Pediatric Cardiology Fellowship
The Division of Pediatric Cardiology provides comprehensive inpatient and outpatient services for patients of any age with congenital heart disease, and children with acquired heart disease. The use of state-of-the-art technologies for diagnosis and treatment, including advanced imaging, and non invasive and minimally invasive interventional procedures, and our nationally recognized faculty are key to our program’s success in training outstanding pediatric cardiologists.
The Pediatric Cardiology Fellowship Training Program at MUSC is a three year program that has been accredited by the ACGME since 1970 and supported by a training grant from the NIH since 1994. The goal of the pediatric cardiology fellowship training program is to train our fellows to become the leaders of tomorrow in the areas of patient care, teaching, and research. In order to achieve these goals, trainees dedicate the initial portion of their training, approximately 18 months, to building their skills in general clinical pediatric cardiology. Subsequent specialized clinical and/or basic research and clinical training is determined by the trainee’s individual goals. Many trainees will require a fourth year of subspecialty training to meet their goals, and several mechanisms are available to support advanced training. At the conclusion of the pediatric cardiology fellowship, trainees will have acquired and successfully demonstrated the knowledge, skills and attitudes to become valued and productive members of the academic pediatric cardiology community.
Our fellows have a strong record of academic productivity in the area of clinical research. Over the past five years, current and former fellows of our program have secured a number of national honors that attest to their excellence. These honors include:
Five fellows have obtained grant funding to further their careers in clinical research at MUSC: from the NIH, the American College of Cardiology, the American Society of Echocardiography and Leducq Foundation
Five fellows have completed a Masters of Science in Clinical Research
Four fellows have obtained grants from the NIH as part of the highly competitive NIH Loan Repayment Program, which rewards fellows who dedicate their careers to academics
Five fellows have been selected finalists at Young Investigator Competitions, and have been invited to present their research at National Meetings
On six occasions, our fellows have been awarded travel grants by national societies to attend their meetings across the country
The program’s success is indicative of the highly supportive academic environment, rich in mentorship and the spirit of scientific enquiry. Training is provided in all areas of pediatric cardiology at The Children's Heart Program of South Carolina including:
Pediatric cardiac critical care
Echocardiography and non-invasive imaging (CT and MRI)
Transplant and heart failure
Adolescent and adult with congenital heart disease
Independent reading and studying
Discussion and interaction with faculty and other fellows
Extramural conferences and training programs
The first year
The first month is split into 3 introductory 10-day blocks that expose the fellow to Inpatient Cardiology, Intensive Care Cardiology and Echocardiography. During the first year the fellow rotates through clinical settings developing clinical skills and a solid foundation.
Pediatric Cardiac Intensive Care: For 2 months the fellow is responsible for medical, preoperative and postoperative patients in the state-of-the-art 12 bed dedicated PCICU. This rotation provides an excellent opportunity to be exposed to the nuances of perioperative management and the team approach: the fellow is supervised by dedicated pediatric cardiac ICU faculty as well as by the cardiac surgeon.
Inpatient Unit: For 2 months the fellow is responsible for general (floor) inpatients with cardiac problems. He/she reports to the attending pediatric cardiologist on service and conducts daily rounds with the latter, together with the pediatric cardiology nurse practitioner. The fellow supervises and teaches pediatric residents and medical students.
Cardiac Catheterization: For 2 months the fellow is assigned to the cardiac catheterization laboratory. He/she evaluates patients who are admitted for hemodynamic and interventional investigation, and interprets echocardiographic data on them prior to the catheterization. The fellow performs the catheterization and analyzes, presents, and reports the hemodynamic data afterwards.
Echocardiography: For 3 months the fellow performs and interprets trans-thoracic echocardiograms; on this rotation, pediatric sonographers and faculty work together to train fellows in scanning and interpretation.
Electrophysiology: One month consists of a rotation in electrophysiology, to develop skills in reading EKG's and Holters, and to assist in the performance of diagnostic and therapeutic intracardiac electrophysiologic procedures.
Research: One month in the first year is spent on research. During this time introductory online courses in the conduct of good clinical research, the protection of human research subjects, and statistical methodology are completed. Planning or initiating research projects and writing case reports are often performed during this time.
Continuity Clinics: The outpatient experience consists of one day a week for the entire duration of the fellowship. This rotation is scheduled on a fixed day of the week, with a designated faculty member. This provides fellows with the continuity of care that is a desirable part of the outpatient experience.
Call schedule: In-house night and weekend call are taken every fourth to sixth night or weekend during the first year (5 nights/month), decreasing in frequency over the subsequent three years.
