Mayo Graduate School of Medicine

Mayo Clinic RochesterRochester, Minnesota

Fellowships inCardiovascularDiseases

Fellowships inCardiovascular Diseases

Mayo Clinic Rochester offers several fellowshipprograms in cardiovascular diseases:

• A four-year Cardiovascular Diseases Subspecialty Fellowship . . . . . . . . . . . . . . . .(page 4)

• A one- or two-year Electrophysiology Subspecialty Fellowship . . . . . . . . . . . . . . .(page 15)

• A two-year Interventional Cardiology Subspecialty Fellowship . . . . . . . . . . . . . . .(page 16)

• A four-year Vascular Medicine Fellowship, with one- and two-year program options . . . . . . . . . . . . . . . . . . . . . .(page 17)

All of these programs offer:

• Comprehensive preparation for a scholarly careerin cardiovascular medicine

• Cardiovascular fellow responsibility andautonomy in patient care management andprocedures – no private patients or attendings

• Extensive hands-on experience with allcardiovascular procedural skills

• Comprehensive didactic curriculum and hands-onphysical examination teaching series

• Diverse patient population composed of local,regional, national and international patients

• Flexible, hands-on clinical and research training inthe most comprehensive and advancedcardiovascular program in the United States

• Separate tracks available for those interested in amore comprehensive research career, includingclinician investigator and National Institutes ofHealth (NIH) pathways

• Options for subspecialty training in interventionalcardiology, electrophysiology, nuclear cardiology,advanced echocardiography, congenital heartdisease and epidemiology

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• Thorough preparation for subspecialty boards andfor a career in private practice or academicmedicine

• Experienced mentors to help you determine yourcareer goals and identify research opportunities

• Eligibility for certification in the subspecialty youselect

The Mayo Clinic Cardiovascular Division consists ofmore than 100 board-certified cardiologists, who arenationally and internationally recognized as leadingauthorities in each one of the different subspecialtyareas of cardiovascular medicine. All consultants inthe Cardiovascular Division participate in theeducation and mentoring of fellows in thecardiovascular training program.

Mayo Clinic’s favorable faculty ratio, large patientpopulation and state-of-the-art diagnostic,therapeutic and research facilities combine to createa truly integrated educational experience. The ‘Mayo Clinic way’ of graduate medical educationensures you will have the finest teaching and thebroadest patient care experience possible during abusy, hands-on fellowship.

Training at Mayo Clinic

Mayo Clinic has a long-standing tradition ofpracticing both the art and science of medicine. Asone of the country’s largest and best-known privategroup practices of academic medicine, Mayo Clinicwas founded on the belief that physicians need towork together, teach and learn from others, andconduct research to provide sustained, excellentpatient care.

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Physicians, scientists, residents, students, nurses andallied health staff members work as a team at MayoClinic. Our staff clinicians and scientists are calledconsultants in recognition of their teaching andmentoring role in the team.

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Mayo Clinic teamworkspans many locations

In Jacksonville, FloridaMayo Clinic Jacksonville

St. Luke’s Hospital

In Rochester, MinnesotaMayo Clinic RochesterSaint Marys Hospital

Rochester Methodist HospitalCharter House

In Scottsdale, ArizonaMayo Clinic ScottsdaleMayo Clinic Hospital

Mayo Health System

Cardiovascular DiseasesSubspecialty Fellowship

Mayo Clinic’s four-year Cardiovascular DiseasesSubspecialty Fellowship is a flexible programdesigned to train academic cardiovascularphysicians. The program can be tailored to meetyour specific needs and career goals. Aftercompleting two years of core rotations, you maycomplete your fellowship training with:

• Two years each of research and clinical electives ina focused subspecialty area

• Two years in interventional cardiology

• Two years in electrophysiology

Clinical TrainingYour clinical training will consist of the first twoyears, spent in core rotations. During the corerotations you will obtain the basic knowledge andtechnical skills needed before you can proceed tomore advanced training in general cardiovascularmedicine or a subspecialty area.

The first year consists of rotations through thevarious subspecialty laboratories to allow exposureto all subspecialty areas. During the second year,the information learned in the laboratories will beapplied to patient care (both inpatient andoutpatient).

The core rotation areas are described on thefollowing pages. A typical rotation schedule followsthe core rotation descriptions.

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First YearCardiac Catheterization Laboratory While you are in the Cardiac CatheterizationLaboratory at Saint Marys Hospital, you will:

• Perform at least 250 catheterization procedures asprimary operator

• Develop formal presentations and leaddiscussions at weekly conferences

• Evaluate patients prior to catheterizationprocedures and select appropriate invasivetechniques

• Gain experience in cardiovascular hemodynamicswith assessment of myocardial and valvulardiseases

• Gain experience in coronary angiography andright-heart catheterization

• Participate in a research project

The staff in the Cardiac Catheterization Laboratoryperform more than 6,000 procedures each year.Clinical practice and research are at the forefront ofinterventional cardiology, including techniques suchas atherectomy, laser angioplasty, stent placementand valvuloplasty.

