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R2 - CARDIOLOGY
Goals and Objectives
Length of Rotation: Each resident will complete a 1 month rotation during their 2nd year
Goal: The goal of this rotation is to increase the resident’s ability to prevent, diagnose and treat
cardiovascular disease common in primary care.
Objectives by competency: By the end of this rotation, the resident will be able to:
Patient Care
 Accurately perform a full history (including cardiac review of systems) and
cardiovascular examination, including identification of murmurs, gallops/extra heart
sounds, and friction rubs
 Use a patient’s history and objective findings to calculate pretest probability of cardiac
disease
 Define, recognize, and rapidly treat patients with acute coronary syndrome
 Describe primary & secondary prevention of CV disease
o Determine a patient’s cardiovascular risk using a validated risk calculating tool
 Framingham for primary prevention
 TIMI for acute coronary syndrome
 CHADS2 score for atrial fibrillation/stroke risk
o Apply the NHLBI Guidelines for CV Disease Risk Reduction in Adults to a real
patient (http://www.nhlbi.nih.gov/guidelines/cvd_adult/index.htm)
 Accurately read and interpret a minimum of 50 EKGs (must include the 50 ECG Wave
Maven EKGs outlined in the online residency manual)
 Perform at minimum 5 stress tests
 Perform pre-operative cardiac clearance for a patient using the ACC/AHA Guidelines
Medical Knowledge
 Describe the ACLS protocols for managing cardiac emergencies
 Describe the ATP III/NCEP guidelines for managing hyperlipidemia
 Describe the JNC 7 guidelines for hypertension
 Describe the USPSTF guidelines on the use of aspirin for primary prevention (including a
discussion on age & gender-based differences in the guidelines)
 Describe secondary prevention of coronary artery disease, including choice and duration
of anti-platelet therapy (Dehmer GJ, Smith KJ: Drug-eluting coronary artery stents. Am Fam Physician
2009;80(11):1245-1253.), as well as use of beta-blockers, statins, ACE-I & ARBs
 Discuss the following conditions, including specific management:
o Congestive heart failure
o Coronary artery disease
 Acute coronary syndrome
 Stable Angina
o Hypertensive emergencies
o Atrial & ventricular arrhythmias
 Discuss the indications for pacemaker & AICD placement (including levels of evidence)
Revised 5/18/11
Practice Based Learning and Improvement
 Maintain E*Value procedure log for all procedures done
 Identify and use appropriate resources, including textbooks, online resources and
evidence based articles to acquire and apply information pertinent to cardiovascular
disease (Dr. Calhoun’s CD on heart murmurs highly recommended)
Interpersonal and Communication Skills
 Communicate management plans appropriately to patients and their families
 Communicate with the entire healthcare team including nursing, senior residents, faculty
and consultants
Professionalism
 Arrive on time
 Complete all medical records in a timely fashion
 Maintain confidentiality
 Interact with colleagues and patients in a professional manner
 Record and track procedures and duty hours in E-Value
Systems Based Practice
 Make cost effective recommendations to patients
 Advocate for patients and assist them through the healthcare system
 Identify local resources to assist patients with the following:
o Smoking cessation
o Exercise/Exercise Prescriptions
o Nutrition (DASH diet)
Expected Procedural Exposure:
 As per patient care competencies
Didactics:
 Attendance is mandatory for all residents at Family Medicine conferences: 12:00-5:00
FM Faculty Liaison: Janalynn Beste, MD
Location: CFMC, NHRMC
Rotation Faculty Contact: Melissa Davis (Formerly Coastal Cardiology), Linda Calhoun, MD
Vacation Allowed?: Yes
Dress Code: Professional/White coats during patient care/Name Tags
Hours – Starting time day #1: 7:00am
Overnight Call: per schedule
Continuity clinic: per schedule
Revised 5/18/11
SCHEDULE:
Monday
AM
Tuesday
CFM clinic
Noon
PM
Revised 5/18/11
Wednesday
Thursday
Friday
Noon Conf.
CFM Clinic
Conference
@ CFM