Clinical Exposure

Scripps cardiology fellowship clinical exposure opportunities in San Diego

Clinical Track for the fellowship program

Scripps cardiology fellowship clinical exposure opportunities in San Diego

The Scripps Cardiovascular Disease Fellowship Program provides a unique balance between clinical exposure and research at a variety of sites.

The fellowship is medium-sized, the division is large and the patient volume is extraordinary. The ratio works in the fellow’s favor in terms of clinical volume and research opportunities.

Most fellowships will allow motivated fellows to become Core Cardiovascular

Training Statement (COCATs) Level 2 in at least two of the following:

Nuclear cardiology
Echocardiography
Transesophageal echocardiography (TEE)
Diagnostic angiography

At Scripps, our high clinical volume provides a higher volume/fellow ratio, which allows our fellows to become Level 2 in each of the above just by showing up to their rotations.

At our program, motivated fellows can also be COCATs Level 2 in pacemakers and vascular ultrasonography.

COCATs Requirements

	Level 1	Level 2	Level 3
Typical program	Basic training All trainees Everyone can do it in a 3 year fellowship	Ability to perform or interpret specific diagnostic tests and procedures Able to sit for boards Some can attain this in a 3 year fellowship	Requires additional training
Our program	Outpatient volume Inpatient volume Electrocardiogram (ECG) Cardiac rehab Stress tests Ambulatory monitoring	Nuclear cardiology Echocardiography TEE Diagnostic angiography Pericardiocentesis Pacemakers Implantable loop recorders Vascular ultrasound	Computed Tomography (CT) Magnetic Resonance Imaging (MRI) Heart failure Electrophysiology (EP) Interventional

Interventional and structural cardiology

Highlights

Approximate institutional procedural volumes:

2,500 coronary interventions per year
380 transcatheter aortic valve replacement (TAVR) procedures per year - Second largest TAVR center in California
175 peripheral vascular procedures per year
75 Mitraclip procedures per year - Third largest in California
44 percutaneous atrial septal defect (ASD)/ patent foramen ovale (PFO)/ ventricular septal defect (VSD) procedures per year
We also have very active Left ventricular assist device (LVAD) and mechanical circulatory support (MCS) device programs using Impella devices, tandem heart and extracorporeal membrane oxygenation (ECMO)

Research

Antiplatelet therapy during and after percutaneous coronary intervention (PCI)
Mitral valve intervention
Tricuspid valve intervention
Left atrial appendage intervention
Novel drug-eluting stents
Hyperbaric oxygen for acute ST segment elevation myocardial infarction (STEMI)
Post-STEMI stem cell treatment
Refractory angina stem cell treatment
Drug coated balloons for the treatment of peripheral vascular disease

Fellows require 300 caths to achieve COCATs Level 2
The average Scripps cardiology fellow performs 400 caths
Fellows who wish to pursue a future in interventional cardiology perform 500 caths by graduation

Electrophysiology

Highlights

Most electrophysiology (EP) procedures on the West Coast
First LINQ in the US and currently #1 implant site in the US
First leadless pacemaker in Southern California
First Watchman in California
First Lariat in San Diego
One of the highest volume device implanter in the US
Ablations: 500 per year
Watchman: 175 per year
Largest Watchman program in the US
#1 and #4 Watchman implanters in the US are in our medical group
EP Save a Life – San Diego non-profit organization that preforms cardiac high school screening

Research

Leadless pacemaker device development
Catheter ablation device development
Watchman database
Left atrial occlusion device development