ACHD Outpatient Rotation

Our fellows are expected to participate in a dedicated ACHD rotation for 10 blocks. Mount Sinai’s outpatient service evaluates approximately 200 patients per month, and fellows will engage in all outpatient clinics with adult congenital faculty members. Our fellows will also participate in the transition and transfer clinic process for adolescents and young adults during their outpatient months.

Under the supervision of a faculty member, there is a half-day session clinic each week, for 20 blocks, set aside for fellows to see their own patients. This consultative evaluation requires the review of prior clinic visits, electrocardiogram, imaging studies, invasive testing, and operative notes.

A subsequent presentation to faculty at the end of every clinic provides our fellows with the opportunity for in-depth discussion of pathophysiology, differential diagnosis, physical examination, and review of pertinent objective data. It also includes a review of all outpatient echocardiograms, advanced cardiac imaging, and cardiac catheterization.

ACHD Inpatient Service

Our inpatient service cares for three to six patients per week, and our Adult Congenital Heart Disease fellows provide consultative services for patients admitted to The Mount Sinai Hospital and the Mount Sinai Children’s Heart Center. This includes intensive care units, medical inpatient units, obstetrical service, and post-cardiac surgical patient care.

Mount Sinai’s inpatient management encompasses a diverse range of adult congenital heart disease areas, including arrhythmia, heart failure, pulmonary hypertension, pregnancy, pre- and post-cardiac surgical management, and noncardiac surgical management. Our fellows are responsible for accepting transfers from within the Mount Sinai Health System, or referring hospitals, for acute medical or surgical care. Additionally, fellows prepare and present cases for the monthly ACHD cardiac catheterization and surgical case conference.

ACHD Imaging

The Mount Sinai Adult Congenital Heart Disease Fellowship provides training in advanced methods of diagnosis, including two-dimensional and three-dimensional, doppler, transesophageal, and stress echocardiography, and MRI/CT in adults with congenital heart disease. During the two blocks of ACHD imaging and 10 blocks of core rotations, our fellows will perform and interpret 150 transthoracic and 25 transesophageal echocardiograms, and review additional ones.

Because there are dual pathways for entry into the fellowship (pediatric and adult), these echocardiograms may be supplemented by further review of general pediatric congenital or adult cardiovascular echocardiograms to achieve competency for each fellow. Our fellows are also expected to review 50 MRI/CT in adults with congenital heart disease.

ACHD Cardiac Catheterization

Our fellows have an opportunity to engage in a variety of  types of catheterization procedures throughout Mount Sinai. They are expected to perform and interpret 10 diagnostic and 20 interventional catheterizations and review additional cases.

Because there are dual pathways for entry into the ACHD Fellowship (pediatric and adult), these catheterizations may be supplemented by further review of general pediatric congenital, or adult cardiovascular catheterizations, to achieve competency for each fellow.

Elective Rotations

Mount Sinai offers a dynamic range of rotations within the pediatric and adult cardiology fellowship that can serve as elective experience, depending on previous training and interest. For example, a pediatric cardiologist may choose further rotations in the adult coronary care unit, heart failure, mechanical circulatory support/transplant service, or adult electrophysiology services. An adult cardiologist may choose further rotation in pediatric echocardiography, congenital electrophysiology/interventional cardiology, or pediatric cardiothoracic surgery. Our fellows also have an opportunity to rotate through pulmonary hypertension, which is housed between Mount Sinai Heart and the Mount Sinai – National Jewish Respiratory Institute.

Research

During their time at Mount Sinai, our fellows are expected to develop an independent research project. We strongly encourage them to meet with each faculty member in the Adult Congenital Heart Program to discuss ongoing projects. Research may range from basic science to purely clinical research, and faculty within the Divisions of Cardiovascular Medicine and Pediatric Cardiology may also act as mentors.

By the end of their fourth month, our fellows are expected to select a research mentor and create a timeline of a research project. The identified research mentor will provide guidance regarding methodology, data collection, data interpretation, analysis, and manuscript preparation during their fellowship, and fellows will have dedicated time for research in six blocks. A monthly review of the research timeline will occur alongside the research mentor.

Finally, fellows are expected to present their research at the local or national level.

All applicants must have successfully completed an ACGME-accredited adult or pediatric cardiology fellowship prior to starting the Mount Sinai Adult Congenital Heart Disease Fellowship.

Our application deadline is August 15, for the planned start of July 1. All applications are accepted through the Electronic Residency Application Service (ERAS), and interviews typically occur during the months of September and October.

Other requirements include completion and passing of all three United States Medical Licensing Examination (USMLE) steps, as well as American Board of Internal Medicine certification or eligibility in general adult or pediatric cardiology. Any accepted applicant must obtain a New York medical license. A valid Educational Commission for Foreign Medical Graduates 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 professional and investigative interest (limit one page)
• USMLE Transcript (Steps 1-3)
• Medical School Transcript
• Educational Commission for Foreign Medical Graduates 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.

National Resident Matching Program (NRMP) Important Dates:

• Match registration opens: August 21, 2024
• Ranking order list opens: September 25, 2024
• Rank order lists certification deadline: November 20, 2024
• Match Day: December 4, 2024