Curriculum, Goals and Objectives

Electrophysiology Fellowship at Newark Beth Israel Medical Center

Goals and Objectives

The Electrophysiology Fellowship at Newark Beth Israel Medical Center is designed to ensure that the fellow will develop proficiency managing their own patients with supervision of the attending staff.

The specialty education of physicians to practice independently is experiential, and necessarily occurs within the context of the health care delivery system. Developing the skills, knowledge, and attitudes leading to proficiency in all the domains of clinical competency requires the resident physician to assume personal responsibility for the care of individual patients. EP fellowships provide advanced education to allow a fellow to acquire competency in the subspecialty with sufficient expertise to act as an independent consultant.

In keeping with the educational objectives outlined by the ACGME, the NBIMC Electrophysiology Fellowship is committed to teaching and assessing the six areas of competency. These six domains in cardiology fellows should be competent are: Patient Care, Medical Knowledge, Practice Based Learning, System Based Practice, Interpersonal and Communication Skills and Professionalism.

General Goals

The trainee is expected to:

  • Communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and their families.
  • Gather essential and accurate information about their patients.
  • Make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment.
  • Develop and carry out patient management plans.
  • Counsel and educate patients and their families.
  • Use information technology to support patient care decisions and patient education.
  • Perform competently all medical and invasive procedures considered essential for the area of practice.
  • Provide health care services aimed at preventing health problems or maintaining health, work with health care professionals, including those from other disciplines, to provide patient-focused care.

Clinical Experience: Specific Goals

Specific goals include:

  • A. Electrophysiology

By the end of the Clinical Cardiac Electrophysiology fellowship, the fellow should be proficient in the interpretation of intracardiac electrograms recorded from the high right atrium, His bundle region, RV apex, and coronary sinus. The fellow should know how to interpret these electrograms to assess sinus node function, AV nodal function, and refractory periods. The fellow should be able to interpret intracardiac electrograms during supraventricular tachycardias and ventricular tachycardias, and perform pacing maneuvers to assist in their interpretation. The fellow should be proficient in mapping and ablation techniques, including pulmonary vein isolation procedures.

  • B. Cardiovascular Implantable Electronic Devices (CIED)

By the end of the Clinical Cardiac Electrophysiology fellowship, the fellow should be proficient in the indications for the insertion of pacemakers, ICDs, cardiac resynchronization devices, leadless pacemakers. The fellow should be able to recognize normal vs abnormal device function and be able to perform device interrogation and reprogramming. The fellow should also be proficient in the insertion of left atrial occlusion devices.

Medical Knowledge

Residents must demonstrate knowledge of established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care. EP fellows are expected to:

Demonstrate an investigatory and analytic thinking approach to clinical situations.

Know and apply the basic and clinically supportive sciences which are appropriate to their discipline.

Acquire cognitive skills and decision making attributes throughout the training process in areas that include:

Cellular and clinical electrophysiology, which includes the theory and practice of:

  • 12 lead ecgs and ambulatory ecgs/event monitors
  • In hospital telemetry
  • Remote device interrogation and transtelephonic ecgs
  • Invasive electrophysiology studies
  • Activation mapping, entrainment mapping
  • Ablation techniques
  • Intra-cardiac ultrasound
  • Lead extraction
  • Implantation of left atrial occlusion devices
  • Implantation of pacemakers, ICDs, and cardiac resynchronization devices
  • Cardioversion
  • Cardiovascular anatomy
  • Cardiovascular physiology
  • Cardiovascular metabolism
  • Molecular biology of the cardiovascular system Cardiovascular pharmacology, including drug metabolism, adverse effects, indications, the effects on aging, relative costs of therapy, and the effects of non-aging, relative costs of therapy, and the effects of non-cardiovascular function
  • Cardiovascular pathology
  • Genetic causes of cardiovascular disease
  • Epidemiology and biostatistics

Educational Conferences

The following is a list of mandatory conferences.

  • Electrophysiology Case Conference (weekly)
  • Electrophysiology Core Curriculum Lecture (weekly)
  • Electrophysiology for Cardiology Fellows Core Curriculum (monthly)
  • Electrophysiology Journal Club (monthly)
  • Research Conference (monthly)
  • Quality Assurance Conference (monthly)
  • Electrocardiography (biweekly)

Progression in Responsibilities

The Program is 24 months. The electrophysiology fellow will be provided progressive responsibilities in the total care of the electrophysiology patient, including preoperative evaluation, therapeutic decision making, operative experience, and postoperative management. The EP fellow will have increasing responsibilities in the electrophysiology laboratory, as well as in decision making in inpatient and outpatient consults, and clinical follow up.