Clinical rotations are scheduled to ensure our graduating fellows meet Accreditation Council of Graduate Medical Education standards for Cardiology Fellowship as well as Core Cardiovascular Training Statement requirements for board certification in Echocardiography and Nuclear Medicine.

Echocardiography
The echocardiography laboratory at Mount Sinai Morningside is a high-volume center performing over 9,000 transthoracic echocardiograms annually. Fellows gain experience in various techniques including stress echocardiography, transesophageal echocardiography, 3D echo, and vascular imaging. The rotation involves both patient care and research activities.

Nuclear Cardiology
Fellows perform daily stress tests and participate in afternoon reading sessions. The rotation covers a wide range of procedures, including single photon emission computed tomography, thallium studies for viability assessment, and radionuclide angiography.

Cardiac Computed Tomography
The cardiac computed tomography (CCT) and coronary computed tomography angiography (CCTA) rotation allows fellows to see a high volume of cases. Using a 256-slice CT scanner, fellows perform inpatient and outpatient cardiac studies to evaluate coronary artery disease, vascular anatomy, and planning for transcatheter aortic valve replacement. Fellows learn to perform a calcium score, recognize calcified and non-calcified plaques, and assess the degree of coronary stenosis on CCTA.

Cardiac Magnetic Resonance Imaging
In our cardiac magnetic resonance imaging (MRI) rotation, fellows learn utilization and interpretation of this imaging modality, focusing on pathologies of ventricular structure and function, valve disease, myocardial scar, and myocardial ischemia. Fellows see the full spectrum of evaluation for non-ischemic cardiomyopathies, pericardial diseases, and cardiac masses.

Interventional Cardiology
This rotation provides a comprehensive understanding of atherosclerotic heart disease, from basic science to invasive therapies. The high-volume interventional cardiology program emphasizes hands-on training in complex coronary, peripheral, and structural cases. Fellows learn about hemodynamics, especially in shock states where mechanical support is considered.

Electrophysiology
During this two-month rotation, fellows are exposed to the principles of arrhythmias, ECG interpretation, device management, and syncope work-up. The experience includes both outpatient and inpatient settings, as well as involvement in invasive procedures in the electrophysiology laboratory.

Heart Failure
This rotation includes experience in outpatient clinics, inpatient consultations, and a dedicated month at The Mount Sinai Hospital on the Upper East Side for heart transplant and left ventricular assist device services. Fellows learn about heart failure pathophysiology, management strategies, and the integration of advanced therapies.

Cardiac Intensive Care Unit
The Cardiac Intensive Care Unit rotation is core to our program, exposing fellows to a wide range of cardiac pathologies. Fellows perform various bedside procedures and gain increasing responsibility in patient management and education of residents, students, and nurses.

Manhattan Track
The goal of this track is to train cardiologists who excel clinically and succeed in academic medicine. First-year and second-year fellows spend the majority of their clinical training at Mount Sinai Morningside and Mount Sinai West, and a few months at the James J. Peters Department of Veterans Affairs Medical Center and The Mount Sinai Hospital. Third-year fellows focus on robust elective time to deepen ongoing research or specific clinical interests.

Veterans Affairs Track
The James J. Peters Department of Veterans Affairs (VA) Medical Center is a multilevel health care Center of Excellence for Veterans Affairs and a renowned research center. Fellows are integrated into the day-to-day cardiology activities: stress testing, echocardiography, telemetry inpatient, cardiac consultation, and cardiology ambulatory clinics.

Cardiology Clinic
A central component of our cardiology fellows’ experience is their weekly cardiology clinic, taking place one afternoon per week. Each fellow manages approximately eight new and returning patients during clinic sessions, under the supervision of our skilled clinical faculty. Fellows follow their patients continuously throughout their three-year fellowship. The goal of this experience is to teach our fellows how to develop and apply the full range of their medical knowledge and experience to clinical problems in real-time.

On-Call Experience
On-call training is a crucial component of the Mount Sinai Morningside and Mount Sinai West cardiology fellowship. Our on-call structure provides invaluable exposure to all levels of acute cardiology to sharpen decision-making and management skills by the fellows. Common issues include the handling of myocardial infarction, unstable angina, hypotension and cardiogenic shock, aortic dissection, atrial and ventricular arrhythmias, heart block requiring pacemaker, mechanical complications of myocardial infarction such as papillary muscle or free wall rupture, suspected cardiac tamponade, and hypertensive emergencies. During the night on-call experience, our fellows perform or assist in a significant number of emergent cardiac procedures such as transthoracic or transesophageal echocardiography and temporary pacemaker insertions.

Cardiology Conferences
Daily conferences are another highlight of our program. Our lecture schedule begins each year with the core curriculum, which is comprised of high yield topics such as management of acute coronary syndrome and atrial fibrillation. Later in the year, we incorporate case-based conferences and topic-driven journal clubs. A particularly special aspect of daily conferences is our weekly Grand Rounds where we invite leading clinical experts and nationally and internationally acclaimed academicians from across the globe to provide our faculty, fellows, and staff with exposure to the latest research and clinical developments in Cardiology.