Cardiology Postgraduate Program

Physicians at the Heart Institute hold teaching appointments within the University’s Faculty of Medicine, overseeing students in their cardiac rotations, residency, and Fellowship programs.

Residency training for Cardiology includes rotations in the Coronary Care Unit, Catheterization Lab, Consultation Service, Cardiology Ward, Electrophysiology, Echocardiography, Non-Invasive Testing, Nuclear Cardiology, Research, Cardiac CT, Pediatric Cardiology, Adult Congenital Cardiology, and Ambulatory Cardiac Care.

Fellowships and Research Fellowships are also offered in Echocardiography, Invasive Cardiology, Nuclear Cardiology, Cardiac CT, and Positron Emission Tomography (PET). The scope of all of the educational programs extends beyond normal parameters, encompassing areas such as advanced practice nursing, research methodology, biostatistics, and medical ethics.

Our Cardiology Program is a fully accredited postgraduate training program by the Royal College of Physicians and Surgeons of Canada. It is a three-year program that provides training in all of the clinical and technical aspects in cardiology.

Requirements for Postgraduate Training in Cardiology are as follows:

  • Three years of training in Internal Medicine in an approved training program including a maximum of six months in clinical cardiology
  • Three years of training in cardiology

General objectives of the Cardiology Training Program include:

  • To produce a specialist in Cardiology with a high degree of skill and knowledge in all aspects of modern clinical cardiology, with a demonstrated ability to act as a consultant to other physicians including other specialists and surgeons.
  • To provide training in specific sub-specialties of cardiology and to meet guidelines developed by the Canadian Cardiovascular Society.
  • As per the guidelines of the Royal College of Physicians and Surgeons of Canada, the Heart Institute provides full training in Adult Cardiology as follows:
    • 14 blocks of clinical residency:
      • Four blocks acute cardiac care
      • Six blocks clinical cardiology (including cardiology CTU and consultation)
      • Two blocks ambulatory cardiology
      • Two blocks pediatric cardiology
    • 14 blocks of laboratory-based residency:
      • Four blocks cardiac catheterization
      • Four blocks echocardiography
      • Two blocks electrophysiology / pacemaker
      • Two blocks ECG / ambulatory ECG monitoring / exercise stress testing
      • Two blocks nuclear cardiology
      • Four blocks elective
      • Four blocks research (clinical and/or basic)

Residents rotate through the clinical services primarily during their first two years of training; generally performing two consecutive blocks at once. Residents do two blocks of dedicated time in the Ambulatory Care Clinic. This can be performed at the University of Ottawa Heart Institute, the Ottawa Hospital – General Site, or the Ottawa Cardiovascular Centre (which is a private practice group in the City of Ottawa). Residents also do out-patient clinics during specific rotations such as the Clinical Teach Unit service (Team Blue), the Arrhythmia Service (for both in-patient and out-patient consultations), and the Adult Congenital Clinic.

In-patient clinical experience is the primary duty of the residents while they are performing pediatric rotation at the Children’s Hospital of Eastern Ontario (CHEO). Finally, third-year residents will run a longitudinal clinic – a one-year clinic where they spend one day per week with an attending cardiologist. The resident is assigned patients and expected to manage all aspects of their cardiac care using the staff cardiologist as a resource.

Residents are given graded responsibility with close supervision of their activities in the first year, with increasing autonomy in the second year. Third year residents, while on call, do call from home allowing them to provide a consultative support to more junior house staff.

Laboratory rotations are organized throughout all three years. Residents receive graded instruction in various technical aspects with examinations at the end of each of these rotations. During their third year, the residents are given additional opportunity to focus on a specific area of special interest. For example, residents are given the opportunity for extra time in the Cardiac Catheterization Laboratory if they are pursuing an Interventional Fellowship program.

Research Four blocks of research are also spread out throughout the entire three years. Residents are contacted to discuss research and introduced to research projects under way at the Heart Institute. At least one research project is identified and conducted during their three-year residency.

Residents are required to make one presentation during the Heart Institute Research Day during their first two years and all residents are required to present a research topic during their third year. Residents are encouraged to present their research material at national and international meetings.

