Cardiology

Rotation Goals and Objectives

I) GENERAL DESCRIPTION

A) Family Physicians actual practices vary considerably in the extent to which they provide cardiology services to their patients. This portion of the curriculum is designed to provide the resident with the skills and knowledge necessary to provide care to the patient with cardiac disease at the level that is expected of family physicians with active practices involving this area. In view of the pervasiveness of cardiac disease in the population, attention must be paid to all aspects of care including management of the patient with disease, early detection of disease, disease prevention, and care of the patient's family. The resident will achieve competency in the management of cardiac disorders commonly cared for by family physicians.

B) The resident will be supervised by a faculty member specializing in cardiology. During this rotation, the resident will be on a one to one basis with the cardiologist or part of a cardiology teaching team including the attending cardiologist, internal medicine residents and medical students. Didactic material is delivered to the resident on an informal basis throughout the course of each day. Assigned readings by the attending will be part of the learning process. It is expected that the resident will be required to present some of the teaching topics.

C) Residents are expected to continue to follow their patients in the Family Medicine Center during this rotation.

D) Level - PG 2/3/4 Years

E) Location -Renown Regional Medical Center, Saint Mary's Regional Medical Center, or VA Medical Center

F) Duration - 2 weeks

G) Cardiology is a full time rotation.

H) Four half days per week are spent in the Family Medicine Center

I) Work hour submission is required during the completion of this rotation.

J) Evaluation of Rotation

1) The evaluation of the resident on this rotation will be done by the completion of an evaluation form by the cardiology attending at the end of the rotation.

2) The resident will fill out a rotation evaluation for at the end of the rotation.

3) The knowledge, skills and competencies acquired during this rotation will be evaluated by a Family Medicine attending as the resident provides care to patients in the Family Medicine Center.

4) The resident's performance on the American Board of Family Medicine In-Training examination will also be used to assess knowledge in this area.

II) PATIENT CARE skills to be mastered

A) Performance of Cardiovascular history taking

B) Performance of Cardiovascular physical examination

C) Develop understanding and skills in the utility, indications, limitations, and interpretation of noninvasive testing

1) Electrocardiograms

2) Chest X rays

3) Exercise Stress testing

4) Nuclear imaging studies

5) Echocardiography

D) Develop and understanding of the utility, indications and limitations of invasive testing

1) Cardiac catheterization and angiography

E) Use of relevant laboratory evaluation

F) Timely use of consultants for cardiac patients

G) Develop an understanding of utility, indications, and limitations of therapeutic options for cardiac patients

1) Coronary artery bypass grafting

2) Angioplasty

3) Pharmacologic management options

4) Pacemakers

5) Cardio version

III) MEDICAL KNOWLEDGE topics to be mastered

A) Normal anatomy and physiology

B) Pathophysiology of Coronary Artery Disease

C) Acute Coronary Syndrome and Myocardial Infarction

D) Arrhythmias and conduction abnormalities

E) Hypertension

F) Congestive Heart failure

G) Thromboembolic disease

H) Valvular Heart disease

I) Peripheral Vascular disease

J) Cardiomyopathies

IV) PRACTICE BASED LEARNING AND IMPROVEMENT

A) This competency is addressed longitudinally throughout the rotation.

1) Scientific evidence will be reviewed by the resident and attending cardiologist in the context of their patients and practice.

2) The practical implementation of evidence-based medicine will be discussed as the medical decision making is reviewed.

3) The use of information technology will be utilized while caring for hospitalized patients on the cardiology service as the hospitals

V) INTERPERSONAL AND COMMUNICATION SKILLS

A) This competency is addressed longitudinally throughout the rotation.

1) The resident will observe and be observed, taught and evaluated in the performance of obtaining patient histories, documenting histories, writing prescriptions and orders, educating patients and families about treatment plans and prognosis, and interactions with patients, families, support staff and physicians.

VI) PROFESSIONALISM

A) This competency is addressed longitudinally throughout the rotation.

1) The attending physician will observe and assess the resident's sense of personal responsibility including attendance, promptness, motivation, completion of duties, and appropriate dress.

2) Ethical and legal practice skills will be taught

3) Respect for cultural, age, and gender differences will be taught, observed and evaluated.

4) The resident is expected to treat patients, families and colleagues with respect, understanding, sympathy and honesty

VII) SYSTEMS BASED PRACTICE

A) This competency is addressed longitudinally throughout the rotation.

1) The resident will learn to become aware of available resources and the cost effectiveness of testing and therapeutic options

2) The resident will gain an increasing understanding of the role of the patient, physician, support staff, and insurer in the health care environment

3) The resident will become aware of the available resources in our community as well as to the limitations of the resources in our community that our available to patients with gastrointestinal disorders.

Updated: May 5, 2018 by Richard Williams, MD