Echocardiography LaboratoryDuring this rotation you will performechocardiographic examinations on at least 250patients and attend weekly conferences to reviewbasic and advanced echocardiography-relatedtopics.

Mayo Clinic’s Echocardiography Laboratoryperforms 25,000 examinations annually, includingapproximately 1,700 transesophagealechocardiograms and 2,000 exercise andpharmacologic stress echocardiograms.

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Electrophysiology ServiceDuring the electrophysiology rotation, you will:

• Assist the medical staff with managing patient’srhythm disturbances

• Complete electrophysiology consultations onhospitalized patients

• Interpret data collected during studies andformulate final case reports

• Learn techniques of right-heart catheterization andcatheter manipulation as they apply toelectrophysiology

• Learn the indications for electrophysiologicalstudies

• Practice various approaches for managing a widevariety of rhythm disturbances

• Be encouraged to participate in a clinical or basicresearch project

Electrophysiology service physicians performinvasive electrophysiological studies and catheterablation procedures in two fully dedicatedlaboratories at Saint Marys Hospital. They alsoparticipate in endocardial and epicardial mappingduring surgical procedures, and assist with theplacement of implantable cardioverter defibrillators.More than 1,300 diagnostic and therapeuticprocedures are performed annually.

Nuclear Cardiology LaboratoryDuring this rotation, you will:

• Develop a basic understanding of the techniquesused to determine ejection fraction

• Learn how to assess regional wall motion andestimate ventricular volume

• Learn how to safely conduct exercise andpharmacologic stress tests and interpret exerciseelectrocardiograms

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• Interpret radionuclide angiography, thalliumscintigraphy and sestamibi studies

• Participate in regular reading sessions with anuclear medicine consultant and a cardiovascularconsultant

• Present one or more conferences that focus onunusual clinical cases

Mayo Clinic’s Clinical Nuclear CardiologyLaboratory performs approximately 4,000 studieseach year.

Pacemaker ServiceDuring the Pacemaker Service rotation, you will:

• Evaluate all hospitalized patients who may needpacemaker implantation

• Oversee the postoperative care of these patients

• Participate in implantation procedures forpacemakers and implantable cardioverterdefibrillators

• Learn the indications for pacing, the principles ofpacemaker function, and the method for analyzingthat function

• Participate in the long-term follow-up ofpacemaker patients in the Pacemaker Clinic

Cardiologists perform pacemaker and defibrillatorimplantation in a fully dedicated operating suitelocated next to the Electrophysiology Laboratories atSaint Marys Hospital. Specially trained nurses andtechnicians participate in all of these procedures —over 600 each year. The Pacemaker Clinic handlesfollow-up consultations for 200 to 250 transtelephonicelectrocardiogram transmissions each week.

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Second YearCoronary Care Unit While you are on the Coronary Care Unit rotation,you will treat critically ill patients with acute andunstable cardiovascular problems. You will:

• Gain experience running the intensive care unit

• Insert all hemodynamic lines and temporarypacemakers

• Supervise the medical residents and studentstaking rotations on the unit

The Coronary Care Unit averages 1,500 admissionsper year. These patients have acute ischemicsyndromes, arrhythmias, refractory heart failure,pacemaker difficulties and a wide variety of othercomplex cardiac problems.

Outpatient ConsultationsThere is a large, outpatient subspecialty practice incardiovascular diseases. During this rotation youwill see 15 to 20 new outpatients per week, with adiversity of diagnoses, including coronary arterydisease, valvular heart disease, pericardial disease,cardiopathy and vascular disease. You will beresponsible for the full workup and followup ofthese patients.

Inpatient ConsultationsDuring these rotations you will see up to eight newcardiac patients per day on the consulting service ofSaint Marys Hospital and make follow-up visits onprevious patients as needed. A cardiovascularconsultant will be assigned to discuss each case withyou and help you develop a plan for diagnosis andpatient management.

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Inpatient Hospital ServiceCardiovascular fellows run a large, highly efficientinpatient service in conjunction with twocardiovascular consultants. On this service you willadmit three to five patients per day, establish a planof care and take primary care of the patient. Thesepatients have a wide spectrum of problems,including acute chest pain syndrome, unstablearrhythmias and heart failure.

Midlevel nurses are on the service and take nightand weekend in-house call on your patients.

Vascular Medicine Hospital ServiceWhile assigned to this service, you will:

• Care for patients with vascular diseases

• Conduct bedside diagnoses of the peripheralvascular system

• Learn noninvasive techniques for evaluatingperipheral venous and arterial circulation

• Learn to interpret arteriograms and venograms

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“Mayo Clinic - where zebrasbecome horses!”

