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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, Christ Hospital
and Medical Center (CHMC) 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-theart, 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
350 surgical operations are performed per year. 70% of these are
open-heart cases.
Ten 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 Catherization laboratory performs approximately 240 cases
per year. Our full time Pediatric Echocardiographic Laboratory
performed nearly 4,200 studies per year. Exercise stress tests,
transesophageal electrophysiologic studies, intracardiac
Electrophysiologic and interventional procedures, Radio Frequency
Ablations and Tilt-tests are performed in other dedicated laboratory
space. (See Table below.)
Special Laboratory Procedures
1. Transthoracic Echocardiogram
4100
Transesophageal Echocardiogram
120
Intracardiac Echocardiogram
20
Fetal Echocardiogram (All campus)
2000
2. Cardiac invasive studies
Cardiac Catherization
240
Intervention (balloon septostomy,
Coils, valvuloplasty, biopsy
127
Intracardiac Electrophysiologic studies +
RF ablation 30
Tilt
tests
80
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
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 critical
care management of pediatric patients with cyanotic or congestive
congenital heart disease. The post-operative surgical service is
included in this role and 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 catherization and interventional
techniques. Cardiac catherizations 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.
A Required Elective
(one month) is strongly recommended in the first year 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.
General program requirements for the subspecialties of Pediatrics by
ACGME
Program Requirements for Fellowship Education in Pediatric
Cardiology - ACGME
ACCF/AHA/AAP
Recommendations
for
Training
in
Pediatric
Cardiology
Application
for Fellowship
Advocate Resident Contract
Introduction and Requirements for Fellowship
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