Welcome to Thic - Teaching - The Pediatric Cardiology Training Program

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 three 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.

Thirteen full-time pediatric cardiologists provide the clinical cardiology service and contribute to the educational and training programs. A total of nearly 9,500 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 nearly 4,500 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.)

       1. Transthoracic Echocardiogram                 4500
       Transesophageal Echocardiogram            120
       Intracardiac Echocardiogram                   20
       Fetal Echocardiogram (All campus)         2000

       2. Cardiac invasive studies
       Cardiac Catheterization                           300
           Intervention (balloon septostomy,
           Coils, valvuloplasty, biopsy, etc           220

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.

In our Molecular Biology laboratory a full time molecular biologist provides a basic research facility for study and investigation of cardiac development at the cellular and subcellular levels. 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 basic science, 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	1-2	1
Non-Invasive	3	1-2	1-2
Cardiac Cath	2	1-2	1-2
Surgery	1	1	-
Electrophysiology	-	1	1
Cardiac pathology	-	1	-
Electives	-	-	1
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. Non-invasive 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 strongly recommended 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.