Cardiovascular Disease Fellowship
Hear our welcome message from the program director, Bobak Rabbani, M.D. F.A.C.C.
The Edith and Benson Ford Heart and Vascular Institute at Henry Ford Hospital is one of the nation’s top centers for heart and vascular disease. We believe that patient care, teaching, and research are all essential missions, and the Cardiology Fellowship underscores these missions with a program designed to provide excellent training in all aspects of modern cardiology. We are proud to offer one of the largest, most comprehensive fellowship programs in the nation with 31 cardiology fellowship positions in every subspecialty of cardiology:
- 3 year General Cardiology Fellowship: 7 positions per year
- 1 year Interventional Cardiology Fellowship: 3 positions per year
- 2 year Electrophysiology Fellowship: 2 positions per year
- 1 year Advanced Heart Failure and Transplant Cardiology Fellowship: 1 position per year
- 1 year Advanced Cardiac Imaging Fellowship: 1 position per year
- 1 year Structural Heart Disease Fellowship: 1-2 positions per year
- 1 year Complex, High-Risk and Indicated Coronary Interventions and Advanced Hemodynamic Care (CHIP) Fellowship: 1 position per year
The Cardiology Fellowship Program is designed to prepare fellows for academic or clinical practice in general cardiology or a subspecialty. With an emphasis on evidence based clinical training with robust volumes, a diverse patient base, and exposure to every stage of cardiovascular disease, the program provides an unmatched training experience in competitive fellowship programs. Fellows benefit from instruction and mentorship by over 40 full-time senior staff cardiologists who are leaders in their fields. Highlights of our program include:
- Overall an outstanding fellowship program with highest ACGME accreditation status recognizing the quality of instruction provided to fellows
- 100% ABIM Cardiovascular Disease board pass rate
- Active teaching agenda provides fellow education through structured didactics and exceptional clinical and procedural training
- General cardiology fellows all given opportunity to gain independent proficiency (level 2 training) in cardiac catheterization, comprehensive echocardiography, and nuclear cardiology
- Daily general cardiology fellow conferences, in addition to conferences in subspecialty fields, are designed to cover topics needed for general as well as echo and nuclear boards
- Frequent grand rounds with visiting scholars from all over the world
- Multiple opportunities for interaction with and teaching medical students and residents
- Daily teaching sessions with small groups, including faculty, on every rotation
- Extensive and vigorous research in peer-reviewed journals with numerous presentations annually at national and international meetings. In 2018, over 150 articles and abstracts were produced from our program.
- Fellows provided with time and faculty mentors for research as well as biostatistics support and institutional grants for research
- No 24-hour overnight call- program utilizes a night float system that is distributed among the 3 years of fellowship
- Program places an emphasis on fellow well-being and quality of life in addition to an outstanding training experience
- Prestigious alumni and faculty networks actively assist fellows in career placement after training
Henry Ford Hospital
Training takes place at Henry Ford Hospital, which is the flagship hospital and research center of the Henry Ford Health System, one of the largest health systems in the nation. Our program is affiliated with Wayne State University School of Medicine and is one of the principal teaching sites of the medical school. The hospital is a comprehensive, 877 bed urban tertiary and quaternary care hospital and regional referral center. As an integrated health care system and non-profit institution, we provide exposure to managed care, fee-for-service and indigent/uninsured patients. Other highlights include:
- One of largest intensive care unit complexes in the country with over 160 adult beds
- Center for clinical excellence in many fields including cardiology, cardiovascular surgery, neurology, neurosurgery, orthopedics, sports medicine, organ transplant, and oncology.
- One of three level 1 trauma centers in the region.
- One of the largest teaching institutions in Michigan – 46 ACGME accredited programs with 650 residents and fellows in training, and over 500 medical students annually.
- Strong institutional commitment to academic medicine and medical education.
- 116 residents in our IM residency, which is one of the most innovative programs in the country
Henry Ford Medical Group
The faculty at Henry Ford are members of one of the nation’s largest, best organized, and most respected medical groups, the Henry Ford Medical Group. Our staff consists of more than 1,200 physicians and researchers in more than 40 specialties who have trained at the best academic institutions in the world. Our self-governed, employed physician practice program has been copied by many others because of our continuing success. The brightest minds in medicine are attracted to become part of the Henry Ford Medical Group because our organization provides physicians the independence to pursue advanced clinical care while undertaking research as well as academic educational initiatives.
- There are no private patients at Henry Ford Hospital - all patients are served by the Henry Ford Medial Group
- Physicians are dedicated to evidence-based medicine without private practice monetary pressures
- We are a national leader in health care and education – faculty have recently been presidents of the ACC, ABIM, ACGME, and AMA.
- Our faculty currently include the national ACC Chair of the Board of Governors and recently held the Presidency of the Michigan Chapter of the American College of Cardiology.