Peripheral vascular disease is an integral part ofcardiovascular medicine, and Mayo Clinic hasestablished a dedicated vascular center that bringstogether the disciplines of clinical medicine, vascularradiology and vascular surgery. The vascularpractice performs approximately 1,400 surgicalprocedures, 4,500 peripheral arteriograms andvenograms, and 5,500 noninvasive procedures eachyear.

Cardiovascular Health Clinic andCardiovascular Surgery The Cardiovascular Health Clinic, located at SaintMarys Hospital, provides graded exercise testing,inpatient and outpatient cardiac rehabilitationservices, and preventive clinical cardiology services.While you are at the clinic, you will:

• Advise patients about lipid control and othermodifiable risk factors

• Develop appropriate exercise programs andadvise patients about them

• Learn how to care for patients and organize theirrehabilitation following cardiac surgery ormyocardial infarction

During the cardiovascular surgery assignment, youwill:

• Spend time in the operating room observingcardiac bypass and other procedures

• Attend rounds with consulting surgeons

• Learn about drugs used for recoveringcardiovascular surgery patients

• Participate in the postoperative care andmanagement of patients in the intensive care unit

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Electrocardiography LaboratoryDuring this rotation you will:

• Learn to read a wide variety of complex tracingsdealing with disorders of cardiac rhythm, acutemyocardial infarction or ischemia, and congenitalheart disease

• Review 24-hour ambulatory monitoringrecordings and interpret signal-averagedelectrocardiograms

• Participate in a clinical research project

You may assist with ElectrocardiographyLaboratory emergencies, such as when a patient hasmarkedly abnormal rhythms or evidence ofmyocardial ischemia or injury during anelectrocardiogram.

Continuity ClinicDuring all four years of your fellowship, you willspend one-half day every week in the ContinuityClinic, providing follow-up care to your patients.

Adult Congenital Heart Disease Service andHeart Failure Clinic (Electives)Mayo Clinic operates one of the few adult congenitalheart disease clinics in the United States. Referralsfrom all over the world come to this clinic forsubspecialty consultation and possible surgery. TheHeart Failure Clinic is a busy practice, managing allaspects of advanced cardiac dysfunction. Activeresearch protocols in this area includeinvestigational drugs and experimental surgicalprocedures. These are optional rotations.

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Typical Core Rotation ScheduleThe following is a typical two-year core rotationschedule.

First YearCardiac Catheterization Laboratory . . . . . . . .16 weeksEchocardiography Laboratory . . . . . . . . . . . . .13 weeksElectrophysiology Service . . . . . . . . . . . . . . . . . .7 weeksNuclear Cardiology Laboratory . . . . . . . . . . . . .9 weeksPacemaker Service . . . . . . . . . . . . . . . . . . . . . . . .7 weeks

Second YearCoronary Care Unit . . . . . . . . . . . . . . . . . . . . .12 weeksInpatient Consultations . . . . . . . . . . . . . . . . .12 weeksInpatient Hospital Service . . . . . . . . . . . . . . .12 weeks Vascular Medicine Hospital Service . . . . . . . .4 weeksCardiovascular Health Clinic and

Cardiovascular Surgery . . . . . . . . . . . . . . . .4 weeksOutpatient Consultations . . . . . . . . . . . . . . . . .4 weeksElectrocardiography Laboratory . . . . . . . . . . .4 weeks

Cardiac Life Support CertificationCertification in Basic Cardiac Life Support andAdvanced Cardiac Life Support (ACLS) is requiredfor all Mayo Clinic residents and fellows. ACLScourses are held during the last week of June, justbefore the start of the academic year. The ACLScourse also is offered evenings every three monthsduring the year to facilitate recertification.

ElectivesYour elective options in Mayo Clinic’sCardiovascular Diseases Subspecialty FellowshipProgram are outstanding. Whether you want to gainmore experience with clinical practice or research,

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you can customize your elective year to meet yourcareer needs. Your elective options include:

• Six to 12 months focusing on invasive cardiology— including complex hemodynamics, proceduressuch as transseptal catheterization andendomyocardial biopsy, and clinical invasiveinvestigation

• Six to 12 months in echocardiography, includingintensive exposure to transesophageal and stressechocardiography

• Six to 12 months in one of the many ongoingclinical research projects

• Six to 12 months in advanced training in nuclearcardiology, which can fulfill the requirements forlicensure by the Nuclear Regulatory Commission.This training will include in-depth exposure tophysics, radiation safety, radiopharmaceuticalsand instrumentation, as well as more experience inreading and interpreting radionuclide angiogramsand thallium/sestamibi scintigrams.

