Curriculum and Rotations
Our three-year fellowship program offers progressive, comprehensive exposure to all major areas of cardiovascular medicine.
Fellows rotate through a variety of subspecialties, gaining clinical expertise, procedural competence, and research experience while working closely with nationally recognized faculty.Training Overview
The echocardiography and advanced cardiac imaging rotations are led by a team of cardiologists with advanced level of training. Our fellows should expect to obtain competence within the first two years of training in TTE, TEE, and stress echocardiography.
Our echo lab focuses on myocardial perfusion, a unique technique that our fellows are familiar with and can use to detect myocardial ischemia. Additionally, our program provides robust and growing training in structural and interventional echocardiography.
Typical echo guided procedures include transcutaneous mitral valve repair/replacement, Watchman, and intracardiac closure devices. Our multimodality imaging rotations provide robust exposure to nuclear cardiology, cardiac MRI and cardiac CT.
Training is individualized to each fellow in order to best suit their ultimate career goals. A dedicated fellow can achieve competence in these areas within three years of training, or additionally plan for a dedicated fourth year of training to meet level 3 requirements.
Our fellows who trained in advanced imaging are very well-established, many of them are leading advanced imaging programs at other institutions nationally.
As a large tertiary referral center, our fellows are exposed to the most challenging cases in electrophysiology. They are expected to achieve independence in interrogation and programming of pacemakers and implantable cardioverter defibrillators.
With two dedicated invasive laboratories, trainees will have the option to participate in electrophysiology studies, as well as electroanatomic mapping and catheter ablation (both radiofrequency and cryo) using the most advanced technologies.
Fellows do also have the opportunity to achieve Level 2 certification (six months required) in pacemaker implantation, with hands-on instruction in device insertion, advanced programming and remote monitoring.
Our Cath lab performs a variety of coronary interventions, including complex high-risk patients (LM, LV supported, bifurcations, and chronic total occlusion cases). We have an extensive intracoronary physiology and imaging program using state-of-the-art technologies (OCT, HD IVUS).
Our interventionists also perform peripheral and structural procedures (including TAVR, PFO closure, left atrial appendage closure, and Mitraclip). We have a very active hemodynamic cath lab that performs over 700 right heart catheterizations every year (including over 500 myocardial biopsies).
Our fellows receive extensive training in measuring and interpreting hemodynamics of complex heart failure and pulmonary hypertension patients.
Rotations
Each block represents four weeks of training. The distribution of rotations is designed to meet all ACGME requirements and the American College of Cardiology’s COCATS guidelines for a general cardiology fellowship.
|
Rotation |
Total Blocks |
Approximate Weeks |
|
Elective |
7 |
28 weeks |
|
Cath Lab |
6 |
24 weeks |
|
Echo |
6 |
24 weeks |
|
Consult Service |
5 |
20 weeks |
|
Multimodality Imaging |
4 |
16 weeks |
|
CHF |
3 |
12 weeks |
|
EP |
3 |
12 weeks |
|
Research |
3 |
12 weeks |
|
ACHD |
1 |
4 weeks |
Rotation Information
- Unique Regional Resource: One of about 30 ACHD programs in the U.S., and the only program in the region certified as a Center of Excellence by the Adult Congenital Heart Association.
- Multidisciplinary Training: Fellows rotate with board-certified ACHD faculty, attend daily clinics at Nebraska Medicine and Children’s Nebraska, and participate in complex ACHD catheterizations, surgeries, and advanced imaging review.
- Advanced Fellowship Pathway: Competitive two-year ACHD fellowship available for fellows pursuing ABIM board certification in ACHD.
- High Volume, High Complexity: More than 40 cardiac transplants and 30 LVAD implants annually, making it one of the largest programs in the Midwest.
- Comprehensive MCS Exposure: Fellows manage ECMO, intra-aortic balloon pumps, and intravascular ventricular assist systems.
- Clinical Mastery: Graduates leave confident in managing the most critically ill cardiac patients independently.
- Advanced Interventions: Coronary procedures on high-risk patients (LM, LV-supported, bifurcations, CTO).
- Cutting-Edge Imaging: Intracoronary physiology and imaging with OCT and HD IVUS.
- Structural & Peripheral Interventions: TAVR, PFO closure, left atrial appendage closure, Mitral and Tricuspid clips
- Hemodynamic Focus: Over 700 right heart catheterizations annually, including myocardial biopsies, with advanced training in pulmonary hypertension and complex HF physiology.
- Team Structure: Two cardiology fellows are assigned to the service at a time, ensuring adequate coverage for the busy consult volume while maintaining an educational environment. Four residents (internal medicine and/or family medicine) rotate on the service, assisting fellows with patient evaluations, diagnostic workups, and care coordination.
- Educational Focus: The presence of residents creates a rich teaching environment, allowing fellows to hone their skills as educators while reinforcing their own knowledge.
- Leadership Development: Fellows take on the role of team leaders, making clinical decisions, prioritizing consults, and guiding residents (i.e. mirroring the responsibilities of an attending cardiologist).
- Schedule: Consult service fellows work Monday through Friday, 7 am to 5 pm, with no routine weekend duties.
- Clinical Breadth: Fellows evaluate a wide range of inpatient cardiology consults, ranging from acute coronary syndromes and advanced heart failure to arrhythmia management, gaining experience in both urgent and complex chronic cardiovascular conditions.
- Structured Training: Led by cardiologists with specialized training in echocardiography and advanced imaging, fellows are expected to develop proficiency in transthoracic, transesophageal, and stress echocardiography within two years.
- Unique Expertise: Our echo lab specializes in myocardial perfusion techniques for detecting ischemia—unique training that fellows learn and apply.
