University of Wisconsin
School of Medicine and Public Health

Heart Failure Fellowship Curriculum

The Heart Failure and Transplant Fellowship at the University of Wisconsin is an integrated 12 month program providing specialized education in the pathophysiology and treatment of heart failure and in cardiac transplantation. The fellow receives extensive training in the management of all etiologies of ventricular dysfunction, including ischemic cardiomyopathy; non-ischemic cardiomyopathy due to hypertension, valvular heart disease, or congenital heart disease, as well as inherited and other unusual cardiomyopathies. The fellow will learn to manage heart failure patients within the entire clinical spectrum, from ambulatory heart failure to severe, drug refractory heart failure.

The fellow will become expert in the selection and management of implantable devices used in heart failure patients, including cardiac resynchronization therapy and implantable cardioverter-defibrillator devices. The fellow will receive training in the management of ventricular assist devices implanted for therapy as bridge to transplantation or destination therapy. Fellows are exposed to new and experimental approaches to heart failure, including, but not limited to, experimental inotropic, vasodilatory and diuretic agents; mechanical circulatory assistance devices; and surgical therapies such as revascularization, valve repair/replacement, and ventricular reconstruction. The fellow is expected to have a complete understanding and working knowledge of the current literature in heart failure including the 2005 “Consensus Recommendations for the Management of Chronic Heart Failure” and the updates to that document.

Fellows will have advanced education in the care of the heart transplant patient including candidate selection, donor management, transplant physiology, immunology and immunosuppression, immediate post-operative care, and long term care, including post-transplant complications. Trainees will have a working knowledge of general immunology and cardiac transplantation as outlined in the Primer on Transplantation published by the American Society of Transplantation. The fellowship program incorporates the United Network for Organ Sharing (UNOS) guidelines for training of a transplant physician.

The clinical experience consists of inpatient care, outpatient clinics and time in the endomyocardial biopsy lab at the University of Wisconsin Hospital & Clinics. Teaching methods during the fellowship includes both the direct tutorial method and the didactic method with the attending heart failure/transplantation cardiologist. Evaluation will be by direct observation and interaction and documented according the ABIM format.

During the fellowship, the fellow will be required to participate in an ongoing clinical research project or pursue an original project. With appropriate funding trainees may pursue an additional 6-12 months of clinical and/or experimental heart failure or transplant research under the direct supervision of a senior scientist. Teaching during this additional training will be by direct mentoring by the senior scientist.