• Six months gaining intensive implantationexperience in the pacemaker laboratory

• More clinical experience in peripheral vasculardiseases and training in noninvasive testing,imaging techniques and catheter therapies

• Twelve-month training in adult congenital heartdisease

• Twelve-month training in the heart failure/transplant clinic

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Additional Training

The Division of Cardiovascular Diseases has alimited number of post-fellowship positionsavailable for individuals who already haveadvanced training and experience in the field. Thesespecial training positions usually last from one totwo years each. Outside funding is encouraged. Youneed to address your application to the director ofthe specific Mayo Clinic laboratory in which youwould like to study; submit it at least twelve monthsbefore the academic year begins.

Fields of additional training include:• Electrophysiology (see page 15)• Interventional cardiology (see page 16)• Adult congenital heart disease• Echocardiography• Heart failure/cardiac transplant• Nuclear cardiology• Pacing

ElectrophysiologySubspecialty Fellowship

If you are interested in advanced training inelectrophysiology, Mayo Clinic offers the option tospend one or two years focused on clinical practiceand research in that subspecialty. You canparticipate in this training in one of two ways:

• You may spend one or two years inelectrophysiology as an elective to finish MayoClinic’s Cardiovascular Diseases SubspecialtyFellowship Program

OR

• You may take the one-year ElectrophysiologySubspecialty Fellowship as an independentprogram after you complete at least three years ofaccredited cardiovascular diseases training atanother institution

In either case, you will conduct research and gainspecific experience in intensive diagnostic andtherapeutic procedures and patient management.For example, you will work with Mayo Clinic’sconsultants to:

• Diagnose and treat patients with radiofrequencyablation for supraventricular arrhythmias (e.g.,AV node re-entry, WPW, atrial flutter) andventricular tachycardia

• Implant and follow up on investigationalimplantable cardioverter defibrillators

• Learn the operative management of atrialfibrillation, ventricular tachycardia and accessorypathways

When you complete this training, you will beeligible for the American Board of Internal Medicinesubspecialty examination in cardiacelectrophysiology.

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Interventional CardiologySubspecialty Fellowship

If you are interested in advanced training ininterventional cardiology, Mayo Clinic offers a two-year option focused on training in clinical practiceand research in that subspecialty. You canparticipate in this training in one of two ways:

• You may spend two years in interventionalcardiology as an elective to finish Mayo Clinic’sCardiovascular Diseases Subspecialty FellowshipProgram

OR

• You may take the two-year InterventionalCardiology Subspecialty Fellowship as anindependent program after you complete at leastthree years of accredited cardiovascular diseasestraining at another institution

In either case, you will spend the first 12 months in acatheter-based research laboratory. Your researchmay include:

• Pathophysiology of restenosis

• Vessel response to injury

• Application of new interventional devices inanimal models

• Local drug delivery approaches for gene therapy

Then you will spend the last 12 months in theclinical intervention laboratory, gaining experiencein:• Mitral Balloon Valvuloplasty• Directional Atherectomy• Doppler Flow• Intracoronary Stents• Intravascular Ultrasound• Laser Angioplasty• Percutaneous Transluminal Coronary Angioplasty• Rotablator

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When you complete this training, you will beeligible for the American Board of Internal Medicinesubspecialty examination in interventionalcardiology.

Vascular MedicineFellowship

Mayo Clinic Rochester also offers a four-yearVascular Medicine Fellowship. This consists of twoyears of vascular medicine training and two years ofcardiology training. The curriculum emphasizesboth clinical medicine and basic research in areassuch as atherosclerosis, lipid disorders andcoagulation disorders.

After successfully completing this fellowship, youwill be eligible for the American Board of InternalMedicine subspecialty examination incardiovascular diseases and be fully trained invascular medicine.

Two other options are available for further vascularmedicine training. For those who have completedcardiology subspecialty training, an additional one-year track is offered. This program emphasizesclinical training in vascular medicine with exposureto both noninvasive and invasive diagnostictechniques.

A two-year option is offered to clinicians who aresubspecializing in other internal medicine fields(e.g., diabetes, rheumatology or dermatology) andwho wish to gain further vascular medicineexperience but do not want to pursue board

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certification in cardiology. This programemphasizes:• Inpatient hospital care• Outpatient consultation in a dedicated vascular

center and a lymphedema clinic• Exposure to noninvasive and invasive vascular

diagnostic modalities• Exposure to interventional vascular radiology

Following completion of the one- or two-yearvascular medicine fellowship, you will be capable ofpracticing clinical vascular medicine in conjunctionwith your primary specialty or subspecialty ofinternal medicine.

Education ProgramInformation

Didactic TrainingClinical conferences, seminars, small discussiongroups, journal clubs and one-on-one instruction areall an integral part of Mayo Clinic’s CardiovascularDiseases Subspecialty Fellowship Program. You willhave ample opportunity to attend and participate inthese activities.

