Kaiser Permanente Southern California Residency and Fellowship Programs
Cardiology - Los Angeles Medical Center

Curriculum

Goals & Objectives

The curriculum emphasizes both didactic and hands-on learning of the entire range of cardiac pathologies. It is modeled after the ACC COCATS 3 recommendations, but with important modifications. Level 1 training is mandatory in all disciplines, with Level 2 training offered in many.

Teaching Program

Teaching conferences are conducted every day of the week, covering various aspects of cardiology. Journal club is conducted monthly. Regularly scheduled (biweekly or monthly) Echo, Interventional Cardiology, EP, Basic Science and Hemodynamic Lectures are given by faculty or fellows
Nationally known speakers are invited with industry support to give Grand Rounds monthly.
A core curriculum lecture series is given by the staff cardiologists at the beginning of each academic year. The series covers all basic aspects of clinical cardiology and serves as orientation for the new fellows.

Research Opportunities

Research opportunities are abundant and active participation is mandatory for all fellows. Fields of research include AF, CHF, CRT, echo, EP, coronary interventions, and racial differences in disease outcomes.
Research meetings are held monthly, during which each fellow reports on the progress of his/her project. All fellows are expected to complete one or more projects and to submit their work for presentation and/or publication.

Self-learning tools include a small but comprehensive departmental library (in addition to the large medical center library), online and CD based resources such as free UpToDate subscriptions for each fellow, all self-assessment programs published by the ACC, and much more.

Representative recent research activities are listed here:

  • Invited/Commissioned Peer-Reviewed Manuscripts
  • Shen A, Chen W, Yao JF, Brar S, Wang X, Go AS. Current Opinion - Effect of Ethnicity on the Efficacy of Warfarin: Potential Implications for Prevention of Stroke in Patients with Atrial Fibrillation. CNS Drugs 2008;22(10):815-25. PMID: 18788834
  • Shen A, Brar SS, Khan SS, Kujubu D.Racial Differences in the Association of Heart Failure and Chronic Kidney Disease. Future Cardiology 2006, 2(4): 441-54. EMBASE indexed. doi:10.2217/14796678.2.4.441

 

  • Peer-Reviewed Original Research Manuscripts
  1. Brar SS, Shen A, Jorgensen M, Kotlewski A, Aharonian V, Desai N, Ree M, Shah AS, Burchette R. Sodium Bicarbonate vs. Sodium Chloride for the Prevention of Contrast Medium-Induced Nephropathy in Patients Undergoing Coronary Angiography: A Randomized trial. JAMA 2008;300(9): 1038-46. PMID: 18768415
  1. Shen A, Yao JF, Brar S, Jorgensen MB, Wang X, Chen W. Racial/Ethnic Differences in Ischemic Stroke Rates and the Efficacy of Warfarin among patients with Atrial Fibrillation. Stroke 2008;39: 2736-43. PMID: 18635860
  2. Brar SS, Kim J, Brar SK, Zadegan R, Ree M, Liu I, Mansukhani P, Aharonian VJ, Hyett R, Shen A. Long-term Outcomes by Clopidogrel Duration and Stent Type in a Diabetic Population with De Novo Coronary Artery Lesions. J Am Coll Cardiol 2008;51(23): 2220-7. PMID: 18534267
  1. Brar S, Khan S, Sandhu G, Jorgensen MB, Parikh N, Hsu JY, Shen A. Incidence, Mortality and Racial Differences in Peripartum Cardiomyopathy. Am J Cardiol 2007;100(2): 302-4. PMID: 17631087
  2. Shen A, Yao JF, Brar S, Jorgensen MB, Chen W. Racial/Ethnic Differences in the Risk of Intracranial Hemorrhage among patients with Atrial Fibrillation. J Am Coll Cardiol 2007;50(4): 309-15. PMID: 17659197
  1. Shen A, Young K, Boyatt J. Transthoracic Echocardiographic Visualization of a Right Coronary to Left Anterior Descending Artery Collateral. Echocardiography 2006;23(2): 162-3. PMID: 16445738
  2. Shen A, Gupta N, Kapoor G. Severe Intraventricular Diastolic Gradient due to Hypertrophic Cardiomyopathy and Systolic Left ventricular Mid-cavity Obstruction.  Echocardiography 2005;22(1): 47-8. PMID: 15660687
  3. Shen A, Wang X, Doris J, Moore N. Proportion of Patients in a Congestive Heart Failure Care Management Program Meeting Criteria for Cardiac Resynchronization Therapy. Am J Cardiol 2004;94(5): 673-6. PMID: 15342309

