Electrophysiology Los Angeles Medical Center - Curriculum

Curriculum and Clinical Experiences

Clinical Cardiac Electrophysiology fellows take calls one week at a time. They are responsible for patients transferred from referring facilities for electrophysiologic evaluation. The Cardiology fellow on call will be available to the Clinical Cardiac Electrophysiology fellows
for discussion of cases in the Coronary Care Unit and telemetry units. There is also a faculty member on call with them to discuss all cases.

Clinical Cardiac Electrophysiology fellows are supervised during invasive and non-invasive procedures, as well as all consultative electrophysiology evaluations. Each consultative Electrophysiology evaluation will be presented and discussed with faculty. The fellow’s work in continuity clinics is reviewed by the assigned faculty. EP teaching conferences include a weekly clinical case conference presented by the Fellows, weekly EP core curriculum teaching conference presented by the faculty, monthly journal club conference and monthly research conference.

Clinical Cardiac Electrophysiology faculty members are available 24 hours a day, 7 days a week for support. Fellows can communicate with supervising physicians with pagers, 24-hour phone availability, e-mail, daily face-to-face interaction, as well as teaching rounds and educational conferences.

Research

There are ample research opportunities during the course of training. Faculty members have ongoing, active research and have presented several accepted abstracts at the Heart Rhythm society meetings. Fellows are encouraged to join existing projects or pursue their own projects under the mentorship of a faculty member.

Twice per year, each fellow is required to select a topic in Cardiac Electrophysiology, research that topic, discuss it with an attending prior to presentation, make the appropriate audiovisual preparations, and present it at a conference in the appropriate Continuing Medical Education format for the topic.

Conferences offered include Medical Center Grand Rounds, Internal Medicine and Family Medicine weekly educational half days, and Cardiology and Interventional Cardiology case presentations and updates. In addition, all major departments and subspecialty divisions have regularly scheduled conferences. There are also one to two day yearly symposia in all specialties and many subspecialties.

All residents and fellows at the Kaiser Permanente Los Angeles Medical Center are required to attend a series of core workshops which include:

• Culturally Responsive Care Workshop
• Doctor /Patient Communication
• Risk Management/Medical Legal
• Bioethics
• Preparation for Medical Practice

Work Schedule

Fellows will rotate every other week between the EP LAB/ RFA Procedures and OR Implants. The average total number of hours worked per week is 60 hours with a mandatory 1 day off per week and 1 week off for educational leave. Fellows receive 3 weeks paid vacation. In addition, one week of educational time may be available with program approval. Each Fellow will have 1 half day clinic per week dedicated for outpatient consultation clinic, which is combined with device interrogation / follow up clinics. In addition, fellows will also be assigned inpatient consultations and follow up of the EP service hospital patients.

Clinical Experiences

Inpatient Program/Outpatient

During a typical ambulatory medicine experience in Clinical Cardiac Electrophysiology, fellows see new patients and follow-up patients in the Electrophysiology weekly continuity clinic. After evaluating the patients, the case is discussed by the Cardiac Electrophysiology attending and both the patient and the attending will discuss the plan of care and options with the patient. They also see patients for pre-operative evaluation for device implantation and also see them in follow-up in ICD clinic and further follow-up management of these patients.

Inpatient Teams

The clinical cardiac electrophysiology fellow is directly responsible for the pre- and post-care of the patient undergoing a procedure and will be supported by the CCEP service hospitalist and nurse practitioner. Thus, there is daily communication and interaction between the two fellows regarding the care of these patients. Also, the cardiovascular disease fellow is on call at night and communicates with the clinical cardiac electrophysiology fellow regarding the care of patients, as needed.

Teaching Opportunities (Students)

Fellows are considered consultants and teachers for the other house staff and medical students on all the services in which they jointly participate. They teach the Internal Medicine and Family Practice house staff on the inpatient services. Fellows also work with the Cardiac Electrophysiology faculty in overseeing the patient care provided by the Internal Medicine, Family Practice, and Cardiology house staff.