Educational Purpose:

To acquire experience and proficiency in managing patients with known or suspected heart disease in both ambulatory and in-patient settings.

Goals and Objectives:

PGY 1-

1.  Perform consultations and continuing care of patients throughout the hospital and in the MUSC Heart Clinic with known or suspected cardiovascular disease.

2.  To develop skills in cardiac diagnosis and functional assessment.

3.  To develop experience and expertise in interpretation of 12-Lead electrocardiograms.

4.  To develop experience and expertise in interpretation of 24-hour ambulatory ECG recordings.

5.  To develop expertise and technical skill in the performance of exercise stress testing.

6.  To understand the indications for invasive and non-invasive cardiac diagnostic studies.

PGY 2&3-

1.  Perform consultations and continuing care of patients throughout the hospital and in the MUSC Heart Clinic with known or suspected cardiovascular disease.

2.  To develop skills in cardiac diagnosis and functional assessment.

3.  To develop experience and expertise in interpretation of 12-Lead electrocardiograms.

4.  To develop experience and expertise in interpretation of 24-hour ambulatory ECG recordings.

5.  To develop expertise and technical skill in the performance of exercise stress testing.

6.  To understand the indications for invasive and non-invasive cardiac diagnostic studies.

7.  Supervise and assist interns and medical students on the service.

Teaching Methods:

Teaching Rounds are held daily on weekdays, usually in the afternoon between 2:00 p.m. and 5:00 p.m. with discussion of differential diagnosis and patient management on all patients seen by house staff and students.  EKG, Holter and stress test interpretations are done between the hours of 8:00 a.m. and 10:00 a.m. on a daily basis with formal teaching conferences of these modalities on Mondays, Wednesdays, and Fridays between those same times.

Mix of Diseases and Pathological Material:

Leading diagnoses include acute coronary syndromes, coronary artery disease, heart failure and cardiomyopathies, valvular disease, pericardial disease, and arrhythmias. Residents care for a diverse patient population with respect to age, ethnicity, and gender.  The majority of the patients are older adults, but there are significant numbers of adolescent and young adult patients in some sites.

Patient Characteristics:

Residents care for a diverse patient population with respect to age, ethnicity, and gender.  The majority of the patients are older adults, but there are significant numbers of adolescent and young adult patients in some sites.

Types of Clinical Encounters:

Residents will evaluate new consults from a variety of inpatient Medical and Surgical services. Residents are expected to develop a care plan for each patient encounter to discuss with their fellow and attendings. In addition, there are several opportunities to participate in outpatient clinics as well.

Procedures and Services:

Residents will have the opportunity to perform and interpret EKG’s as well as observe or assist in other procedures including echocardiograms, heart catheterizations, stress tests, EP studies, elective cardioversions.

Supervision:

The upper level residents’ rotation on the Cardiology Consult service is supervised by the Cardiology fellow and attending.  They in turn supervise the senior medical students and interns rotating on the service.

Educational Resources to be Used and Reading Lists:

A reading list is provided by attending faculty.  This includes standard textbooks of Cardiology (example:  The Heart, 9^th Edition and Clinical Cardiology).  Peter Gazes is author and faculty member.  Participants on this rotation attend Cardiology Division Conference at 7:30 a.m. on Friday mornings.  This conference is Cardiology fellow/Medicine resident’s conference which is a case presentation and review of the literature.

Method of Evaluation of Resident Competence:

The teaching physician evaluates Patient Care and Medical Knowledge through direct observation and questioning on rounds.  Systems-Based Practice is emphasized in that the resident interacts with multiple members of the health care team including attendings, fellows, other residents, students, and the nurse practitioner.  The resident also gains experience in the role of a medical consultant.  Practice-Based Learning is evaluated based on the ability to consult the literature and to improve their performance throughout the rotation.  The residents evaluate the rotation and the attending physician through the E*Value system.  The consult attendings review the rotation evaluations and each attending anonymously receives his or her evaluations. Interpersonal and Communication Skills and Professionalism is assessed by the attending physician via the global evaluation form.