Abstract Presentations at National and International Conferences

  1. Shah A, Brar SS, Fakheri S, Shi JM, Sobnosky S, Burchette RJ, Jorgensen MB, Shen A. Race/Ethnicity is an Independent Predictor of 30-day and 1-year All Cause Mortality among Patients Hospitalized with Sepsis. Abstract accepted for poster presentation at the 22 Annual Congress of the European Society of Intensive Care Medicine in Vienna, Austria in October 2009.
  2. Shah A, Brar SS, Fakheri S, Shi JM, Sobnosky S, Burchette RJ, Shen A, Jorgensen MB. Statin Use is Associated with Reduced Thirty Day Mortality among Patients Hospitalized for Sepsis Irrespective of Atherosclerotic Disease Status. Abstract presentation at the 2009 Scientific Sessions of the American College of Cardiology in Orlando, FL in March 2009.
  3. Shah A, Brar SS, Fakheri S, Shi JM, Sobnosky S, Shen A, Jorgensen MB. High Dose Statins are Associated with a Reduced All Cause Mortality in Patients Hospitalized with Sepsis & Severe Sepsis. Oral presentation at theSociety of Critical Care Medicine’s 38th Critical Care Congress in Knoxville, TN in February 2009.
  • Recipient, Society of Critical Care Medicine 2009 Annual Scientific Award. Cash prize awarded to the top 10 highest scoring abstracts.
  1. Shen A, Sobnosky S, Liu MJ, Ichiuji A, Shah A, Chen W. Race/Ethnicity is an Independent Predictor of Atrial Fibrillation among Individuals 60 Years and Older. Oral presentation at the 2008 AHA Scientific Sessions in New Orleans, LA in November 2008.
  2. Shah A, Brar SS, Fakheri S, Shi JM, Burchette R, Shen A, Jorgensen MB. Statin Use is associated with Reduced All Cause Mortality among Patients Hospitalized with Sepsis and Severe Sepsis. Oral presentation at the 2008 American College of Chest Physicians (ACCP) Conference in Philadelphia, PA in October 2008.
  3. Shah A, Brar SS, Fakheri S, Shi JM, Burchette R, Jorgensen MB, Shen A. Impact of Recent Healthcare Utilization and All Cause Mortality among Patients Hospitalized with Sepsis and Severe Sepsis. Abstract presentation at the 2008 American College of Chest Physicians (ACCP) Conference in Philadelphia, PA in October 2008.
  4. Brar SS, Shah AI, Shen A, Jorgensen MB, Kotlewski A, Aharonian A, Desai N, Burchette RJ. A Randomized Trial for the Prevention of Contrast Induced Nephropathy with Sodium Bicarbonate versus Sodium Chloride in Patients Undergoing Coronary Angiography (MEENA Trial): 6-month clinical outcomes. Abstract presentation at the 2008 Transcatheter Cardiovascular Therapeutics in Washington, DC in October 2008. Am J Cardiol 2008:102(8)(Suppl 1):115i.
  5. Brar SS, Sandhu G, Khandhar S, Khan S, Shen A, Jorgensen M, Hsu JY. Risk Profile of Women with Peripartum Cardiomyopathy and Heart Failure with Preserved Ejection Fraction. Abstract presentation at the 2008 Scientific Sessions of the American College of Cardiology in Chicago, IL in March 2008.
  6. Brar SS, Watanabe C, Shen A. Gender and Race/Ethnicity Differences in Atrial Fibrillation Prevalence in Patients with Non-ischemic Cardiomyopathy. Abstract presentation at the 2008 Scientific Sessions of the American College of Cardiology in Chicago, IL in March 2008.
  7. Shen A, Yao JF, Brar SS, Hsu J, Jorgensen MB, Wang X, Chen W. Intracranial Hemorrhage and Ischemic Stroke Rates in Nonwhites Compared to Whites with Atrial Fibrillation. Poster presentation at the 13th World Congress on Heart Disease, Vancouver, BC, Canada in July 2007.