Weekly Conferences• Adult Catheterization Laboratory Conference• Cardiovascular Grand Rounds• Catheterization Laboratory Hemodynamic

Conference• Clinical Examination Teaching Conference• Echo Laboratory Conference• Electrophysiology Conference

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• Hypertension Conference• Nuclear Cardiology Conference• Pacemaker Conference• Pediatric Catheterization Conference• Vascular Conferences

Monthly Conferences• Cardiovascular Society Dinner Meeting• Echo Journal Club• Heart Failure Journal Club• Nuclear Journal Club• Trainee Journal Club

A core curriculum conference sequence forcardiovascular fellows is held each Monday eveningthroughout the academic year. This series covers allmajor areas of cardiovascular medicine. The initialhalf-hour of each meetings is devoted to theteaching of electrocardiography. In addition, six toeight visiting faculty dinner meetings andlectureships are held annually.

Cardiovascular Board ReviewProvided free to Mayo Clinic cardiovascular fellows,the Mayo Cardiovascular Review Course forCardiology Boards and Recertification will providethe internist and cardiologist an overview of allaspects of cardiovascular medicine. In-depthdidactic lectures on state-of-the-art subjects incardiovascular medicine will be given by well-known experts in each field. Although this course isdesigned specifically to prepare the cardiovascularspecialist for the Cardiovascular Boards, it will alsoprovide the internist or practicing cardiologist withan update on the latest knowledge and advances incardiovascular medicine. This course will also serveas a review for those who will be taking thecardiovascular recertification boards.

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Each participant will be provided a comprehensivetextbook, Second Edition – Mayo Clinic CardiologyReview, edited by Joseph G. Murphy, M.D., andspecifically written for those taking theCardiovascular Boards.

Case StudiesDuring your fellowship you will prepare case studypresentations for CV Grand Rounds, present thepertinent information of an interesting case, conductan in-depth discussion of that case, and create acurrent bibliography.

Teaching OpportunitiesYou will have the opportunity to teach MayoMedical School students and visiting students fromother medical schools, as well as internal medicineresidents, through bedside instruction and formaldidactic lectures.

Research Training

Mayo Clinic has a long tradition in CardiovascularResearch and it is our goal to make this importantpart of your training a productive experience. Infact, the Division of Cardiovascular Diseasespublished over 200 peer-reviewed articles per yearin the fields of basic, disease-oriented and patient-oriented research.

Throughout the entire fellowship, you will have theopportunity to participate in various researchactivities in our division, working closely withexperienced mentors. Depending on your interest,one or two years of your fellowship will be

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specifically designated for fulltime research trainingto allow you to gain significant experience in aparticular research field. A CardiovascularMentoring Program Booklet provides detailedinformation about existing research programs,available research mentors, and regulatory affairspertinent to the conduct of research.

In brief, for those interested in a two-year researchcurriculum, both the NIH Cardiovascular ResearchTraining Grant in “Cardiovasology” and the MayoClinician-Investigator Program provide stipendsupport. The two years of research are commonlyconducted in state-of-the-art research laboratoriesprior to initiation of core clinical rotations. For suchresearch opportunities, you are encouraged to applyin advance.

For fellows interested in pursuing one year ofresearch training, this is usually integrated as thethird year in fellowship training prior to pursuing asubspecialty elective in the fourth year.

Research opportunities are available in the followingfields:• Genetics of Cardiovascular Diseases• Cellular and Molecular Biology of Cardiac

Function and Dysfunction• Molecular Medicine of Cardiovascular Diseases• Cellular and Molecular Electrophysiology• Cardiac Bioenergetics and Cardioprotection• Gene Therapy• Cardiorenal Physiology and Pathophysiology• Endothelial Function and Dysfunction• Cardiac Endocrinology• Translational Research in Heart Failure and

Xenotransplantation• Ultrasound Research and Cardiac Imaging• Epidemiology and Population-Based Research• Neural Circulatory Control• Sleep and Cardiovascular Regulation

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Clinical subspecialty training integrated withresearch is commonly performed includes:• Adult Congenital Heart Disease Clinic• Cardiac Catheterization Laboratory• Cardiac Imaging Laboratory• Echocardiography Laboratory• Electrophysiology Laboratory• Heart Failure Clinic and Transplant Service • Hemodynamics Laboratory• Nuclear Medicine Laboratory• Vascular Laboratory

Traditionally, Mayo Clinic cardiovascular fellowshave been highly successful in publishing peer-reviewed articles and competing for nationalawards, including awards from the American

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Bench to bedsideMayo Clinic is committed to basic and clinicalresearch that leads to better patient care.

