Clinical Rotations

Fellows will complete 2-3 months during their fellowship as a part of the cardiology service.  The cardiology service manages complex cardiac patients throughout multiple phases of care. Patients can remain on the same service while transitioning between the ICU, the cardiac-step down unit, and cardiac telemetry beds. The cardiology fellow is responsible for guiding patient management with a team of residents, pharmacists, and students including supervising bedside procedures and providing teaching to the members of the team.

The CICU is a large combined cardiology and cardiac surgery intensive care unit with advanced management capabilities including inotropes, intra-aortic balloon pumps (IABPs), Impella, extracorporeal membrane oxygenation (ECMO), ventricular assist devices (VAD), and a variety of right ventricular support and pulmonary embolism management devices including the EKOS system. Advanced mechanical circulatory support devices are collaboratively managed between the cardiology team, advanced heart failure team, and the cardiac surgical team. The cardiac step-down unit is capable of stable VAD, inotrope, and advanced diuretic management. The cardiac telemetry unit is further able to transition care for patients.

Fellows will spend a minimum of 2 months on the Advanced Heart Failure service with additional time available during elective time for those wishing to gain additional experience or pursue a career in Advanced Heart Failure. Fellows will round with a multidisciplinary team of heart failure attendings, pharmacists, ventricular assist device (VAD) advanced practice providers, and social workers. As a destination VAD center, fellows will gain experience with mechanical circulatory support decision making and an in depth understanding of hemodynamics using Swan-Ganz catheters, inotropic support, and both LV and RV mechanical support options. Elective options are available for those who wish to gain more experience with heart transplant management.

Fellows will spend a minimum of 2 months on the Electrophysiology (EP) consult service with extensive exposure to advanced arrhythmia management including complex atrial and ventricular rhythms. You will be exposed to cutting edge EP procedures including conduction system pacing, cardioneural ablations, and laser balloon ablation for atrial fibrillation. Fellows have the option to participate in ablation procedures, pacemaker/defibrillator implantations, device extractions, and loop recorder implantations.  Fellows also gain extensive understanding of device interrogation with a support team of EP nurses and EP fellows.

There is also an option to join the Combined CVD/EP "2+2" Pathway in which a fellow will complete both General Cardiology and Electrophysiology fellowships at RUSH after just 4 years of instead of 5 years.

Fellows will complete a minimum of 4 months in the cardiac cath lab and have ample opportunity to achieve higher COCATS level 2 during their fellowship. General cardiology fellows will serve as the primary operator in diagnostic right and left heart catheterization procedures and have significant exposure to percutaneous coronary/peripheral interventions and coronary microvascular testing. Additionally, they will assist in complex interventional procedures such as chronic total occlusion (CTO) interventions, a variety of atherectomy devices (e.g. rotational, orbital, laser), mechanical circulatory support assisted PCI (e.g. Impella), and pulmonary embolism interventions including a variety of thrombectomy and thrombolysis devices.

Fellows are able to rotate through the cardiac catheterization labs at RUSH University Medical Center as well as John H. Stroger, Jr. Hospital of Cook County. They also have an option to participate in congenital and structural cases including TAVR, MitraClip, transcatheter mitral valve replacement, PFO/ASD closure, and left atrial appendage closure. Fellows also have the option of participation in pediatric interventional cardiology including complex congenital structural interventions. Each year, RUSH accepts 2 fellows to an interventional cardiology fellowship focused on coronary, peripheral, and pulmonary disease interventions. RUSH also has 1 fellow per year dedicated to an additional year of structural interventional training including congenital and valvular interventions.  

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RUSH fellows are exposed to multiple advanced imaging modalities.  Fellows will have abundant exposure to stress echocardiography, transthoracic echocardiography, and transesophageal echocardiography with the option of achieving COCATS level 3 in echo.  We have one of the busiest PET/CT programs in the Midwest with a dedicated cardiac PET/CT scanner enabling high quality stress test imaging with myocardial blood flow measurements. Our new Rubschlager Ambulatory Building (RAB) houses the most advanced cardiac CT and cardiac MRI technology with a photon counting CT scanner (Siemens NAEOTOM Alpha® with Quantum Technology) capable of an extremely high temoral and spatial resolution at a lower radiation dose unencumbered by coronary artery calcifications or prior stents.

Fellows are assigned a weekly half-day continuity clinic that is maintained throughout fellowship.  They will also have an option to rotate through subspecialty clinics including Cardio-Oncology, Electrophysiology, Advanced Heart Failure, Structural and Congenital, Interventional.

RUSH also has dedicated Lipidology and Obesity Management clinic that will expose fellows to advanced lipid management techniques including complex familial lipid disorders. You will also have a number of community outreach opportunities and exposure to outpatient cardiac rehabilitation programs.

RUSH is a large referral center for cancer treatment including the new Rubschlager Ambulatory Building (RAB) which specializes in advanced cancer management. Fellows have extensive exposure to cardiovascular complications of malignancy and cancer treatment including a dedicated Cardio-Oncology clinic.

RUSH Cardiology has the privilege of associating with Midwest Orthopaedics at Rush, the top ranked orthopedics program in Illinois which provides care for a number of athletes and athletic programs around the Chicagoland area.  Our sports cardiologist and electrophysiologists treat complex athletic related issues including return to play for conditions such as hypertrophic cardiomyopathy, arrythmias, and other congenital heart disease.  We benefit from a great collaboration with a number of professional, collegiate, and high school programs.

Fellows will rotate at our RUSH community hospital just west of Chicago which provides a true community cardiology experience. With minimal house-staff, fellows will act as cardiology consultant on ED, floor, and ICU patients. If a patient needs a cardiology procedure including a cardiac catheterization or transesophageal echocardiogram, the cardiology fellow at be the one to perform these procedures with the attending.

The Illinois Medical District is just off the CTA Blue Line and is occupied by 4 different major hospitals and a number of academic and research facilities. RUSH cardiology has a special affiliation with the John H. Stroger, Jr. Hospital of Cook County (CCH), a high volume teaching county hospital just across the street from RUSH that provides advanced subspecialty care to the community. Cook County Hospital is one of the largest level 1 trauma and burn centers in the country. RUSH University Medical Center acts as a referral center from CCH for disease processes such as advanced heart failure needing mechanical circulatory support. RUSH fellows will rotate in their Cardiac Intensive Care Unit (CICU) where they will oversee housestaff care of advanced cardiac diseases. RUSH benefits from great academic collaboration with CCH with many faculty members holding positions at both hospitals.

RUSH Cardiology has an in-house night float system. Time spent on night float is graduate and becomes less with every year of fellowship. Monday-Saturday a cardiology fellow will be in-house from 6pm-7am and tasked with overseeing resident management of the Cardiac ICU including oversight of bedside procedures, respond to emergent general cardiology/advanced heart failure consults, and assist with emergent interventional procedures such as STEMIs, pericardiocentesis, or percutaneous mechanical circulatory support placement. Fellows will get Sunday night off, and will never be scheduled to work on a post-call day.