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The Heart Institute
for Children (THIC) and its Pediatric Cardiology Fellowship
Program educates physicians-in-training at the Advocate Hope
Children’s Hospital/Advocate Christ Medical Center located in
Oak Lawn, Illinois, a southern suburb of metropolitan Chicago.
In 1987, a group of academic clinicians from several medical
schools joined together to form this centralized clinical model
specifically to provide excellent cardiac care for children and
to provide excellent training programs in Pediatric Cardiology
through the Institute's commitments in clinical and basic
research in the pursuit of the nature, the cause and the
treatment of pediatric heart disease.
The pediatric cardiac
program functions under the supervision of the members within
The Heart Institute for Children with its four divisions:
medical, surgical, cardiac pathology and research/education. The
medical division has the clinical service
(inpatient/outpatient), critical care service, and the
invasive/non-invasive cardiac diagnostic service as its three
main service areas. These highly specialized cardiac services
for infants and children are provided at the 827-bed,
not-for-profit teaching hospital, Advocate Christ Medical
Center/Advocate Hope Children’s Hospital which is affiliated
with the University of Illinois. Advocate Hope Children’s
Hospital, located on the campus of Advocate Christ Medical
Center, opened in 1996 with a vision of providing state-of-art,
superior pediatric care to children and families throughout
Chicago and the Midwest. The four-story, 69-bed pediatric
medical facility is the third largest freestanding children’s
hospital in the Chicago area. Our institution has accredited
residency programs in emergency medicine, family practice,
internal medicine, adult cardiology, general surgery, neurology,
obstetrics/gynecology, orthopedics, and pediatrics. We are one
of the three accredited Pediatric Cardiology Fellowship Training
programs in the state of Illinois.
The Cardiothoracic
surgical division for congenital/acquired heart disease in
newborns, infants and children is supported by two full time
Pediatric cardiac surgeons. In addition, they provide the
services for the ECMO (Extracorporeal Membrane Oxygenation)
program as well as supervising the "specialized" training
program in Pediatric Cardiac Surgery where a fully- trained
cardiothoracic surgeon may be certified for the one year
experience in this area of congenital heart surgery. Being a
very active clinical cardiac service, over 400 surgical
operations are performed per year. 70% of these are open-heart
cases.
Sixteen full-time
pediatric cardiologists provide the clinical cardiology service
and contribute to the educational and training programs. A total
of more than 10,000 outpatient evaluations are seen per year at
the Advocate Hope Children’s Hospital and at our other various
off-campus sites. The clinical service area includes 14 major
community hospitals, covering nearly 35,000 live births in an
area encompassing nearly 400 square miles.
The Pediatric Cardiac
Catheterization laboratory performs approximately 300 cases per
year. Our full time Pediatric Echocardiographic Laboratory
performed 5,500 studies per year. Exercise stress tests,
transesophageal electrophysiologic studies, intracardiac
Electrophysiologic and interventional procedures, Radio
Frequency Ablations and Tilt-tests are performed in dedicated
laboratory space. (See Table below.)
|
Special
Laboratory Prrocedures |
|
1 |
Transthoracic Echocardiogram |
5,500 |
| |
Transesophageal Echocardiogram |
200 |
| |
Intracardiac Echocardiogram |
25 |
| |
Fetal Echocardiogram (All campuses) |
2000 |
| |
|
|
|
2. |
Cardiac invasive studies |
|
| |
Cardiac Catheterization total |
340 |
| |
Intervention (balloon septostomy,
Coils, valvuloplasty, biopsy, etc) |
220 |
| |
Intracardiac Electrophysiologic studies + RF
ablation |
150 |
| |
|
|
|
3. |
Tilt tests |
120 |
THIC also provides the echocardiography interpretation for many
hospitals for additional 6000 echocardiogram per year.
The Congenital Heart
and Conduction System Center is a unique aspect of our cardiac
morphology/pathology division which is currently headed by a
nationally recognized cardiac pathologist. It provides an
outstanding collection of cardiac specimens which are
categorized for study and on-going research. CT Cardiac Imaging
and Cardiac MRI scans are also performed at our campus.
The fellowship
training program in Pediatric Cardiology is broad in scope
covering the spectrum of congenital and acquired heart disease
in all age categories. The program emphasizes a balance between
learning, teaching and research and the need to have all the
understanding and clinical skills to care for the clinical
cardiac problems one might encounter in all age groups and
clinical situations. The curriculum also includes the
understanding of adults with medically-treated or
surgically-treated congenital heart disease, as well as fetal
and preventive cardiology.
The training period
commitment is three (3) years. 24 months are primarily for
clinical training, 12 months are spent in research. See outline.
|
Rotations |
year 1 |
year 2 |
year 3 |
|
Inpatient Service |
3 |
2 |
1 |
|
Echocardiography |
3 |
2 |
1 |
|
Cardiac Cath |
2 |
2 |
1 |
|
Surgery |
1 |
1 |
1 |
|
Electrophysiology |
1 |
- |
1 |
|
Cardiac pathology/Echo |
1 |
- |
- |
|
Electives |
- |
- |
2 |
|
Research |
2 |
5 |
5 |
|
Vacation |
1 |
1 |
1 |
The clinical training
occurs during the clinical rotations on the cardiac inpatient
service where the fellowship training emphasizes care management
of pediatric patients with cyanotic or congestive congenital
heart disease. In the post-operative surgical service, the
cardiology fellow manages the post-operative patients in
conjunction with the surgical service and it provides an
excellent experience. All in-house newborn and pediatric
consultations are included in the responsibilities of the
rotation. In addition, this rotation requires the fellow to work
closely with the house staff by providing supervision of and
education of the pediatric colleagues. A full-time faculty
member of the cardiology section will assume ultimate charge of
patient care and the one-on-one aspect of the trainee's
educational process during the Daily Rounds conducted.
On the cardiac
diagnostic service, the fellowship training program provides
opportunities under close supervision for the trainee to gain
skills in the performance of cardiac catheterization and
interventional techniques. Cardiac catheterizations are
performed 4 days per week. Echocardiography rotation, fellow
attains the skills and understanding of cardiac ultrasound
techniques applied for transthoracic, transesophageal as well as
fetal echocardiography. Cardiac anatomy, angiography, volume
analysis, cardiac physiology and pathophysiology are taught
closely by the supervisors of the Invasive and Noninvasive
laboratories. The trainee on this rotation will have the
opportunity to formally present much of the clinical data during
the Combined Cardiology-Surgical Conference.
Cardiac pathology
rotation is at the Congenital Heart and Conduction System Center
where the cardiac morphology and anatomy of congenital heart
disease is available for hands-on study, a unique educational
experience that cannot be overemphasized.
Having the ability to
conduct and understand basic and clinical research is an
important aspect of the fellowship program. The trainee is
guided and strongly urged to participate in many of the on-going
research projects and is expected to develop, work on, and
complete one major project with collaboration. The results of
these projects are often presented at regional or national
meetings. The fellows are encouraged to participate in this
unique experience and opportunity. |