  8. Brar SS, Ellini K, Aharonian V, Mansukhani P, Liu IA, Shen A. Glomerular Filtration Rates at Cardiac Catheterization Predicts Future Adverse Cardiac Events. Oral presentation at the 13th World Congress on Heart Disease, Vancouver, BC, Canada in July 2007.
  9. Brar SS, Brar SK, Kim J, Zadegan R, Ree M, Liu I, Mansukhani P, Aharonian V, Hyett R, Shen A. Clopidogrel Use and Death or MI After Stent Implantation in a Diabetic Population. Oral presentation at The 30th Annual Scientific sessions of the Society for Cardiovascular Angiography and Interventions (SCAI) in Orlando, FL in May 2007. Presentation won 2nd place. Catheterization and Cardiovascular Interventions 2007; 69:S3.
  10. Brar SS, Zadegan R, Ellini K, Kim J, Beckham J, Ree M, Brar SK, Shen A, Mansukhani P, Hyett R, Liu I, Aharonian V. Difference in Outcomes Between Drug Eluting and Bare Metal Stents After Vein Graft Interventions. Poster presentation at The 30th Annual Scientific sessions of the Society for Cardiovascular Angiography and Interventions in Orlando, FL in May 2007. Catheterization and Cardiovascular Interventions 2007; 69:S51.
  11. Brar SS, Jorgensen M, Kotlewski A, Aharonian V, Desai N, Ree M, Burchette R, Shen A. A Randomized Controlled Trial for the Prevention of Contrast Induced Nephropathy with Sodium Bicarbonate versus Sodium Chloride in Persons Undergoing Coronary Angiography (MEENA Trial). Oral presentation, Late Breaking Clinical Trials at the 2007 Scientific Sessions of the American College of Cardiology in New Orleans, LA in March 2007.
  1. Brar SS, Ellini K, Ambegaonkar A, Shen A, Mansukhani P. Prevention of Postoperative Atrial Fibrillation with Statins in Persons Undergoing Isolated Aortic Valve Replacement. Poster presentation at the 2007 Scientific Sessions of the American College of Cardiology in New Orleans, LA in March 2007.
  2. Brar SS, Parikh N, Sandhu GK, Jorgensen MB, Khan SS, Hsu J, Shen A. Peripartum Cardiomyopathy: Incidence, Mortality and Race in a Large Community Based Cohort. Oral presentation at the 2007 Scientific Sessions of the American College of Cardiology in New Orleans, LA in March 2007.
  3. Shen A, Yao JF, Brar SS, Jorgensen MB, Wang X, Chen W. Short Term Mortality Rates after Intracranial Hemorrhage among White and Nonwhite Patients with Atrial Fibrillation. Poster presentation at the International Stroke Conference 2007 in San Francisco, CA in February 2007.
  4. Shen A, Yao JF, Brar SS, Jorgensen MB, Wang X, Chen W. Short Term Mortality Rates after Ischemic Stroke among White and Nonwhite Patients with Atrial Fibrillation. Poster presentation at the International Stroke Conference 2007 in San Francisco, CA in February 2007.
  5. Brar SS, Liu A, Gupta N, Shen A. Differences in the Prevalence of Atrial Fibrillation and Flutter in Hispanics and Whites in a Large Community Heart Failure Population. Oral presentation at the 2006 AHA Scientific Sessions in Chicago, IL in November 2006.
  6. Brar SS, Kim JJ, Yu D, Aharonian VJ, Shen A, Hsu J, Mansukhani PW. Vasodilator Therapy and Survival in Patients Undergoing Mitral Valve Surgery for Chronic, Severe, Non-Ischemic Mitral Regurgitation. Oral presentation at the 2006 AHA Scientific Sessions in Chicago, IL in November 2006.
