Fellowship training in Cardiovascular Medicine at Dartmouth-Hitchcock prepares the fellow to sit for the American Board of Internal Medicine (ABIM) Cardiovascular Disease certifying exam. Achieving this goal involves competency-based training as endorsed by the ACGME and ABIM, which includes a focus on six specific core competencies:
- Patient Care that is compassionate, appropriate, and effective for treating health problems and promoting health
- Medical Knowledge about established and evolving biomedical, clinical, and cognate (e.g., epidemiological and social-behavioral) sciences, and the application of this knowledge to patient care
- Practice-Based Learning and Improvement that involve investigation and evaluation of a fellow’s patient care, self-appraisal, assimilation of scientific evidence, and improvements in patient care
- Interpersonal and Communication Skills that result in effective information exchange and teaming with patients, their families, and other health professionals
- Professionalism as manifested by a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population
- Systems-Based Practice as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value
The curriculum is designed to assist the trainee in developing these competencies as described in COCATS 4 (PDF) and form the basis of activities that patients and the general public expect all competent clinical cardiologists to perform and as delineated in the Core Cardiology Training Statement (COCATS 4). These include:
- Cardiovascular Consultation – Evaluate, diagnose, and develop treatment plans for patients with known, with suspected, or at risk of developing cardiovascular disease.
- Acute Cardiac Care – Manage patients with acute cardiac conditions.
- Chronic Cardiovascular Disease Management – Manage patients with chronic cardiovascular diseases.
- Cardiovascular Testing – Appropriately utilize cardiovascular testing.
- Disease Prevention and Risk Factor Control – Implement disease prevention and risk factor control measures, addressing comorbidities.
- Team-Based Care – Work effectively to promote patient-centered interdisciplinary team-based care
- Lifelong Learning – Engage in lifelong learning.
The following components form the basis of the training program in Cardiovascular Disease at Dartmouth-Hitchcock. In all aspects of the curriculum, Level 1 training is provided during the course of the three-year fellowship. Fellows are encouraged to seek additional knowledge, skills, and competencies to achieve benchmarks or certification consistent with Level 2 training in many of these areas:
- Adult congenital heart disease
- Ambulatory and longitudinal care
- Arrhythmia, cardiac pacing, and electrophysiology
- Cardiac catheterization
- Cardiac imaging (including nuclear, computed tomography, and magnetic resonance imaging)
- Cardiothoracic surgery
- Cardiac consultation
- Critical care cardiology
- Heart failure, including advanced therapies
- Intermediate coronary care
- Preventative cardiovascular medicine
- Vascular medicine
In addition to the above, all fellows will spend time at the White River Junction Veterans Administration Medical Center (in nearby White River Junction, VT), which includes a curriculum oriented toward cardiac consultation, ECG interpretation, echocardiography, and advanced multi-modality imaging.