Fellows have some flexibility in developing a schedule of rotations based on a combination of the individual fellow's subspecialty interests and the clinical needs of the program. Clinical rotations provide increasing autonomy as the fellow matures in skills and approach. In addition, 4 to 5 months of protected research time are scheduled for developing and implementing research projects under the supervision of a faculty mentor. Fellows are expected to present the progress and the results of these projects with the goal of publication in a peer-reviewed journal.
Clinical rotations during the third and fourth year are structured based on a combination of the individual fellow's subspecialty interests and the clinical needs of the program. Clinical rotations provide increasing autonomy as the fellow matures in skills and approach.
Enrollment in the Master's of Science in Clinical Research program at MUSC is available in the fall of year three. This two-year program is designed specifically to train individuals for leadership roles in academic medicine and clinical research, with the goal of obtaining extramural grant funding. This two-year program requires class work two afternoons a week for two years, and consists of a 38 academic credit hour curriculum that includes classroom lectures and seminars. This is a non-thesis program; students demonstrate their proficiency in clinical research by developing a grant suitable for submission to a funding agency. This graduation exercise is expected to occur in the summer of year four. The tuition for this program is covered by our program's institutional training (T32) grant. Our division is committed to the success of fellows who enroll in this program, but it requires hard work and commitment to be able to balance the demands of the MSCR with the clinical demands of the fellowship training program.
Scheduled conferences provided around the year include:
Preoperative Patient Care Conference: Weekly (1.5 hours)
Medical Patient Care Conference: Every 2 weeks (1 hour)
Didactic Lecture (78-week rotating curriculum based on ACC/AHA/ABP guidelines): Weekly (1 hour)
Mortality and Morbidity Conference: Every month (1 hour)
Clinical Research Conference: Every 2 months (1 hour)
Echocardiography Quality Assurance Conference: Every 2 months (1 hour)
Journal Club: Every 2 months (1 hour)
Learning Activities and Evaluation Methods
The Pediatric Cardiology Training Program provides learning opportunities in each competency domain and uses multiple assessment methods to evaluate and ensure fellow competence in each area.
Learning activities include:
On-the-job learning of procedural skills in the pediatric cardiac intensive care unit, echocardiography laboratory and the cardiac catheterization laboratory
Role-modeling and mentoring by faculty
Discussion with faculty
Review of cardiac catheterization, radiographic and echocardiography images with faculty
Review of cardiac treatment options with faculty
Evaluation of patients in multiple settings
Discussion with patients and families
Interaction, discussion with other healthcare workers and teachers
Extramural conferences and training courses
Web-based curricula and educational tools
Medical simulation experiences/Procedural workshops
Fellows as teachers
Assessment/evaluation methods include:
Direct observation by faculty
360º or Multisource Professional Feedback
Self evaluation forms and self-assessment tools (i.e. board review questions).
Regular and timely feedback from program director including semiannual written evaluations.
ABP board exam (ABP)
ABP board in training exam (SITE)
Medical Simulation experiences.
Chart review of fellows’ notes, reports and other documentation by faculty
Morbidity and Mortality Review/Quality Assurance Conference
Global rating (evalue)
As is expected of pediatric cardiologists in “real world” practice, these experiences occur simultaneously throughout the fellowship. This allows the fellow to participate in all aspects of the care of a wide variety of patients including pre-procedural assessment, diagnostic and interventional therapeutic procedures, post-procedural care in the hospital and long term, and in research relative to the field. As the fellow learns and gains experience, it is expected that he/she will integrate this knowledge and finesse to become a complete, well-rounded, competent pediatric cardiologist.
We participate in the ERAS fellowship process (https://www.erasfellowshipdocuments.org/). Documents that must be submitted through ERAS include:
Medical School Transcript
3 letters of recommendation
We request (suggested but not mandatory) that each of your references fills out the following document in addition to their letter of recommendation, and send it in to ERAS. The Pediatric Cardiology Evaluation Form can be downloaded here and is also posted on the ERAS website.
ECFMG status report (if applicable)
PLEASE NOTE: Due to the requirements of the Institutional Training (T32) Grant, we are only able to fund fellowship training for applicants who are US Citizens or permanent residents (Green Card holders). CANDIDATES MUST BE ELIGIBLE FOR SC MEDICAL LICENSE.
Please submit the following (if applicable) directly to our office, since they are not accepted within ERAS:
Copies of any research papers or scholarly work that you have authored.
Eric M. Graham, MD, FACC
Director, Pediatric Cardiology Fellowship Training Program
Medical University of South Carolina