  7. Brar SS, Kim JJ, Ambegaonkar A, Mansukhani PW, Shen A, Liu IA, Hyett R, Aharonian VJ. Long-term Cardiovascular Outcomes and Death in Diabetics Treated with the Sirolimus or Paclitaxel-Eluting Stents. Poster presentation at the 2006 Transcatheter Cardiovascular Therapeutics in Washington, DC in October 2006.
  8. Shen A, Yao JF, Chen W, Jorgensen MB, Brar SS. Hospital Admission Rates and Duration for Atrial Fibrillation or Flutter among Caucasians, Asians, Hispanics, and African Americans. Poster presentation at Cardiostim 2006, the 15th World Congress in Cardiac EP and Cardiac Techniques in Nice, France in June 2006. Europace Suppl. 2006; 8(S1): 98P/26.
  9. Shen A, Yao JF, Chen W, Jorgensen MB, Brar SS. Prevalence of Risk Factors for Stroke among Caucasians, Asians, Hispanics, and African Americans with Atrial Fibrillation. Oral presentation at Cardiostim 2006, the 15th World Congress in Cardiac EP and Cardiac Techniques in Nice, France in June 2006. Europace Suppl. 2006; 8(S1): 135/2.
  10. Brar SS, Liu A, Vasquez C, Shen A. Sleep Apnea, Atrial Fibrillation and Hospitalizations in Heart Failure. Oral presentation at Cardiostim 2006, the 15th World Congress in Cardiac EP and Cardiac Techniques in Nice, France in June 2006. Europace Suppl. 2006; 8(S1): 10/3.
  11. Shen A, Yao JF, Chen W, Jorgensen MB, Brar SS. Risk of Hemorrhagic Stroke in Atrial Fibrillation: Is there an Ethnic Difference in its Incidence and in the Effect of Warfarin? Oral presentation at the 2006 Scientific Sessions of the American College of Cardiology in Atlanta, GA in March 2006. J Am Coll Cardiol 2006; 47(4) (Suppl A):363A. (One of the highest graded abstracts for ACC 2006 per the Editor-in-Chief of JACC).
  12. Shen A, Yao JF, Chen W, Jorgensen MB, Brar SS. Risk of Ischemic Stroke in Atrial Fibrillation: Is there an Ethnic Difference in its Incidence and in the Effect of Warfarin? Poster presentation at the 2006 Scientific Sessions of the American College of Cardiology in Atlanta, GA in March 2006. J Am Coll Cardiol 2006;47(4) (Suppl A):35A. (Was among ~1% of all papers selected for presentation at the "Highlights of ACC 2006" session).
  13. Brar SS, Liu A, Khan SS, Kotlewski A, Shen A. Diabetes, Insulin, and the Prevalence of Atrial Fibrillation in a Large Heart failure Population. Oral presentation at the 2006 Scientific Sessions of the American College of Cardiology in Atlanta, GA in March 2006. J Am Coll Cardiol 2006;47(4)(Suppl A):10A-11A.
  14. Brar SS, Liu A, Khan SS, Kotlewski A, Shen A.  Prevalence of Atrial Fibrillation and Flutter by Different HMG-CoA Reductase Inhibitors and Doses in Heart Failure. Oral presentation at the 2006 Scientific Sessions of the American College of Cardiology in Atlanta, GA in March 2006. J Am Coll Cardiol 2006;47(4)(Suppl A):61A.
  15. Brar SS, Shen A. Association of Coronary Artery Disease, Chronic Kidney Disease and Attainment of Low Density Lipoproteins and Hemoglobin A1c Targets in Patients with Diabetes in the Community. Poster presentation at the AHA 46th Annual Conference on Cardiovascular Disease Epidemiology and Prevention in Phoenix, AZ in March 2006.
  16. Brar SS, Liu A, Shen A. Racial Differences in Ischemic Stroke Survivors in Heart Failure (abstr). Poster presentation at the AHA International Stroke Conference 2006, Kissimmee, FL in February 2006.