Mayo Clinic’s hallmark is teamwork —• Among basic and clinical investigators• Among investigators and clinical

practitioners• Across Mayo Clinic sites• Between Mayo Clinic and other institutions

Mayo Clinic people in research —• 250+ full-time physicians and scientists• 400+ associates and fellows• 1300+ administrative and allied health staff

Research funding sources —• Extramural funds = $130 million+• Mayo Clinic funds/other revenue = $110

million+

College of Cardiology, the North American Societyof Pacing and Electrophysiology, the AmericanHeart Association and the American Society forClinical Pharmacology and Therapeutics.

The Division of Cardiovascular Diseases encouragesand supports individuals who are interested inpursuing independent research careers. Fellows areencouraged to apply for specific extramural fundingthrough the American Heart Association or theNational Institutes of Health as well as to take partin complementary curriculum programs, includingthose in Clinical Research Training and ClinicalPharmacology funded through existing trainingprograms at Mayo Clinic.

General ProgramInformation

The Cardiovascular Fellowship Programs providethe highest quality education possible in the field ofcardiovascular diseases. During the applicationprocess and again (within the first two years oftraining), the career goals of fellows will beidentified to determine if the individual shouldpursue a career as a clinical cardiologist, clinicalsubspecialist, clinician investigator or basicresearcher.

The standard four-year track aims to provide acomprehensive overview of all aspects ofcardiovascular medicine with primary specializationin one area.

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Fellows interested in education leading to a career asa research scientist are best served by the five-yearNIH Training Grant track (two years of research andthree years of clinical study) or the four and one-halfyear Clinician Investigator track (two years ofresearch and two and one-half years of clinicalstudy).

The goal of all of the fellowship tracks is to traincardiovascular clinician scholars, defined asphysicians with expertise in: 1) providing high-quality cardiovascular specialty care to patients in ahumanistic, professional manner, 2) criticallyassessing the scientific literature, 3) participating inresearch, and 4) disseminating knowledge.

Patient and Service Mix As a regional medical center for the Midwest, MayoClinic Rochester registers more than 320,000 patientseach year. Eighty percent of the clinic’s patients areself-referred and come from within a day’s drive.Although Mayo Clinic has a reputation forsuccessfully handling the most obscure and difficultmedical problems for people from around the world,common medical concerns are actually the norm.This allows you to see and treat an exceptionalvariety of illnesses during your clinical training.

The Division of Cardiovascular Diseases inRochester has 100 staff cardiologists and 32 fellows.Each year, they care for approximately 12,000outpatients and 7000 inpatients, performing a widerange of tests and procedures. For example, MayoClinic averages 150 echocardiograms and 30 to 35catheterization procedures daily. This volumeallows you to see and treat an exceptional variety ofillnesses during your clinical training.

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Call FrequencyYour call schedule will vary by individual rotation.Mayo Clinic follows the recommendations of theAccreditation Council for Graduate MedicalEducation.

Committee AssignmentsYou will be given an opportunity to gain experiencein a number of administrative capacities during yourtraining by opportunities to participate in a varietyof committees.

MoonlightingMoonlighting is permitted for licensed residents andfellows beyond the PGY-1 level. Moonlightingactivities may be scheduled during those timeswhen you are assigned to consultative or outpatientrotations.

EvaluationTo ensure that you acquire adequate knowledge anddevelop your technical skills, your performance willbe monitored carefully during the course of yourCardiovascular Fellowship Program. You will beevaluated formally by your supervising facultymember after each clinical rotation. In addition, youwill regularly evaluate the faculty to ensure thatyour educational needs are being met.

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Career DevelopmentYou will meet periodically with various facultymembers, administrators and the program directorsto discuss your career goals. Mayo Clinic recruitsmany of its staff physicians from its own trainingprograms. Thus, when you successfully completethe fellowship in Cardiovascular Diseases, jobopportunities may be available at one of MayoClinic’s group practices.

Graduate OutcomesThe most important sign of the success of anytraining program is how graduates fare after theybegin their careers. In the past three years, thisprogram in Cardiovascular Diseases has producedhighly selective fellows who have a 92 percent passrate on ABIM certifying examinations.

Faculty

In addition to caring for patients in their clinicalpractices, Mayo Clinic’s faculty members arecommitted to teaching and facilitating the growth ofmedical knowledge. Many of our faculty havepublished and lectured extensively and are well-regarded in their field. You will have direct access tothese individuals throughout your trainingprogram.

AdvisersEvery fellow is assigned a faculty adviser who canprovide comprehensive educational advice and

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personal support. The adviser will also serve as amentor to oversee your progress in the trainingprogram.