Elective Rotations In addition to core cardiology training, the Division of Cardiology at the Heart Institute encourages residents from other centres to perform electives. Residents contact the Program Director to arrange these electives in all areas of subspecialty cardiology. Our program has particular strengths in Interventional and Cardiac Catheterization, Echocardiography, Electrophysiology, Nuclear Medicine / PET Imaging, and Cardiac Transplantation.

The training program is three years with further Fellowship training available in subspecialties. The program includes the following clinical and laboratory aspects of cardiology: Electrocardiography,  Echo Doppler, Nuclear Cardiology including PET Imaging, Invasive Cardiology, Angiography and Hemodynamics,  Electrophysiology, and Pacemaker/Defibrillator.

Principal goals are to develop clinical diagnostic skills with emphasis on history taking and physical examination and the use of sound principles of logic and deduction to make an accurate bedside diagnosis in all aspects of adult cardiovascular disease. Other skills involve a wide variety of cardiology subjects including:

  • Selection of patients for surgery
  • Indications for and use of rehabilitation programs
  • Pharmacology of drugs
  • Dietetics
  • Psychological aspects of cardiac disease
  • Preventive cardiac medicine

Skills will relate to all aspects of acute coronary care, including prevention and management of dysrhythmias and the use of invasive techniques such as intra-arterial catheter insertion and Swan-Ganz catheter insertion, for example. Training involves using drugs in the management of low output states and cardiogenic shock, familiarity with methods of mechanical support of the circulation and indications for and management of cardiac transplantation.

Other skill development involves the use of non-invasive forms of investigation, including:

  • ECG Exercising Testing and Holter Monitoring
  • Echocardiography and Doppler Ultrasound
  • Imaging and functional testing using radioisotopes including PET Scanning

Program Content A flexible rotation list is combined with a wide variety of teaching rounds with attending cardiologists for daily rounds in the Coronary Care Unit and weekly professor rounds. Weekly conferences cover hemodynamics, electrocardiography and non-invasive testing procedures, and weekly lectures and combined rounds with the departments of Cardiac Surgery and Pathology. In addition, a weekly one hour post-graduate course covers aspects of basic and clinical science and a regular journal club is available.

The rotation plan is influenced by individual need:

  • CCU: 4 months
  • Echo Doppler: 4 months
  • Nuclear Cardiology: 2 months
  • Cath Lab: 4 months
  • Congenital Heart Disease: 2 months (including pediatric cardiology)
  • Electrophysiology: 4 months
  • Heart Failure & Transplantation: 2 months
  • Research: 4 months
  • Electives: 4 months
  • Electives: 4 months

Our program is designed to accommodate level 2 training Canadian Cardiovascular Society (CCS) in Echo Doppler or Cardiac Catheterization. In addition, one year of training can be provided towards North American Society of Pacing and Electrophysiology (NASPE) qualifications in EP. Electives are offered in Research, Cardiac Rehabilitation, Preventive Cardiology, Lipidology Hypertension, or further training in the basic rotations. Cardiology Training for Residents in Internal Medicine, Anesthesia, Family Practice, and Emergency Medicine Trainees in Internal Medicine at the University of Ottawa rotate through the University of Ottawa Heart Institute and gain experience in bedside diagnosis and management, coronary care, and the insertion of Swan-Ganz and transvenous pacemakers. In selected cases, a one-year training program in Cardiology is available to those residents who wish to continue their training in Internal Medicine with a special interest in Cardiology. In addition, training periods are provided for residents in Anesthesia, Family Practice, and Emergency Medicine, particularly in electrocardiography and acute coronary care.

Program Training Committee A Program Director, Chief of Cardiology, Chief Cardiology Resident, four staff cardiologists from various subspecialty aspects (including representation from the Ottawa Hospital – General Site) and an elected cardiology resident form the training committee, which meets every month. Residents are interviewed quarterly with the Director. The Chief Cardiology Resident plays an important part in the committee and participates in all discussions.

Applications should be sent to:

Dr. Michael Froeschl  Program Director (Adult Cardiology) University of Ottawa Heart Institute 3411-40 Ruskin Street Ottawa, ON CANADA K1Y 4W7