Cardiology

Educational objectives:
Demonstrate the knowledge and skills to perform a detailed history and physical examination on patients presenting with cardiac complaints.
Demonstrate the knowledge and skills to evaluate and initiate treatment of patients with acute cardiac problems, including but not limited to, myocardial infarction, unstable angina, congestive heart failure, dysrhythmias, hypertensive emergencies, valvular disease and aortic dissection.
Demonstrate the knowledge and skills to interpret an ECG.
Demonstrate knowledge of the indications and contraindications of thrombolytic agents, their appropriate administration, IIA/IIIB agents, and indications for acute angioplasty.

Description of clinical experiences:
The duties and responsibilities of the resident on the cardiology service involve initial and ongoing responsibility for patients admitted to the coronary care and telemetry units, under direct supervision of a cardiology attending and fellow. Daily teaching rounds are held to discuss patient care and attendance is mandatory. In addition, the resident is expected to see patients in cardiology clinic. Finally, the resident will have the opportunity to evaluate cardiology patients in the emergency department under the supervision of the cardiology fellow or faculty.

Description of didactic experiences:
The medicine conferences include morning report and noon grand rounds. The residents are expected to attend the emergency medicine conferences held each Wednesday morning.

Evaluation process:
Residents are informally evaluated by the attending staff on the various rotations as well as the supervising emergency medicine faculty during their clinical shifts in the emergency department. This is one of the most important ways in which residents receive direct, immediate feedback. Residents receive written evaluations after completing rotations to the Cardiology service. Residents are evaluated on their knowledge base, facility to perform procedural skills as appropriate for their level of training. Residents are required to keep a logbook of all procedures they perform. In addition to the rotation evaluations, residents are evaluated on the oral examinations administered to all residents annually, the national in-service examination, and case presentations at conferences.

Feedback mechanisms:
Residents receive immediate feedback from the supervising emergency medicine faculty in the ED and the attending staff on the other rotations. Such feedback is considered most important in the resident's education. Several times during the year, the preceptor meets with the resident. In addition, the Program Director meets with each resident at least twice each year to formally review the department's evaluation of the resident.