- One-third of all physicians in Michigan received training at Henry Ford Hospital, and our post-graduate medical education enterprise is among the largest in the country.
Edith and Benson Ford Heart and Vascular Institute
The Heart and Vascular Institute is a leader and innovator in comprehensive cardiac care, research and education. Our volumes are among the highest in the Midwest, giving us the experience to set protocols that become national standards. Our services include world-class heart failure, transplant, structural heart disease, advanced imaging, electrophysiology, interventional, cardiac and vascular surgery, and preventive cardiology programs. Other highlights of the training experience include:
Clinical cardiology training
- Inpatient service includes a superb 32-bed Cardiovascular Intensive Care Unit and a large cardiology inpatient service with 65 telemetry beds
- Large cardiology consult service provides care for hospital medical and surgical services as well as the Henry Ford Emergency Department
- Busy outpatient clinics serving a base population of more than 4.5 million people in Southeast Michigan.
- Very diverse patient base with exposure to both urban and suburban settings
- Extremely busy interventional program serving the Detroit metropolitan area and Southeastern Michigan with many regional, national, and international referrals
- Fellow-centric, fellow-friendly cath lab environment with outstanding full-time Interventional Faculty with national involvement as proctors, COCATS authors, ACC/SCAI/CRF faculty, and ACCSAP/CathSAP authors.
- Active research program participating in national and investigator-initiated trials
- More than 100 acute ST elevation myocardial infarctions and greater than 1,000 percutaneous coronary interventions performed yearly
- Five newly renovated state of the art cardiac catheterization laboratories at Henry Ford Hospital including 2 hybrid OR-cath lab suites.
- In addition to simple and complex coronary disease, fellows are exposed to peripheral vascular interventions, myocardial biopsies, intra-aortic balloon counterpulsation, pulmonary embolism interventions, and percutaneous left ventricular assist devices(including Impella, Tandem Heart, and ECMO)
- 70% transradial/distal transradial cath and PCI
- Fellows serve as primary operator in all diagnostic and most interventional cases
- Revascularization referral center of last resort for the Midwest due to our expertise
- Training in right heart catheterization including physiologic/vasodilator challenge and hepatic wedge pressure evaluation in evaluation of advanced heart failure/transplant/LVAD, pulmonary hypertension, and congenital heart disease
- Nationally recognized cardiogenic shock program
- World renowned chronic total occlusion intervention program
- Hospital performs over 400 cardiac surgeries per year, many of them complex.
- Henry Ford offers one of the only dedicated complex, high risk percutaneous coronary intervention (CHIP) sub-fellowship to train fellows in the most complex coronary interventions including chronic total occlusions and hemodynamic support devices
- Complete training in all noninvasive modalities in a busy laboratory performing more than 20,000 studies annually
- Fully digitized transthoracic and transesophageal echocardiography (2 D and 3D) lab with advanced electronic data mining capabilities for research projects
- All fellows assigned dedicated teaching sonographers as well as senior staff during their echo months
- Training in the full spectrum of nuclear cardiology studies with all latest protocols including CT attenuation correction
- Outstanding nuclear didactic curriculum also includes interpretation basics of PET stress and viability
- Extensive research opportunities with ability to participate in single and multicenter noninvasive trials in addition to fellow driven projects with mentorship by nationally renowned noninvasive cardiologists
- Fellows have full access to advanced cardiac imaging training in cardiac CT and MRI
- Only program in Michigan to offer a multimodality advanced cardiac imaging fourth year fellowship opportunity for fellows desiring advanced imaging training
- State of the art electrophysiology facilities
- 500 invasive electrophysiology studies performed annually; excellent exposure to consultative EP, pacemaker insertion and evaluation,and ICD implantation.
- Very active VT ablation and high-risk lead extraction program with frequent referrals from around the region
- State of the art magnetic navigation laboratory for complex ablations
- Training in implantation of leadless pacemakers
- The arrhythmia section is actively involved in clinical research and participates in national multi-center trials as well as on-going investigator initiated studies
- Many notable recent accomplishments including first in Michigan to implant the only subcutaneous defibrillator to treat patients at risk for sudden cardiac arrest without touching the heart, and the nation’s first program to implant the commercially available Watchman left atrial appendage closure device
Heart failure training
- Only hospital in Detroit metropolitan area performing heart transplantation or left ventricular assist devices, and only 1 of 3 in the state of Michigan
- One of the nation’s most experienced heart transplant teams
- Busy ambulatory heart failure service following more than 160 heart transplant patients and over 90 LVAD patients
- About 25-30 heart transplants and 55-60 LVADs performed yearly
- Active research program including clinical trials, genomics, mechanical circulatory support, exercise physiology and pre-clinical/ basic laboratory studies. Mentors are active in heart failure and transplant societies and national registries. Heart Failure program generates about 50 publications per year.
