Interventional Cardiology

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Overview

The Interventional Cardiovascular Training Program at Jackson Memorial Hospital in affiliation with Miami VA Medical Center and University of Miami Hospital has been designed according to the specifications of the Accreditation Council for Graduate Medical Education- Special Requirements for Training Programs in Interventional Cardiovascular Diseases.

Educational Program
The educational goal of this 12-month fellowship program is to prepare its trainees to function at a high level of clinical performance in interventional cardiology. This includes the development of appropriate clinical judgment in selecting patients for cardiac interventional procedures and a high level of technical skill in performing them. This overall goal has four components:

  • To understand the effectiveness and limitations of coronary interventional procedures in order to select patients and procedure types appropriately
  • To achieve the appropriate cognitive knowledge and technical skills needed to perform interventional cardiac procedures at the level of quality attainable through the present state of the art
  • To foster an attitude of life-long learning and critical thinking skills needed to gain from experience and incorporate new developments
  • To understand and commit to quality assessment and improvement in procedure performance

To achieve these goals, the clinical training program is competency-based, and follows all ACGME rules and guidelines.  The educational program is directed towards and fulfills all of the ACGME Program Requirements for Fellowship Education in the Subspecialties of Internal Medicine and the Program for Added Qualifications in Interventional Cardiovascular Disease. Fellows are expected to participate in clinical, basic, or health services research. 

Faculty
There are a total of 6 Key Cardiology faculty members who come in contact with the three interventional fellows.  They are led by Dr. Alexandre Ferreira, Director of the Interventional Program, Dr. Alan Schob, Assistant Program Director at VAMC, and Dr. Eduardo de Marchena, Assistant Program Director at UMH. 

 

ACGME Accredited:  Yes
Residents or Fellows per year:  Three
Duration: One Year
Postgraduate Training Required:   Internal Medicine Residency and Cardiovascular Fellowship
U.S. Citizenship Required:  No

Residents/Fellows who have graduated our program in the last 10 years obtained faculty positions at:

  • Jackson Memorial Hospital/Jackson Medical Group
  • University of Miami Miller School of Medicine

Our Interventional Cardiology Fellowship Program only accepts applications through the ERAS system, a centralized application processing service—paper applications will not be accepted.  The Interventional Cardiology program follows the December application cycle as stated in the ERAS Timeline.

For more information about ERAS, ACGME and ECFMG, please refer to the following sites:
ECFMG

Applicants must satisfy the following requirements by the beginning of the program:

  • Graduate of an ACGME-accredited Cardiology Fellowship training program
  • Graduate of an ACGME-accredited Internal Medicine Residency training program
  • US citizen, US permanent resident, or in possession of a J-1 visa (we do not sponsor H1 visas)
  • ECFMG-certification if a foreign medical graduate,
  • Passing scores on Steps 1, 2, and 3 of USMLE or COMLEX-USA.

Applications must consist of the documents listed below.

  • Updated CV, including publications
  • Medical School transcripts
  • One page personal statement detailing your interest in Interventional Cardiology, as well as career goals
  • Medical School Performance Evaluation (formerly the Dean’s letter)
  • ECFMG Certificate (International Medical Graduates only)
  • USMLE test scores
  • Minimum of three recommendation letters, including one from your cardiovascular program director.
  • Photo

All applications will be reviewed and an interview is required to be considered for the program.  Incomplete or applications submitted to ERAS past the deadline will not be reviewed.  Due to the large volume of applications, the program will only contact candidates chosen to be interviewed.

Recruitment Time Line:

  • December 1:  ERAS Fellowship application season begins.  You may submit your ERAS fellowship token request at this time https://www.erasfellowshipdocuments.org/.  When you receive your electronic token, copy the electronic token # and use it to register at my MyEras homepage.  You may start submitting documents to the EFDO (ERAS fellowship documents office) for processing and selecting fellowship programs. 
  • December 30:  Interventional Cardiology Fellowship Application Deadline. COMPLETE applications are due at this time—Incomplete or late applications will not be reviewed.
  • Mid-January to February: Interviews will be conducted.
  • March (mid-to-late): Final fellow selection is made and the recruited candidates are contacted.  The interventional program does not participate in the NRMP match. 

Every rotation has its own competency based curriculum, approved by the Program Director.  Individual curricula document the skills in each of the six competencies that are expected to be acquired at each level of training. A Core Curriculum forms the backbone of the educational experience at all levels of the training program, with focus on 3 general disciplines in cardiology, each of which are taught via a competency-based curriculum: 

  • Interventional cardiac and peripheral procedures
  • Continuity clinic
  • Research

Research
Fellow involvement in one or more research projects is a requirement for accreditation of the training program and for the fellow’s board eligibility. Published manuscripts are strongly suggested but not mandatory due to the short duration of the training.  The program will provide instructions in the critical assessment of new therapies published in medical literature during research conference and journal clubs.  A list of fellows’ publications in peer reviewed journals and presentations at scientific meetings by the fellows will be maintained. The type of project a fellow selects will depend on his/her interest and expertise.  The ideal project would be one that is designed and implemented primarily by the fellow. 

