Curriculum and Clinical Experiences

Fellows take calls one week at a time. They are responsible for telephone consultation for referring providers as well as accepting patients in transfer from referring facilities for electrophysiologic evaluation. The fellow on call will be available to the Clinical Cardiology 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 residents 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 resident’s work in continuity clinics is reviewed daily 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. Residents 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 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
• Bio Ethics
• 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. Fellows recieve 4 weeks of paid vacation. 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, residents 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 resident is directly responsible for the pre- and post-care of the patient undergoing a procedure.  Patients are often admitted to the CCU/telemetry unit where a cardiology resident is in charge.  Thus, there is daily communication and interaction between the two residents regarding the care of these patients.  Also, the cardiovascular disease resident is on call at night and communicates with the clinical cardiac electrophysiology resident 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.