Graduate Medical Education (GME): Image-Guided Cardiovascular Intervention Fellowship Program

Program Overview   

The Image-Guided Cardiovascular Intervention Fellowship Program is designed to train physicians seeking an academic research career in image-guided catheter-based cardiovascular intervention. 

The goals of the training program are to:  (a) prepare physicians to conduct clinical or translational academic research in image-guided cardiovascular intervention, and (b) enable trainees to gain expertise in the catheter-based treatments of coronary, peripheral, and structural heart disease in adults. 

The training program consists of two years of research in pre-clinical and clinical image-guided intervention and one year of clinical training in catheter-based cardiovascular intervention. 

During the first two years of the training program, the trainee will conduct research in image-guided intervention, including cardiovascular interventional MRI.  This component of the training program will prepare the physician for a translational research career in image-guided intervention and provide intensive hands-on training in imaging science, preclinical catheter intervention, and research to support early investigation in human research subjects.  

In the first two years, roughly eighty percent (80%) of the trainees’ time is protected for research conducted at the NIH.  For the other 20% of the trainees’ first and second years, and during the clinically-focused third year, the learning experience is devoted to patient care.  Most of this clinical training is provided at the George Washington University Hospital [disclaimer] and other affiliated medical centers.

Research-Oriented Experience  (Years 1 and 2)
The trainee is expected to serve as the lead investigator in large mammal preclinical and/or human investigational clinical experiments of mechanical and/or biological interventions for cardiovascular disease.  Examples of such projects might include the following clinical catheter-based treatments:  stenting using MRI, novel catheter-based treatments for structural heart disease such as mitral cerclage annuloplasty, and development of MRI-guided targeted drug delivery. The trainee is expected to participate fully in the research activities of the program, including preclinical testing of therapeutics for cardiovascular disease and, if possible, first in man clinical testing.  The trainee is expected to take the lead in these and other experiments of interest, with an expectation of serving as first author on the papers emanating from this research.

The trainee will also receive formal instruction in consultative vascular medicine, peripheral vascular intervention, and magnetic resonance angiography in the context of research trials in the branch.  The trainee is expected to assume or share care of patients and research subjects of the Cardiovascular Intervention Program with the other physician members of the team.   This will include coronary artery interventional procedures for stable angina, acute coronary syndromes, and ST-segment elevation myocardial infarction. 

Clinical-Oriented Experience (Year 3)
The majority of the trainee’s clinical-oriented third year will take place at George Washington University in Washington, DC.  This will include training in the catheter-based treatment of peripheral artery disease, such as intermittent claudication and limb-threatening ischemia, visceral ischemia, and cerebrovascular disease. There are likely to be other opportunities for further clinical training in structural heart disease.
The twelve months constituting this third year may be divided so as to extend over the course of two years, by prior arrangement with the Program Director and the fellow.

A fourth year of additional research and clinical training may be offered by prior arrangement with the Program Director and the fellow. This additional year of training is appropriate for trainees needing to finish ongoing projects and/or to obtain additional advanced training.

--back to top--

Resources   

As a trainee, you will be:

  • Mentored closely in the design and conduct of preclinical and/or clinical experiments. 
  • Guided on the regulatory aspects of investigational new drug and device exemptions.
  • Trained in the design, conduct, analysis, and reporting of Phase I clinical trials. 
  • Encouraged to access the combined clinical and large-animal interventional X-ray and MRI suite, which includes veterinary and clinical technologist support.
  • Working closely with research nurses and clinical technologists in the Cardiovascular Interventional Program. 
  • Establishing close collaborations with the Medical Imaging Section in the Laboratory of Cardiac Energetics. 
  • Accessing the numerous Core Laboratories of the Division of Intramural Research, especially the Core Catheter Fabrication Facility, toward translation of mechanical MRI-guided interventions into human research subjects.
  • Provided opportunities for formal instruction in imaging science and MRI physics, and encouraged to take graduate courses relevant to research projects.

--back to top--

Faculty   

Robert J. Lederman, M.D., Director of Cardiovascular Intervention, will be primarily responsible for the teaching aspects of the Program.

Additional Faculty:

  • Jonathan S. Reiner, M.D., Director of Cardiac Catheterization Services, George Washington University
  • Douglas Rosing, M.D., Chief of Consultative Cardiology, NHLBI
  • Marcus Chen, M.D., Chief of Cardiac CT, NHLBI
  • Andrew Arai, M.D., Chief of Cardiovascular MRI, NHLBI
  • Anthony Z. Faranesh, PhD, Staff Scientist, Cardiovascular Intervention Program
  • Michael S. Hansen, PhD, Staff Scientist, Laboratory of Cardiac Energetics
  • Venkatesh K. Raman, M.D., Staff Cardiologist, NHLBI
  • Kanishka Ratnayaka, M.D., Pediatric Interventional Cardiologist, NHLBI and Children’s National Medical Center

--back to top--

Requirements   

Trainees must have completed at least two years of full-time clinical training in cardiovascular diseases, in addition to training in internal medicine, and have an unrestricted state medical license at the beginning of training. The program is open to physicians with an equivalent training background. Preference is generally given to fellows with a substantial background in catheter- and imaging-based diagnosis and treatment of cardiovascular disease.  

Applicants are evaluated by the NHLBI Director of Cardiovascular Intervention and the Director of the Cardiac Catheterization Laboratory at George Washington University. Additional input when evaluating promising candidates is provided by other cardiologists in the Translational Medicine Branch and at GWU.

--back to top--

Application Process   

For further information on this program, and to apply, please contact: 

Robert J. Lederman, MD
Director, Cardiovascular Intervention Senior Investigator
Translational Medicine Branch, Division of Intramural Research
National Heart Lung and Blood Institute
National Institutes of Health
Building 10, Room 2C713, MSC 1538
Bethesda, MD 20892-1538
Phone: 301-402-6769
Fax: 301-451-5451
E-mail: lederman@nih.gov

--back to top--