Interventional Cardiology - SHSC

Fellowship Title:

Interventional Cardiology - SHSC

Division:

Cardiology

Fellowship Type:

Clinical

Supervisor:

Dr. Sam Radhakrishnan

Duration:

2 years

Anticipated Start Date(s):

July 1

Number of position(s) per year:

3-4

Description:

CLINICAL RESPONSIBILITIES
Fellows will be expected to be involved in all aspects of angioplasty procedures.  This includes:

1. initial evaluation of new referrals in the out-patient clinic and in hospital;
2. assessment and pre-op workup of accepted patients in the pre-admission clinic;
3. admission and consent of same-day admission patients;
4. communication with referring physicians when appropriate;
5. performing the actual procedure as either primary or secondary operator;
6. post-operative documentation and orders;
7. sheath removal and/or supervision of closure devices;
8. availability after hours and weekends for emergencies or routine care issues;
9. discharge orders and documentation;
10. follow-up (in the clinic).

It is not expected that fellows will perform all the above tasks for every patient.  However, some cases should be followed through in all aspects from start to finish, while involvement with other cases will only be partial.  The clinical care of angioplasty patients will be shared between the interventional fellows and staff physicians, but it is important for fellows to be aware that angioplasty training extends outside the cath lab.

Pre-assessment and follow-up clinics will be arranged in blocks so that fellows can see several patients during a half-day session.  Approximately one such session per week will be scheduled.

Fellows will be expected to scrub in on 300 to 400 cases per year.  Based on experience and case complexity, they will progress from second to first operator to solo first operator (with staff physician in the control room).  The case work will include conventional balloon angioplasty, a wide variety of stents, rotational atherectomy, possibly directional atherectomy, thrombectomy, as well as ancillary diagnostic tools such as intra-vascular ultrasound, and intra-coronary Doppler and/or pressure measurements.

A good angioplasty operator must be capable of performing very high quality diagnostic angiography.  Therefore, fellows will perform at least 50 diagnostic studies under the supervision of a staff physician, mostly concentrated in the early months of training.  Subsequently, fellows may be asked on occasion to perform a limited number of diagnostic studies.

In accordance with University of Toronto Division of Cardiology policy, interventional fellows (along with other sub-specialty fellowship trainees) may be asked to cover general cardiology in-house call up to two nights per month.

It is anticipated that clinical responsibilities will comprise about 50-60% of the fellows’ time.

RESEARCH
The research experience in this combined clinical and research fellowship will be viewed as an essential component, with up to 40% of time allotted to research activities.  Both expectations of, and support for, research productivity can be anticipated.  Early in the fellowship (within the first four weeks), fellows should conceive (with input from staff) at least one independent research project which they will design and carry out over the course of their fellowship.  In addition, submission of one or more abstracts to CCS and AHA will be strongly encouraged.  In the interest of completing the project, the goals should be realistic, and the project should take advantage of existing expertise and infrastructure.  Fellows must also be familiar with ongoing interventional research protocols and should help in recruitment of patients to clinical trials.  Depending on interest and career objectives, the fellow should also consider becoming involved as a collaborator or research assistant on an additional, established project.

ROUNDS AND TEACHING
Fellows will be responsible for coordinating the weekly Cardiology / Surgery Angio rounds (0700 hrs Friday), and to present many of the cases, including providing SYNTAX scores.  At least two presentations will be expected during the year at either the Research  Rounds (0800 Thursday) or Cardiology Grand Rounds (0800 Friday).  On a very occasional basis, fellows may be asked to conduct teaching rounds with the housestaff in the CCU or on the cardiology ward.

Interactive small group teaching will be provided to interventional fellows through the University of Toronto monthly ‘City-wide’ Interventional Cardiology Fellows Teaching series.  This highly regarded longitudinal teaching series is unique amongst interventional training programs in Canada.  It covers major topics in interventional cardiology and draws from the expertise of the teaching staff at all three University of Toronto interventional sites (SHSC, SMH, UHN).

Contact Name:

Dr. Sam Radhakrishnan

Role:

Director, Interventional Cardiology Training Program

Telephone:

(416) 480-4668

E-mail:

sam.radhakrishnan@sunnybrook.ca

Mailing Address:

Sunnybrook Health Sciences Centre
A-253 - 2075 Bayview Ave