Visiting ProfessorsThe Department of Internal Medicine invites morethan 60 prominent academic faculty members tovisit Mayo Clinic each year. They present their workat Medical Grand Rounds and other conferences,and participate in hospital rounds. Once a year theCardiovascular Division’s fellows select and invite anationally recognized specialist in cardiovasculardiseases to come to Mayo Clinic for a visitingprofessorship. All fellows are encouraged to spendthree full days with this visiting professor -attending ward rounds, didactic talks, presentationsand social gatherings. This has been a highly valuedexperience for both fellows and the visitingprofessor. In addition the Fellows Visiting professor,outside recognized leaders and researchers arefrequently invited to speak at various Mayo Cliniccardiovascular conferences.

Facilities and Resources

FacilitiesThe Mayo Clinic campus in Rochester, Minnesota,includes two hospitals with nearly 1,300 beds, aLevel One Trauma Center, a comprehensiveoutpatient medical complex, a variety of researchfacilities, and several full-service laboratories andon-site pharmacies. More than 1,000 staff physiciansrepresent virtually all clinical specialties.

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The Coronary Care Unit at Saint Marys Hospital has16 beds with 24-hour technician coverage andsupport from the echocardiography, nuclearcardiology, electrophysiology and cardiaccatheterization laboratories. There are another 88beds, with 24-hour centralized technician-monitoredsupport, located in the general cardiology wards.Both the Coronary Care Unit and these wards arefully equipped with a unique, Mayo Clinic-designed, on-line computerized monitoring systemthat covers all aspects of data management.

Mayo Clinic’s Echocardiography Laboratorycurrently performs more than 150 patientexaminations per day. You will have access to awide range of instruments and the newesttechnologies. More than 25 exam rooms areequipped with state-of-the-art two-dimensionalimaging, Doppler ultrasound, and color flowimaging equipment.

There is a newly developed catheterizationlaboratory with state-of-the-art digital and computerequipment in 10 operational rooms. There are morethan 30-35 cardiac catheterizations done every dayand 8-12 interventional procedures using the latesttechnology.

Libraries Mayo Clinic’s library system in Rochester has one ofthe largest medical collections in the world - morethan 4,300 journal subscriptions, nearly 353,000bound volumes, and several medical databases andsearch engines. The main library provides studyspace, computers, microfilm readers and reader-printers, translations, duplicating machines, andbook ordering and audiovisual services.

Reference librarians can arrange interlibrary loans,perform literature searches, and teach you how to

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use the computer database services that link MayoClinic to a global network of scientific information.More than 625 clinical conferences are preserved onvideotape each year. You can view these tapes at thelibrary or check them out for use at home.

Branch libraries include a health-related scienceslibrary, two hospital libraries and the LearningResource Center (LRC). The LRC, devoted mainly tothe Mayo Medical School curriculum, offers specialcollections emphasizing women’s issues in medicineand health, medical education, and ethics.

Computer ServicesMacintosh and IBM personal computers andsoftware are available for fellows to use. In addition,Mayo Clinic’s Microcomputer Education Centerprovides training in the use of computers for wordprocessing, data collection and data analysis.

Telecommunications SystemMayo’s clinics in Rochester, Scottsdale andJacksonville are linked via a sophisticatedtelecommunications system, which provides videoteleconferencing and data transmission. Staff canhave live, interactive consultations with physiciansand their patients at the other sites via TV monitors.In addition, X-rays, laboratory test results, CT scans,ECG tests, angiograms and pathology slides can betransmitted between sites.

An advanced telecommunications system also is thefoundation for Mayo Clinic’s unique five-digittelephone dialing and pager system. Physicians canbe easily accessed for consultations or updates,strengthening the teamwork among consultants,fellows, residents and allied healthcare staff at allthree practice sites.

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Compensation and Benefits

Vacation and Trip PolicyYou may take up to 15 working days (three weeks)each year for vacation.

You are encouraged to present your research atregional and national meetings. If you are selected tomake a presentation, Mayo Clinic will pay theauthorized expenses for you to attend that meeting(within the United States).

You are also given one paid trip for attendanceduring your training program.

Stipends and Other BenefitsMayo Clinic has highly competitive stipends and abenefits package that includes:• A comprehensive medical care plan• Short-term disability insurance• Voluntary basic life insurance, disability

insurance, and family life insurance• Voluntary additional life insurance• Voluntary accidental death and dismemberment

insurance• A dental assistance plan• Excess personal liability insurance• Professional liability coverage

Additional information about stipends and benefitswill be provided during personal interviews.

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The Rochester Community

Home of the original Mayo Clinic and an array ofsuccessful technology-based companies, Rochester,Minnesota, welcomes thousands of visitors fromaround the world each year. Rochester, population80,000, provides all the benefits of small town livingwhile offering amenities associated with largercities.

If you’re interested in the fine arts, you’ll find anactive network of enthusiasts who support asymphony orchestra and chorale, four theaters, acommunity art center, and several choruses andbands.