- Procedural Experience: Fellows participate in echo-guided interventions such as transcutaneous mitral valve repair/replacement, Watchman device placement, and intracardiac closure procedures.
- Multimodality Exposure: Comprehensive rotations include nuclear cardiology, cardiac MRI, and CT imaging.
- Flexible Progression: Training is tailored individually; many reach competence in these modalities within three years. For fellows seeking Level 3 imaging credentials, a dedicated fourth year is available.
- Academic Success: Alumni who trained in advanced imaging frequently lead imaging programs at institutions nationally.
- High-Complexity Exposure: At our tertiary referral center, fellows engage with complex EP cases.
- Skill Development: Fellows progress to independence in device interrogation and programming (pacemakers, ICDs).
- Hands-On Procedural Training: With two invasive EP labs, trainees perform EP studies, electroanatomic mapping, and catheter ablations (radiofrequency and cryo-ablations), using cutting-edge technology.
- Level 2 Certification: Fellows have the opportunity for Level 2 certification in pacemaker implantation with comprehensive device insertion and programming experience.
- Fellows Continuity Clinic
- Longitudinal Care: One half-day weekly during the first two years, managing a diverse outpatient population.
- Faculty Mentorship: Direct oversight and progressive autonomy to prepare fellows for independent practice.
Sample Schedule Block
|
Month |
First Year |
Second Year |
Third Year |
|
1 |
Cath |
Cath |
Echo |
|
2 |
Cath |
Cath |
MMI |
|
3 |
Cath |
Cath |
MMI |
|
4 |
Echo |
Echo |
MMI |
|
5 |
Echo |
Echo |
Consult |
|
6 |
Echo |
MMI |
CHF |
|
7 |
Consult |
Consult |
EP |
|
8 |
Consult |
Consult |
Elective |
|
9 |
CHF |
CHF |
Elective |
|
10 |
EP |
EP |
Elective |
|
11 |
ACHD |
Elective |
Elective |
|
12 |
Elective |
Elective |
Elective |
|
13 |
Research |
Research |
Research |
Night Float System
At UNMC, our cardiology fellowship uses a Night Float system - meaning fellows do not take traditional 24-hour calls. This structure promotes better work–life balance while ensuring consistent patient care.
The Night Team includes the night float fellow, an internal medicine resident and a cardiology APP, who work together to oversee all cardiovascular care overnight.
- Week Night Float: Five consecutive nights (Sunday–Thursday) from 5 pm to 8 am
- Weekend Night Float: Two consecutive nights (Friday–Saturday) from 5 pm to 8 am
- Night Float is scheduled only during non-service rotations (Echo, MMI, Cath, Elective, Research) so daytime learning and procedural experiences are preserved.
Annual Night Float & Coverage Distribution
|
Training Year |
Weeknight NF Rotations (Sunday–Thursday) |
Weekend NF Rotations (Friday and Saturday) |
Weekend Day Coverage (Saturday-Sunday) |
Holidays |
|
First Year |
5 |
5 |
10 |
2 |
|
Second Year |
3 |
3 |
7 |
1 |
|
Third Year |
0 |
0 |
3 |
1 |
Advanced Training and Research
With more than 40 cardiac transplantation, and about 70 LVAD implants every year, our heart failure program is considered one of the largest in the Midwest. Our fellows obtain extensive exposure to advanced heart failure patients and are very comfortable in dealing with complex hemodynamics and managing mechanical circulatory support devices (including ECMO, intra-aortic balloon pumps, and Intravascular Ventricular Support System).
This level of exposure allows our graduates to be confident in treating the most complex cardiac patients independently.
Cardiology fellows will have a unique opportunity to rotate with a group of board-certified Adult Congenital Heart Disease faculty members. UNMC's program is one of roughly 30 programs in the United States, and the only program in the region working directly with adult cardiology fellows, certified as a center of excellence by the Adult Congenital Heart Association.
In addition to the core curriculum, fellows on the rotation will attend daily ACHD clinics at Nebraska Medicine and Children’s Hospital. Additionally, fellows will be able to attend complex ACHD cardiac catheterizations and surgeries, as well as to review echocardiography and advanced imaging of these complex patients.
Competitive advanced fellowship opportunities are available to cardiology fellows seeking additional training and board certification in ACHD (two-year fellowship via the American Board of Internal Medicine).
Our division has an active collaboration with iEXCEL, a state-of-the-art program and infrastructure on medical simulations at UNMC.
Through our computational simulation and virtual/augmented reality platforms we provide a unique training and education on cardiovascular imaging and interventions to our faculty, fellows and staff. We are building simulation models that will form an essential component of the fellows’ experience during fellowship in a step towards migrating the education out of the conventional lecture rooms to a whole new world that allows the learners to dive within and relate to the educational materials.
A large variety of research activities are available at UNMC. Our clinical research is supported by a large database of patients who received advanced level of care at Nebraska Medicine's tertiary center.
Nebraska Medicine offers a well-established electronic medical records system that contains over 2.2 million patients, the ongoing improvements to our data mining capabilities, as well as the high exposure to patients with relatively rare conditions, constitute a huge advantage for those interested clinical outcome research.
We participate in a large number of multi-center trials for both new pharmaceutical and device therapies. Multiple of our cardiology faculty work on externally (i.e. NIH) as well as internally funded projects.
The Nebraska Cardiovascular BioBank has nearly 1,000 research subjects consented and enrolled. These BioBank subjects will facilitate the study of most all-cardiovascular questions via chart review and/or tissue-based cellular and molecular studies. There is a variety of active projects in areas like cardiac perfusion imaging, cardiac genetics, coronary artery disease arteriosclerosis pathology and computational models, molecular and cellular immunology, electronic medical records development, and others.