While considering a project, the fellow should identify an attending mentor who has expertise and interest in that particular area.  The mentor will provide feedback regarding the feasibility, administrative support needed, and scientific strengths and weaknesses of the project.  The fellows should select projects that are relatively straight forward and can be completed during their short training period.  The fellow may also participate in a research project that is already on-going.  They may also participate in multicenter cooperative studies.  After the study is completed, the fellow will be advised and supervised by the mentor in the preparation of the manuscript or the abstract for publication. Monthly research conferences are held during the Thursday conference.  Interventional fellows must attend this conference monthly and will occasionally present.  Scholarly activities such as writing review articles and reports of interesting or unusual cases are strongly encouraged

Call
The objective of on-call activities is to provide fellows with acute cases which allow them to develop skills to perform interventions in patients with acute myocardial infarction and cardiogenic shock. At-home call (pager call) is defined as call taken from outside the medical center, and the duty hours are kept precisely in accordance with the ACGME requirements.

  • Fellows taking at-home call are provided with 1 day in 7 completely free from all educational and clinical responsibilities, averaged over a 4-week period.
  • When fellows are called into the hospital from home, the hours fellows spend in-house are counted toward the 80-hour limit.
  • The program director and the faculty monitor the demands of at-home call in the program and, when necessary, make scheduling adjustments as necessary to mitigate excessive service demands and/or fatigue.  Feedback from the fellows is a crucial part of the monitoring process.  This feedback is recorded by quarterly monitoring of work hour logs.
  • The on-call and vacation schedules are developed and distributed well in advance.

Facilities and Resources
There are three principal hospital sites for the training program, each with high educational impact:

  • Jackson Memorial Hospital (JMH), a 1300-bed teaching hospital, is the primary teaching institution in the program.  Fellows spend four months at JMH.  Faculty coverage is provided by University of Miami Miller School of Medicine and Jackson Memorial Hospital academic faculty.  The clinical experience is a particular strength in JMH, and includes tertiary care private as well as indigent patients with acute and chronic cardiac disease, advanced heart failure, cardiac surgery, cardiac transplantation, and continuity clinic. Fellows perform approximately two thirds of their total number of coronary procedures at JMH, as well as performing a number of peripheral vascular interventions, valvuloplasties, septal ablation for hypertrophic myopathy and septal closure of congenital heart defects.   The institutional support for the training program is excellent.  Thus, given the extent and breadth of cardiology exposure, JMH has high educational impact.
  • The Miami VA Medical Center (VAMC), a 563-bed general hospital, is a critical part of the training program.  Fellows spend four months at the Miami VAMC.  The faculty coverage is provided entirely by University of Miami Miller School of Medicine academic faculty.  The clinical experience is strength of the Miami VAMC, and includes a mix of local VAMC patients and tertiary care VA patients as well. With regards to clinical services at the Miami VAMC, fellows supplement their coronary interventional procedures at the VAMC. The patient population includes patients with fairly advanced vascular disease, high risk subsets and complex interventions are performed at the VAMC.  Many peripheral vascular disease interventions are done at the VAMC.  Thus, the Miami VAMC plays an important role in the training program and has high educational impact.
  • The University of Miami Hospital (UMH), formerly Cedars Medical Center (465-beds) adds a sophisticated and cutting-edge interventional experience within a community-based hospital. The case mix at UMH includes an especially broad range of procedures, allowing fellows exposure to structural cardiac interventions such as percutaneous aortic valve implantation and catheter-based injection of stem cells into infarcted myocardium, in addition to a very active acute MI program, advanced coronary disease intervention and a peripheral arterial disease program. Fellows spend four months at University of Miami Hospital.

Faculty

Alexandre C. Ferreira, MD
Director, Interventional Fellowship Program
Site Supervisor, Jackson Memorial Hospital
Voluntary Professor of Medicine, University of Miami Miller School of Medicine

Eduardo de Marchena, MD
Site Supervisor, Interventional Program at the University of Miami Hospital
Director, UM Interventional Cardiology
Professor of Medicine and Surgery

Alan Schob, MD
Site Supervisor, Interventional Program at the VA Medical Center
Professor of Medicine, University of Miami Miller School of Medicine

Carlos Alfonso, MD
Director, Cardiovascular Fellowship Program
Assistant Professor of Clinical Medicine, University of Miami

Claudia Martinez, MD
Assistant Professor of Clinical Medicine
University of Miami Miller School of Medicine

Cesar Mendoza, MD
Medical Director, JHS Cardiology
Jackson Health System, Jackson Main Hospital

Noemi Melendres  
Phone: 305-585-5540
Fax: 305-585-7089
Email: nmelendr@med.miami.edu

Prospective Residents

Physicians Services / Housestaff Office
Jackson Memorial Hospital
East Tower Room 1004
1611 NW 12th Avenue, Miami, Florida 33136
Phone: 305-355-1122
Fax: 305-355-1123

Graduate Medical Education Office
Jackson Memorial Hospital
Institute 118B
1611 NW 12th Avenue, Miami, Florida 33136
Phone: 305-585-4310
Fax: 305-585-4309

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