Hospital of the University of Pennsylvania, Corporal Michael J. Crescenz Veterans Affairs Medical Center, and Penn Presbyterian Medical Center) are located within a 10-minute walk of each other in the University City section of Philadelphia.

Inpatient rotations include

  • General cardiology consults at the Hospital of the University of Pennsylvania, Corporal Michael J. Crescenz Veterans Affairs Medical Center, and Penn Presbyterian Medical Center
  • Cardiac floor rotations (where the fellow is the team leader) at the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center
  • Cardiac intensive care unit rotations (where the fellow is the team leader) at the Hospital of the University of Pennsylvania, Corporal Michael J. Crescenz Veterans Affairs Medical Center, and Penn Presbyterian Medical Center
  • Advanced heart failure/mechanical circulatory support/heart transplant consults at the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center. Ambulatory heart failure subspecialty rotations will also take place at Penn Presbyterian Medical Center
  • Electrophysiology consults at the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center
  • Adult congenital heart disease consults at the Hospital of the University of Pennsylvania and the Children's Hospital of Philadelphia

Procedural rotations include

  • Cardiac catheterization laboratory at the Hospital of the University of Pennsylvania, Corporal Michael J. Crescenz Veterans Affairs Medical Center, and Penn Presbyterian Medical Center
  • Electrophysiology laboratory at the Penn Presbyterian Medical Center

Cardiac imaging rotations include

  • Echocardiography (including transesophageal and structural echocardiography) at the Hospital of the University of Pennsylvania, Corporal Michael J. Crescenz Veterans Affairs Medical Center, and Penn Presbyterian Medical Center
  • Nuclear cardiology at the Hospital of the University of Pennsylvania
  • Multimodality imaging (cardiac CT and MRI) at the Hospital of the University of Pennsylvania

Ambulatory experience

Throughout their fellowship training, our fellows participate in at least two continuity ambulatory clinics where they are the primary clinicians caring for patients with a variety of cardiovascular diseases. There is typically one continuity clinic session/week when fellows are not on inpatient rotations.

Perelman Center for Advanced Medicine (PCAM) clinic: In this clinic, fellows are responsible for serving as the primary cardiologist for a panel of patients. Fellows typically will grow those panels by following patients they met on inpatient services as well as by seeing new patients referred to clinic for initial, second, or third opinions. They are assigned a clinic preceptor, based on shared interests, who serves as a clinical as well as longitudinal career mentor. Fellows are supported in clinic with a variety of multidisciplinary resources including administrative assistant, nurse, pharmacist, exercise physiologist, and dietician. They also have access to a comprehensive EHR dashboard to help review quality of care in their panel as a whole.

Fellows participate in in-person as well as telemedical encounters during these clinics.

VA clinic: The VA clinic continuity experience is based at the Corporal Michael J. Crescenz Veterans Affairs Medical Center. Having a continuity clinic at the VA allows fellows to gain experience both with a different patient population but also a different practice setting/model.

Penn Presbyterian (PHI) clinic: Clinical Track fellows will have a weekly continuity clinic with an attending clinic preceptor during here their 3 years of fellowship. Similar to the PCAM clinic, fellows with be the primary cardiologist for their panel of patients.

Fellows also participate in in-person and telemedical encounters during these clinics.

Fellows also have access to a variety of subspecialty ambulatory clinics which they can incorporate into their training (including continuity experiences over the course of one to two years). These clinics include but are not limited to the following areas:

  • Adult congenital heart disease
  • Cardio-oncology
  • Sports and exercise cardiology
  • Women's cardiovascular health/cardio-obstetrics
  • Preventative cardiology
  • Pulmonary vascular disease/pulmonary hypertension
  • Inherited heart disease and cardiovascular genetics
  • Perioperative cardiac medicine
  • Cardiac and vascular surgery
  • Outreach clinics located within and outside Philadelphia

Clinical Track

Watch video titled Cardiovascular Disease Fellowship Clinical Track on YouTube

The Penn Cardiovascular Disease Fellowship Clinical Track was formulated with the objective of training of future outstanding clinicians and leaders in cardiology.

