Adult Congenital Heart Service Clinician Resources

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Letter to referring physiciansDrs. Landsberg and Mullen

Dear colleagues and friends:
As many of you know, the Boston Adult Congenital Heart (BACH) and Pulmonary Hypertension (PHT) program was created in 1990 and began accepting patients in 1992. It was formed in response to the highly specialized needs of a rapidly expanding patient population: Adults with Congenital Heart Disease (ACHD). As we expected, the number of patients and families cared for by BACH has grown and grown, and thankfully, so has our team.

Our current BACH caregiver group consists of full time staff cardiologists, additional dedicated staff cardiologists, cardiovascular surgeons, mid-level practitioners, dedicated fellows, and two administrators.

Cardiology staff:

Michael Landzberg, MD, director, BACH service
Thomas Johnson, MD
Paul Khairy, MD, PhD
Mary Mullen, MD, PhD
Michael Singh, MD
Laurence Sloss, MD
Anne Marie Valente, MD
Fred Wu, MD

BACH surgeons:

Pedro del Nido, MD, Chair, Dept. of Cardiac Surgery
Francis Fynn-Thompson, MD
John Mayer, MD
Frank Pigula, MD
Prem Shekar, MD

Mid-level practitioners:

Dorothy (Disty) Pearson, PA-C
Susan Fernandes, PA-C, MPH
Caitlyn O'Brien-Joyce, PA-C
Nancy Barker, PA-C
William M. Kerr, BSN, RN
 

Administrative staff:

Jilian Sachs
Lauren Serge

We welcome you and your patients to the BACH program. We look forward to partnering with you to provide the highest level of care and education for your patients.

Sincerely,

The BACH Team
 

 

Teaching

Staff members of BACH actively teach Harvard Medical School (HMS) students, Harvard Science and Technology (HST) students, and other post-graduates at various levels of training. Staff members participate annually as faculty for the HMS Cardiopulmonary Pathophysiology Module and HST Cardiovascular Physiology Course.

Inpatient staff members of the BACH group are responsible for teaching pediatric and internal medicine residents and pediatric and adult cardiology fellows on a regular basis.

The BACH service is one of five programs worldwide that sponsors a yearlong fellowship for advanced cardiovascular fellows with the goal of training academic leaders in ACHD care. Staff members lecture locally, nationally and internationally.

Fellowships

The rapidly growing population of adults with congenital heart disease has heightened the need for specifically trained individuals who can provide comprehensive outpatient and inpatient care.

The Adult Congenital Heart Disease fellowship program at Boston Children's Hospital aims to produce a highly trained cohort of ACHD specialists who are capable of assuming a leadership role in the creation of an integrated network of specialized centers.

The Boston Adult Congenital Heart Disease (BACH) and Pulmonary Hypertension Service is an internationally recognized multi-departmental, multi-institutional clinical service that functions as a center of excellence for both adult congenital heart disease and pulmonary hypertensive disorders.

Our program involves Brigham and Women's Hospital and Boston Children's Hospital as the two primary institutions, and has strong ties with Massachusetts General Hospital and Beth Israel Deaconess Medical Center as well as developing affiliations with Boston Medical Center and the New England Medical Center.

The BACH service at Harvard Medical School actively follows more than 6,000 adult patients with both inpatient (approximately 35 to 45 patients per month) and outpatient (approximately 120 visits per month) services, accepting approximately 5 to 10 new referrals per week.

The patient base at Boston Children's Hospital and Brigham & Women's Hospital represents one of the greatest strengths of the fellowship training program. It reflects the hospitals' long histories of leadership in caring for congenital and acquired heart disease, and includes large local, regional, national and international referral sources.

Our patients include many living here in New England as well as adults who travel from as far away as Norway. In this way, our ACHD fellowship program provides world-class hands-on training in clinical skills, diagnosis, and management of the most complex patients. To date, the BACH service has graduated over 25 full-time fellows.

