The fellowship curriculum includes experience in the following clinical rotations:

 Outpatient Rotation

The outpatient experience is the cornerstone of the fellowship. Fellows participate in a minimum of 10 dedicated Adult Congenital Heart Disease (ACHD) clinical blocks and gain exposure to a high-volume practice that evaluates approximately 200 patients each month across the full spectrum of congenital heart disease complexity. Working alongside our core faculty, fellows participate in general ACHD clinics as well as several specialized multidisciplinary programs, including Transition of Care for adolescents and young adults with congenital heart disease, the multidisciplinary ACHD Fontan Clinic, and the ACHD High-Risk Pregnancy/Cardio-Obstetrics Clinic with Maternal-Fetal Medicine specialists.

To foster progressive autonomy, fellows participate in a dedicated half-day continuity clinic each week throughout the fellowship, where they evaluate and manage their own ACHD patients under core faculty supervision. These consultations require comprehensive review of prior clinic notes, electrocardiograms, echocardiograms, advanced cardiac imaging, catheterization data, and operative reports. Each clinic session concludes with detailed case presentations and faculty discussions focused on pathophysiology, physical examination findings, differential diagnosis, longitudinal management, and review of imaging and invasive studies. This longitudinal experience provides fellows with the knowledge and clinical judgment necessary to independently manage adults with congenital heart disease across their lifespan.

Inpatient Service

The inpatient service provides fellows with extensive experience caring for hospitalized patients across the full spectrum of congenital heart disease. Fellows provide consultative and longitudinal inpatient care at both The Mount Sinai Hospital and the Mount Sinai Children’s Heart Center, including patients in intensive care units, medical and surgical inpatient services, obstetrical units, and post-operative cardiac surgical settings. The service typically manages three to six hospitalized ACHD patients per week, exposing fellows to a broad range of clinical scenarios and disease complexity.

Inpatient training includes the management of congenital and acquired cardiovascular complications such as arrhythmia, heart failure, pulmonary hypertension, high-risk pregnancy, Fontan-related complications, perioperative care, and non-cardiac surgical management in adults with congenital heart disease. Fellows play an active role in coordinating transfers from within the Mount Sinai Health System and outside referral centers, participating in multidisciplinary decision-making, and presenting cases at the monthly ACHD cardiac catheterization and surgical conference. This experience provides valuable training in acute care management, leadership, and multidisciplinary collaboration for complex ACHD patients.

Advanced Cardiac Imaging

The fellowship provides comprehensive training in advanced cardiovascular imaging, including two-dimensional and three-dimensional echocardiography, Doppler imaging, transesophageal echocardiography (TEE), stress echocardiography, cardiac MRI, and cardiac CT. Fellows develop expertise in the acquisition, interpretation, and integration of multimodality imaging findings for patients across the full spectrum of congenital heart disease. During dedicated ACHD imaging rotations and core clinical rotations, fellows perform and interpret at least 150 transthoracic echocardiograms and 25 transesophageal echocardiograms in adults with congenital heart disease, while reviewing numerous additional studies. Fellows also review a minimum of 50 congenital cardiac MRI and CT studies, gaining proficiency in advanced anatomical and functional assessment. Because trainees enter the fellowship from both pediatric cardiology and adult cardiovascular disease pathways, imaging experiences are individualized and may be supplemented with additional pediatric congenital or adult cardiovascular imaging to ensure competency in all aspects of ACHD imaging.

ACHD Cardiac Catheterization

Fellows gain extensive exposure to the full spectrum of diagnostic and interventional cardiac catheterization procedures performed throughout the Mount Sinai Health System. Training includes invasive hemodynamic assessment of complex congenital heart disease, pulmonary hypertension, Fontan physiology, shunt lesions, valvular heart disease, and advanced heart failure, as well as participation in a wide range of congenital and structural transcatheter interventions. During fellowship, trainees are expected to participate in and interpret at least 10 diagnostic and 20 interventional congenital cardiac catheterization procedures, while reviewing and discussing numerous additional cases. Because fellows enter the program from both pediatric cardiology and adult cardiovascular disease training pathways, catheterization experiences are individualized to ensure competency across congenital and adult cardiovascular hemodynamics, imaging, and intervention. Additional exposure to pediatric congenital catheterization, adult coronary angiography, structural heart interventions, and pulmonary vascular disease may be incorporated based on each fellow’s prior experience and educational needs.

Elective Rotations

The fellowship offers a flexible and individualized curriculum that allows fellows to tailor their training based on their prior background, career goals, and areas of interest. A broad range of elective rotations are available across both pediatric and adult cardiovascular disciplines. For example, pediatric cardiology-trained fellows may pursue additional experience in adult advanced heart failure, mechanical circulatory support and transplantation, coronary intensive care, structural heart disease, or adult electrophysiology. Adult cardiology-trained fellows may elect to spend additional time in pediatric echocardiography, congenital electrophysiology, congenital interventional cardiology, fetal cardiology, or pediatric cardiothoracic surgery. Fellows also have the opportunity to rotate through several highly specialized multidisciplinary programs, including pulmonary hypertension, which is jointly supported by the Mount Sinai Fuster Heart Hospital and the Mount Sinai Respiratory Institute. These elective experiences allow fellows to develop expertise in areas most relevant to their future practice while ensuring comprehensive exposure to the full spectrum of adult congenital heart disease care.

Research is a core component of the fellowship. Fellows are expected to develop an independent research project and are encouraged to meet with faculty throughout the program to explore ongoing research opportunities. Projects may span the spectrum of basic, translational, clinical, outcomes, education, or quality improvement research, with mentorship available from faculty within the Divisions of Cardiovascular Medicine and Pediatric Cardiology. By the end of the third month of training, fellows are expected to identify a research mentor and establish a project timeline. Fellows are provided dedicated research time throughout fellowship, including six dedicated research blocks, and receive ongoing mentorship in study design, methodology, data collection, statistical analysis, interpretation of results, and manuscript preparation. Progress is reviewed regularly with the research mentor to ensure timely completion of project goals. Fellows are expected to present their work at local, regional, and national scientific meetings and are strongly encouraged to publish their findings in peer-reviewed journals.

All applicants must have successfully completed an ACGME-accredited Adult Cardiovascular Disease or Pediatric Cardiology fellowship prior to starting the Mount Sinai Adult Congenital Heart Disease Fellowship. Our application deadline is August 15, 2026, for the planned start of July 1, 2027.

Applicants for the fellowship program must be registered with Electronic Residency Application System (ERAS) using the National Resident Match Program (NRMP) match rules. All applications are accepted through ERAS, and interviews typically occur during the months of September and October. Other requirements include completion and passage of all three United States Medical Licensing Examination (USMLE) steps, as well as American Board of Internal Medicine (ABIM) or American Board of Pediatrics (ABP) certification or eligibility in general Adult Cardiovascular Disease or Pediatric Cardiology fellowship. Any accepted applicant must obtain a valid New York State medical license. A valid Educational Commission for Foreign Medical Graduates (ECFMG) certificate is required for all foreign medical graduates, and only J-1 visas are accepted.

To apply, the following documents must be submitted through ERAS:

• Curriculum vitae
• Statement of interest (limit one page)
• USMLE Transcript (Steps 1-3)
• Medical School Transcript
• Educational Commission for Foreign Medical Graduates (ECFMG) certificate, if needed
• Three letters of recommendation:
  • One must be from a cardiology fellowship program director, or chief of cardiology
  • The other two letters must be from cardiology faculty