The Cardiovascular Disease Clinical Track was developed to train the next generation of outstanding high-quality cardiologists.  Training at HUP and Penn Presbyterian Medical Center (PPMC) gives trainees access to a unique cardiology learning environment across two hospitals on the University of Pennsylvania Campus.  

As part of this pathway, trainees will focus on clinical cardiology, healthcare innovation, and quality improvement. 

Clinical Track fellows will spend a ½ day per week at their continuity clinic during most weeks with the same clinic attending preceptor/mentor during their three years of fellowship.  Clinical Track fellows start a three year long innovation project utilizing the Double Diamond approach, culminating in a scholarly project/paper by their third year.  Lectures include the business of medicine, and running multiple outpatient clinics in various urban and suburban settings.

This track is for you if:

  • You know you want a career that focuses on clinical cardiology
  • Your career interests include clinical leadership, clinical innovation, and quality improvement.
  • You are hoping to learn more about different outpatient practice sites, and their business model in today’s healthcare landscape
  • You have no plans to pursue a T32 or another research training grant
  • You are not interested in fast tracking into electrophysiology or interventional cardiology
  • You prefer to spend 3 dedicated years honing your general cardiology skills

All 12 fellows in both the traditional track and clinical track rotate through Penn Presbyterian Medical Center during their first 2 years. PPMC rotations during their first year include:

  • HVICU (Heart and Vascular Intensive Care Unit)
  • General cardiology consults
  • Echocardiography lab, with dedicated teaching attending
  • Electrophysiology: time spent in the EP lab, clinic, consults, and ECG reading

PPMC rotations during their second year include:

  • Vascular medicine/surgery: combination of clinic, vascular study interpretation, inpatient rounding, vascular procedures, OR time with Vascular surgery
  • Advanced heart failure rotation: time spent on specialty ambulatory clinics such as Amyloid, Pulmonary hypertension, and LVAD clinic as well as inpatient rounding/consults

3rd year of fellowship in the Clinical Track:

  • Additional 2-4 week rotations will include:
  • CT surgery: following patients from the OR → HVICU → floor until discharge
  • Critical Care: rounding with anesthesia intensivist in the HVICU
  • Junior Cardiologist Rounder as the primary inpatient cardiologist on floor patients with inpatient attending acting as preceptor
  • Additional rotations based on interest, with some examples:
    • Structural imaging
    • Interventional cardiology, including structural interventional
    • Electrophysiology
    • Advanced heart failure, including amyloid, pulmonary hypertension, etc.
    • Vascular Medicine
    • Cardio-Oncology
    • Preventative cardiology
    • General cardiology clinic at one of the other 12 sites

Research

Our fellows have access to the unparalleled resources of Penn Medicine and the University of Pennsylvania community in carrying out their research endeavors across the basic, translational, clinical, outcomes, and health systems/quality improvement science domains. The physical space of our training program in the Perelman Center for Advanced Medicine is co-located on the same floor with the Penn Cardiovascular Institute, home to many researchers within our community.

Highlights of opportunities for research include:

Resources for fellow research

  • Fellows within our program have access to the Penn Cardiovascular Disease Fellows' Innovation Fund, which provides end-to-end (study conception to publication) statistical support for fellow-initiated, faculty-mentored projects
  • Fellows can also access the division's cardiovascular informatics program which facilitates access to analytic datasets generated from the electronic health record at Penn under one unified, existing IRB protocol
  • Fellows are also financially supported to travel to and attend one national conference/year in addition to other conferences during which they are presenting their work

Research collaborations

Previous fellows have collaborated and developed research projects as well as obtained funding with/from many groups in the University of Pennsylvania community including:

Curriculum and virtual education

Our fellowship program prides itself in deliberately crafting a structured educational experience for our fellows. Each year, our chief fellows revise the curriculum based on direct feedback from fellows in the program. Additionally, we have been pioneering virtual education and the incorporation of technology into our educational programs for the last several years.

Weekly structured education schedule

We have conferences scheduled from 730am-0830am and 12p-1p each weekday with the expectation that fellows attend conference - this is baked into the culture of our fellowship program. Our conference series kicks off each year with a summer bootcamp series covering the basics of cardiovascular medicine.