Rochester offers excellent sports and physical fitnessfacilities. Within the city limits are six golf courses;tennis and health clubs; an extensive network ofwalking, biking and in-line skating trails; nearly2,000 acres of city parks; and a communityrecreation center. Several state parks are nearby, andit’s a very short drive to fishing, hunting, hiking,camping, boating, skiing or skating.

The Twin Cities of Minneapolis and St. Paul are only80 miles north of Rochester. Among manyattractions are the nationally famous GuthrieTheatre, the Minnesota Orchestra, the St. PaulChamber Orchestra and the Walker Art Center. Bothprofessional and collegiate baseball, football andbasketball teams are based there. The Twin Citiesalso have world-class shopping and restaurants,including the Mall of America.

Good, moderately priced housing is relatively easyto find in Rochester. The public school system is oneof the best in the state. Rochester has been selected

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as “one of the best places to live” in the U.S. byMoney magazine for several consecutive years.

Close proximity between Mayo Clinic and homefacilitates time with family and makes call fromhome quite manageable.

Appointments andApplications

EligibilityThe following positions are available annually on acompetitive basis. To be eligible, applicants musthave successfully completed previous training froman accredited program, as noted below:

• Cardiovascular Diseases Subspecialty Fellowship(5-7 positions)

- Three years of postgraduate training in an accredited internal medicine program

• Electrophysiology Subspecialty Fellowship(1-2 positions)

- Three years of cardiovascular training

• Interventional Cardiology SubspecialtyFellowship (1-2 positions)

- Three years of cardiovascular training

• Vascular Medicine Fellowship (1-2 positions)

- Three years of postgraduate training in an accredited internal medicine program

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Application ProcessTo apply for any of these Mayo Clinic fellowships,you need to submit:

• A completed Mayo Graduate School of Medicineapplication form

• Official college, graduate school and medicalschool transcripts

• An official record of board scores (NBME, FLEX,USMLE, LMCC, VQE or FMGEMS)

• A dean’s letter and two other letters ofrecommendation

• A curriculum vitae

• A personal statement

• A valid ECFMG certificate (if you graduated frommedical school outside of the United States orCanada)

The academic year for all of these programs beginsin July.

Applications for the Cardiovascular DiseasesSubspecialty Fellowship Program and the VascularMedicine Fellowship are due by December, 18months before the July in which you wish to beginyour studies.

Applications for the Electrophysiology SubspecialtyFellowship and the Interventional CardiologySubspecialty Fellowship are due no later thanOctober, at least nine months before the July inwhich you wish to begin your studies.

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InterviewsIf you are considered for an appointment, you willbe asked to visit Mayo Clinic Rochester for aninterview with the appropriate program directorand selected faculty. Interviews for all of theseprograms are conducted in February or March eachyear.

Inquiries

If you would like an application form or moreinformation, please contact:• Guy Reeder, M.D., Director

Cardiovascular Diseases Subspecialty Fellowship507-284-3667

• Stephen Hammill, M.D., DirectorElectrophysiology Subspecialty Fellowship507-284-4888

• Stuart Higano, M.D., Education DirectorInterventional Cardiology SubspecialtyFellowship507-255-6092

• Roger Shepherd, M.D., DirectorVascular Medicine Fellowship Program507-266-1111

• James Seward, M.D., Echocardiology SubspecialtyFellowship507-284-9470

• Carole Warnes, M.D., Adult Congenital HeartDiseases Subspecialty Fellowship507-284-3644

• Richard Rodeheffer, Heart Failure/CardiacTransplant Subspecialty Fellowship507-284-3611

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• Raymond Gibbons, M.D., Nuclear CardiologySubspecialty Fellowship507-284-3611

All of the above can be contacted at the followingaddress:

Mayo Graduate School of Medicine200 First Street S.W.Rochester, MN 55905

For more information about the Mayo GraduateSchool of Medicine, please visit our Web site athttp://www.mayo.edu/mgsm/gsm.htm

If you would like to discuss any of these fellowshipprograms with Mayo alumni living in your area,please write to us for a list of their names.

Copyright 2000, Mayo Foundation for Medical Education andResearch. “Mayo,” “Mayo Clinic,” and the triple shield Mayologo are marks of Mayo Foundation for Medical Education andResearch.

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MAYO FOUNDATION IS AN AFFIRMATIVE ACTION AND EQUALOPPORTUNITY EDUCATOR AND EMPLOYER.

MAYO FOUNDATION IS A SMOKE-FREE INSTITUTION.

Notes

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Mayo FoundationMayo Graduate School of Medicine 200 First Street SWRochester, Minnesota 55905

http://www.mayo.edu

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© 2000, Mayo Press

MAYO, MAYO CLINIC andthe Mayo triple-shield logo

are registered marks ofMayo Foundation for Medical

Education and Research.