- Advanced intensive care hemodynamic training
- Pre-transplant evaluation
- Post-transplant immunosuppressive management
- Myocardial biopsy performance and interpretation
- Management of implanted ventricular assist devices and forms of artificial hearts
- Management of all forms of implanted ventricular assist devices (including temporary support) and forms of artificial hearts
- Training in pulmonary hypertension management and participation in catheterization studies unique to patients with PH and RV failure
- Training in cardiopulmonary stress testing for all fellows
Structural heart disease training
- One of the most active and innovative Structural Heart Disease (SHD) Programs in the world with more than 2,500 patient encounters per year, over 300 transcatheter aortic valve replacements per year (the largest volume in Michigan and one of the largest in the country), over 70 percutaneous left atrial appendage closures per year, and over 125 mitral intervention procedures annually. Review a complete listing of our Center for Structural Heart Disease procedure volumes.
- Our program receives the most complex referrals from other in-state and out-of-state structural programs
- Henry Ford recognized for performing its 1000th TAVR procedure in 2017, now completed over 1400
- Over 1000 patients treated with the aid of 3-D printing
- Over 430 patients have undergone mitral valve interventions
- Multiple first in country and first in human successful SHD interventions including:
- First percutaneous mitral valve replacement in the world
- First hospital in the world to perform transcaval (from IVC to aorta) TAVR when traditional approaches are not available
- First percutaneous tricuspid valve replacement in the United States
- First-in-man late partial recanalisation after LARIAT suturing of the left atrial appendage successfully treated with an AMPLATZER™ septal occluder device.
- First-in-man experience with cryoplasty during graded balloon atrial septostomy to reduce spontaneous closure in a patient with severe pulmonary arterial hypertension.
- First fully percutaneous placement of a 5 liter Impella left ventricular support device via transcaval access
- First intentional percutaneous laceration of the anterior mitral valve leaflet to prevent outflow tract obstruction during transcatheter mitral valve replacement- LAMPOON procedure
- Novel use of Watchman in ascending aorta for embolic protection
- Multiple firsts in the state of Michigan including first Lariat percutaneous left atrial appendage closure, first trans-apical TAVR, first percutaneous trans-apical paravalvular leak closure, and first percutaneous transcatheter mitral valve-in-ring and first non-surgical mitral valve repair
- SHD Director, Dr. Bill O’Neill, was the first cardiologist to perform a percutaneous aortic valve replacement in the United States (done prior to joining Henry Ford)
- Developed and lead the Detroit and now National Cardiogenic Shock initiative
- Developed, patented and published the Left Ventricular Outflow Tract Modeling protocol to assess for obstruction post mitral valve replacement. Now recognized as standard modeling protocol
- Developed and published left atrial appendage sizing algorithm: decreases procedure time and procedural complications
- Helped develop the use of Electrocautery transcatheter treatments
- LAMPOON: intentional laceration of the Anterior Mitral Leaflet to prevent outflow obstruction during TMVR
- BASILICA: intentional laceration of aortic valve leaflets to prevent obstruction during TAVR
- First institution in Michigan to perform over 350 Watchman (left atrial appendage closure) procedures
- Developed intentional right atrial exit insufflation to facilitate needle entry into the pericardial space
- Core lab for 3 major clinical trials: CT lab for MITRAL Trial, CT Lab for NIH Mitral trial and Echo lab for NIH Mitral trial
- Wide variety of transcatheter structural heart disease interventions including PFO/ASD/VSD closure, alcohol septal ablation, percutaneous aortic and mitral valvuloplasty, transcatheter valve replacement (all valves), percutaneous left atrial appendage closure, percutaneous repair for mitral regurgitation, balloon atrial septostomy, and percutaneous paravalvular leak closure
- One of the few programs in the state to perform MitraClip for mitral regurgitation
- Fellows benefit not only from clinical and procedural exposure to SHD interventions but also from novel training in advanced structural heart imaging (e.g. 3D TEE in structural heart interventions, cardiac CT and MRI) that few programs are able to provide
- Partnership of our advanced cardiac imaging specialists with the Henry Ford Innovation Institute has resulted in the first 3D imaging program and 3D modeling of cardiac valves and structures to help make structural procedures safer and more effective.
- Henry Ford offers one of the only dedicated SHD fellowships in the nation and trains 1-2 fellows per year
- SHD fellows are primary operators on our broad range of SHD procedures. SHD training includes a comprehensive curriculum and participation in highly educational multidisciplinary conferences
Thank you for taking the time to learn about our program, and we hope that you will consider applying. As you can see the framework for our fellowship is strong, but the most important aspect of our program is our fellows. They are our colleagues and friends, and are clearly what makes our program so special. We hope to see you on the interview trail in Detroit, and please do not hesitate to contact us if you have questions.
Bob Rabbani, M.D., F.A.C.C.
Cardiovascular Disease Fellowship Program
Henry Ford Hospital