  • Summer (July-September): Bootcamp lectures
  • Monday:
    • Fellows' case conference
    • Adult congenital heart disease case conference
    • Division Journal Club/Focused Topic Reviews
  • Tuesday:
    • Cardiac catheterization film review
    • Specialty series
    • Adult Congenital Heart Disease series
    • Health Systems Science/Quality Improvement Series
    • Cardio-oncology series
    • Women's Cardiovascular Health Curriculum (MUCHACHA)
    • Click here for a description of this curriculum published in JACC: Case Reports
    • Fellows' Professional Development Series/Fellows' Research Work-in-Progress
    • Fellow-focused catheterization film review
  • Wednesday:
    • Joint cardiovascular medicine/cardiovascular surgery conference
    • ECG conference
  • Thursday:
    • Cardiovascular Medicine Grand Rounds
    • Accompanied by fellows' conferences and meetings with grand rounds speakers
    • Echocardiography conference
    • Echocardiography research conference
  • Friday:
    • Cardiac catheterization film review
    • Multimodality Imaging Conference
    • Preventative Cardiology Conference

Innovation in fellowship education

Since 2016, we have hosted a virtual clinical learning environment/community containing recorded lectures and other resources. In 2020, we debuted our redesigned conference room (equipped with state-of-the-art video conferencing/broadcast facilities) and launched our Microsoft Teams collaboration platform. Each conference is broadcast live to the division community and recorded/posted on Microsoft Teams for fellow access anytime/anywhere.

Additionally, we use Microsoft Teams for fellow/faculty collaboration and live, ongoing case discussion.

We have also deployed other novel educational technologies including:cath simulator:

  • Simulation tools (using augmented reality/Microsoft HoloLens) for echocardiography and cardiac catheterization
  • Point-of-care ultrasound using the Butterfly ultrasound platform as well as sharing/recording of heart sounds enabled by the Eko platform
  • Audience participation in lectures through Poll Everywhere

Fellow wellness

Fellow wellness is a top priority within our fellowship training program.

Overview

In recent years we have implemented several interventions designed specifically to promote wellness within our fellowship community. Highlights include:

  • Addition of a cardiac sonographer on-call every night, on weekends, and and holidays
    • At the discretion of the on-call fellow, a sonographer is available to perform to perform echocardiograms both at the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center
  • On-call ride sharing provided through Uber
    • All fellows have access to fellowship Uber account through which rides can be charged when on-call
  • Regularly scheduled fellowship class dinners and happy hours throughout the city of Philadelphia
  • Access to the PennMedicineTogether wellness community and resources

Parenting and fellowship training

Fellowship is a busy time for growth of not only fellows' professional careers but can also be for fellows' families. Below are resources for information on parental leave as well as lactation.

Parental leave

Female and male fellows may use up to 12 weeks of FMLA leave in any rolling 12-month period for the birth, placement for adoption, placement for foster care of a child, or for the house officer’s own serious health concern or the serious health concern of a family member. Of the available 12 weeks, 4 weeks are typically paid vacation, another 6 weeks are paid without moonlighting, and 2 weeks are unpaid FMLA (with benefits). Doing this means that graduation from the general CVD program would be based on ABIM approval of Deficits in Required Training Time policy (please refer to the ABIM Policies and Procedures on Canvas) and demonstration of competency as judged by the fellowship clinical competency committee. Only program directors may request that the ABIM apply the Deficits in Required Training Time policy on a trainee’s behalf. This request can only be made during the trainee’s final year of training. In general fellows do NOT need to extend training if they take 12 weeks for FMLA once during their fellowship.

Lactation

Our fellowship program and the Division of Cardiovascular Medicine are committed to supporting physician-mothers who continue to breastfeed after returning from maternity leave. Typically, a nursing mother needs 25-40-minute break every three to four hours, including time to get to and from lactation areas. In order to uphold patient care and clinical continuity, fellows will provide advance notice to their Program Director and attendings on appropriate services if they require time to pump. Fellows will be allowed to step away from clinical duties at reasonable intervals and before and after cases whenever possible during procedural rotations (cath, ECHO, EP). Fellows will be allowed to leave mandatory conferences for pumping if necessary. Recognizing the challenges of pumping as a physician-mother, the Division of Cardiovascular Medicine continually seeks to promote a supportive environment and for our physician mothers and their well-being.