Training Expectations

The Boston Adult Congenital Heart Disease and Pulmonary Hypertension Service accepts up to three new fellows a year into our 1- to 2-year training program. We welcome applicants who will have completed 3 years of fellowship training in adult and/or pediatric cardiology by the start of their ACHD fellowship.

While many of our fellows have benefited from previous training in combined internal medicine-pediatrics residency programs, this is not a requirement. However, depending on the individual applicant's long-term goals, those with limited internal medicine or pediatrics exposure may be strongly urged to complete a 2-year ACHD fellowship.

The BACH ACHD fellowship curriculum is based largely upon recommendations set forth by the American College of Cardiology in the 1995 Recommendations for Training in Adult Cardiovascular Medicine Core Cardiology Training (COCATS) Task Force 9, the COCATS II revision in 2002, and the 32nd Bethesda Conference Task Force 31-3.

To date, there have been no formal recommendations for ACHD training in pediatric cardiology. Our fellows attend general ACHD clinic one day a week, medical/surgical conferences one day a week, and present at least four times a year at the weekly Brigham and Women's cardiology conference.

Full-time BACH senior fellows are expected to provide at least six months of direct inpatient on-service time during the course of training, including inpatient responsibilities 18 weekends per year. For individuals with specific interests, there is potential for tailoring the curriculum to include emphasis on non-invasive imaging (echocardiography and/or MRI), interventional procedures, or electrophysiology. For trainees with limited or no background in internal medicine, additional exposure to primary prevention, coronary artery disease, and heart failure will be ensured. Similarly, those with limited background in pediatric cardiology will be presented with additional opportunities for acquiring familiarity with embryology and post-operative management.

BACH ARCHES (Adult Registry for Congenital Heart Evidence, Evaluation and Standards) is a data management and registry program designed to accurately and efficiently catalogue and assess BACH clinical, research, and financial activity, and to assay productivity and outcomes. Clinical research within the ARCHES program of BACH is an expected and necessary part of the BACH training program. Fellows are expected to bring a desire to further understand basic or clinical mechanisms of normalcy, disease, and health recovery in ACHD patients, and will be mentored to continue this pursuit of knowledge within their fellowship and future academic careers.

Interested individuals should contact:

Anne Marie Valente, MD
Boston Adult Congenital Heart Group
Department of Cardiology
Boston Children's Hospital
617-355-6508

Application Process

To apply to our fellowship program for July 1, 2011, you will need to submit the following documents by October 1, 2010:

  • A completed online Training Application Form
  • Official medical school transcript (copy accepted)
  • Official record of USMLE board scores
  • 3 letters of recommendation, including 1 from current fellowship program director
  • Curriculum Vitae
  • Personal Statement describing your experience, research interests and career goals.
  • A valid ECFMG certificate (if you graduated from medical school outside of the United States or Canada). Graduates who are not United States citizens or permanent residents must obtain a J-1 visa from the Education Commission of Foreign Medical Graduates (ECFMG).

Please mail your application materials to:

Peter Lang, M.D
Director, Clinical Training Program
Department of Cardiology
Boston Children's Hospital
300 Longwood Avenue
Boston, MA 02115

References:

  • Skorton DJ, Cheitlin MD, Freed MD, et al. Guidelines for training in adult cardiovascular medicine. Core Cardiology Training Symposium (COCATS). Task force 9: training in the care of adult patients with congenital heart disease. J Am Coll Cardiol 1995;25:31-33
  • Beller GA, Bonow RO, Fuster V. Core Cardiology Training Symposium (COCATS). ACC revised recommendations for training in adult cardiovascular medicine. Core Cardiology Training II (COCATS 2). J Am Coll Cardiol 2002;39:1242-1246
  • Child JS, Collins-Nakai RL, Alpert JS, et al. Task force 3: workforce description and educational requirements for the care of adults with congenital heart disease. J Am Coll Cardiol 2001;37:1183-1187
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