The three-year program emphasizes training to develop a fellow into a well-rounded clinical cardiology consultant. The specific structure of the program varies somewhat from year to year. The first year is generally comprised of 6 months on clinical services, 4 months on non-invasive services including echocardiography and nuclear cardiology, and 2 months of invasive cardiology. The second year is comprised of 4 months each of clinical services, non-invasive, and invasive services.

Fellows in the Cardiovascular Diseases Fellowship Program at Lankenau Hospital rotate on a variety of clinical rotations to become well-rounded consultants in the management of the cardiac patient. These rotations include intensive care unit service, cardiothoracic service (including operating room experience) and clinical consultative services. These consultative services span the spectrum of primary and tertiary cardiology including electrophysiology referral practice, interventional referral practices, and consultative cardiology involving patients on internal medicine, general surgery, surgical subspecialties, and obstetrics- gynecology services.

Fellows also rotate for 1 or 2 months a year at Bryn Mawr Hospital for further clinical training and cardiac care unit training. Non-invasive and invasive experience is also available. The peripheral vascular training experience has markedly expanded in the last few years. This includes training in the clinical, non-invasive ultrasonagraphic, and interventional aspects of this field.

The noninvasive service stresses proficiency in the performance and interpretation of conventional electrocardiographic and myocardial perfusion imaging exercise tests, equilibrium scintigrams, first-pass radionuclide studies, ambulatory ECG monitoring, M-mode, two-dimensional and Doppler echocardiograms including color flow studies, exercise, and transesophageal echocardiograms. Time away from the institution is permitted to obtain 200 didactic hours in nuclear cardiology. This added to the 1,000+ clinical hours of training during the fellowship have qualified graduates of the program to obtain NRC (Nuclear Regulatory Commission) Licensure for their nuclear laboratories. In addition, the fellowship program includes training in peripheral vascular disease including ultrasonography, cardiac rehabilitation and exercise physiology.

Each fellow spends at least 4-6 months in the Cardiac Catheterization Laboratory during the first 2 years. Training in clinical electrophysiology is included. A fourth year of cardiac catheterization is mandated to become certified for cardiac interventional techniques. All fellows rotating through this laboratory should become proficient in pre- and post-catheterization care, routine Judkins' left heart catheterization, right heart catheterization, temporary pacemaker insertions, cineangiographic and hemodynamic data interpretation and operation of the catheterization technology.

A third year of training is devoted to obtaining expertise in advanced echocardiographic techniques. A fourth year of training is available in electrophysiology including permanent pacemaker insertion and catheter ablation techniques. A fourth year is also available for training in coronary interventional techniques including angioplasty, atherectomy, and stent placement.

Each fellow will be on call every fourth to sixth weeknight and every fourth to sixth weekend. When on call, the fellow will be responsible for all:

• Swan-Ganz catheter and pacemaker insertions.
• Portable M-mode and two- dimensional echocardiograms.
• Emergency catheterization procedure.
• Supervision of thrombolytic administration.
• Assistance in the management of critically ill patients. Senior fellows are scheduled as back-up call for emergency interventional procedures and transesophageal echocardiography. 

Each fellow is entitled to three weeks vacation each year in addition to conference time.