  17. Brar SS, Liu I, Khan SS, Kotlewski A, Toluie K, Shen A. Racial Differences in Atrial Fibrillation and Flutter in Heart Failure (abstr). Oral presentation at the 2005 AHA Scientific Sessions in Dallas, TX in November 2005. Circulation. 2005;112:II-178.
  18. Brar SS, Shen A. Racial Differences in the Association of Heart failure and Chronic Kidney Disease (abstr). Poster presentation at the American Heart Association 59th Annual Fall Conference and Scientific Sessions of the Council for High Blood Pressure Research in association with the Council of the Kidney in Cardiovascular Disease, Washington, DC in September 2005. Hypertension. 2005 Oct;46(4):863.
  1. Brar SS, Mehany A, Zadegan R, Lai A, Shen A. Predictors of Recurrent Emergency Department Visits in a Large Heart Failure Care Program (abstr). Poster presentation at the 12th World Congress on Heart Disease, Vancouver, BC, Canada in July 2005. J Heart Dis July 2005;4(1):18.
  2. Shen A, Wang X, Doris J, Moore N. Few Patients in a Heart Failure Program qualify for Cardiac Resynchronization Therapy (abstr). Poster presentation at Cardiostim 2004, the 14th World Congress in Cardiac EP and Cardiac Techniques in Nice Acropolis, France in June 2004. Europace Suppl. 2004; 6(S1): 137P/17.
  3. Shen A, Zadegan R, Moore N. Proportion of Patients in a Large Congestive Heart Failure Care Management Program that may benefit from Defibrillator Implantation for the Primary Prevention of Sudden Death (abstr). Poster presentation at Heart Rhythm 2004, the 25th Annual Scientific Sessions of NASPE in San Francisco, CA in May 2004. Heart Rhythm 2004;1(1S):S274.
  4. Wang X, Dullet N, Shen A. Ventricular Tachyarrhythmia Cycle Length, but not Ejection Fraction, Predicts Implantable Defibrillator Shocks (abstr). Plenary session oral presentation at the 3rd World Congress on Heart disease in Washington, DC in July 2003. J Heart Dis July 2003;3(1):18.
  5. Moore N, Wang X, Taitano MT, Dullet N, Shen A. Prevalence of Electrocardiographic Conduction Abnormalities Among 475 Patients With Ejection Fraction <0.35 and Congestive Heart Failure (abstr). Poster presentation at the 2003 American College of Cardiology Scientific Sessions in Chicago, IL in March 2003. J Am Coll Cardiol 2003;41 (Suppl A): 101A.
  6. Moore N, Wang X, Taitano MT, Dullet N, Shen A. Correlation between QRS Duration and Ejection Fraction among 679 Patients with Ejection Fraction =0.40 and Congestive Heart Failure (abstr). Poster presentation at the 2003 American College of Cardiology Scientific Sessions in Chicago, IL in March 2003. J Am Coll Cardiol 2003;41 (Suppl A):135A.

Clinical Experiences & Rotations

The 3-year program consists of 39 rotations (4 weeks each) with the number of rotations as follows: CCU 9, cath lab 6, noninvasive 4 (includes nuclear medicine, pacemaker clinic, and treadmill testing), echocardiography 5, research 4, EP 2, inpatient consults 4, pediatric cardiology 1, cardiac surgical unit 1, cardiac CT 1 (at Harbor-UCLA) and electives 2. Three weeks paid vacation is given each year and may be taken on certain rotations.

Each fellow will maintain a one half-day continuity clinic each week, except when on vacation. Two electives may be taken in the third year, provided arrangements are made and approved by the program director.

All fellows are expected to serve as teachers and role models for residents and students on his or her team.