Adult Congenital Heart Association

Actelion Fellowship Award Application

The Adult Congenital Heart Association (ACHA) and Actelion offer the ACHA Actelion Fellowship Award program as a means to provide scholarship funding to an ACHD program and an academic institution dedicated and equipped to develop and maintain ACHD fellowship training. This fellowship is a 24 month ACHD training program for those interested in a cardiovascular career specializing in the care of adults with congenital heart disease.

Requirements

  • Cardiovascular fellows completing either internal medicine or pediatric cardiology are eligible to apply.
  • Applicant must be U.S. citizen.
  • Fellowship application process and decision is at the ACHD program’s discretion.
  • Fellowship funds can be utilized at any time during the Fellowship, but they must be exhausted within the 24 month timeframe.

All qualified applicants will be considered without regard to race, sex, color, ethnicity, or national origin. Fellowships will be awarded based on applicants' eligibility and merit (based on academic preparation and potential).

Curriculum

  • The ACHD Fellow will participate in outpatient clinics throughout the fellowship.
  • The ACHD team should consist of the attending ACHD cardiologists, ACHD APN, and ACHD RN.
  • The fellow on average should visit 10-20 pts per week. In a month not specifically assigned to a rotation, when not assigned to a clinical rotation the fellow should attend all available clinics (at least 1-2/week) and that when assigned to a clinical rotation should attend at least 1 clinic a week (ie MRI, inpatient, Echo).
  • ACHD Inpatient Consults: The ACHD Fellow will provide consults and round on the ACHD inpatients when available during year one (1) of fellowship and provide inpatient support on a more regular basis during year two (2).
  • Internal Medicine vs. Pediatric Pathway: This format should follow the proposed petition to the ABIM for subspecialty certification for ACHD.
  • ACHD Cardiac Imaging: To better understand childhood CHD with unrepaired defects, undiagnosed newborns, recently repaired lesions, and intraoperative TEE and to gain experience with ischemic heart disease, analysis of LV wall motion, stress testing, and TEE.
  • ACHD MRI/CT: Advances in ACHD care lead to the ACC/AHA guidelines for the management of ACHD published in 2008. Embedded within those guidelines are lesion specific recommendations for the evaluation of adults with CHD. For most forms of moderate and severe/complex CHD, evaluation by Cardiac MRI (CMR) is a Class 1 indication. As such, those caring for adults with CHD must have a strong knowledge base in CMR/CT for ACHD
  • ACHD Cardiac Catheterization: The majority of ACHD cardiac catheterization time can be spent in observation.
  • ACHD CTICU: The ACHD fellow will spend time understanding and managing (along with the ACHD team) the post-op care for ACHD patients undergoing CT surgery. This should be on the form of post-op consults in the CTICU and the floor unit.
  • ACHD CMR/CT, echocardiography, pulmonary Electives May include but are not restricted to; hypertension, and research.
  • ACHD Research: as part of the program, will be an ongoing process throughout fellowship. All research should be reported to ACHA during the quarterly reports. The Fellow will be expected to perform meaningful ACHD research as part of the ACHD research team.

APPLICATION GUIDELINES

Please read the following carefully and provide all required information. Only complete applications will be considered.

The following items must be submitted:

  1. Application checklist.
  2. Application cover sheet.
  3. ACHD Program narrative which must include the following elements:
  4. Program background, founding, and development;
  5. Program’s current goals;
  6. Program staffing, including names of all staff, credentials and years in CHD care;
  7. Care setting, including locations of outpatient, invasive cardiac procedures, catheterization-based procedures, and invasive electrophysiology procedures;
  8. Current and previous ACHD research involvement;
  9. Approach to organizational planning and focus of any current planning efforts;
  10. Challenges and opportunities facing the program in the next three to five years.
  11. Program’s role in promoting regional and/or national ACHD collaboration, including most significant interactions with other organizations and efforts.

(Requirements: 5 page limit, 11 point font, .75 inch margins)

  1. ACHD Fellowship training plan which includes the following elements:
  2. Available program resources.
  3. Proposed two-year curriculum, in accordance with ABMS and ACGME guidelines for ACHD training. Must include congenital anatomy and imaging, surgery, diagnostic and interventional catheterization, electrophysiology, heart failure, pulmonary and systemic vascular disease, intensive care medicine, transition medicine, general adult and pediatric medicine and cardiology.
  4. Plan for research training and oversight for trainee.
  5. Trainee evaluation process.
  6. Nature and amount of ACHD patient exposure expected and to be monitored during fellowship.

(Requirements: 8 page limit, 11point font, .75 inch margins)

  1. CVs for all key supervisory and mentoring staff involved in training and mentoring ACHD fellows.
  2. Letters of support from the Medical Director of Hospital / Internal Medicine and/or Head of Graduate Medical Education, the Medical Director of Cardiovascular Disease, and the Medical Director of Pediatric Cardiology. Additional Letters of support from among the following are strongly encouraged : Chief/s of Cardiac Surgery (Pediatric/Adult/Adult Congenital); Head/s of Imaging division/s; Head/s of Interventional Cardiology division/s; Head/s of electrophysiology division/s; Head/s of heart failure division/s; Head/s of pulmonary vascular division/s; Intensive care unit/s director/s
  3. Budget.

Please send attachments via e-mail to withyour organization name in the subject line.

Applicant Information

Date of Application:
Name of Organization to which fellowship would be paid. Please list the exact legal name:
Name of affiliation hospitals or universities (please no abbreviations):
Purpose of Fellowship (one sentence):
Name and Contact information of ACHD Program Director:
Contact person and title (if different than Program Director):
Mailing address of organization:
Telephone Number:
Fax Number:
Email address:
Website:
Anticipated start and finish date of Fellowship (Month/Day/Year):
Start: July 2018
Finish:
Total fellowship budget for two years:
Dates covered by this budget (Month/Day/Year):
Mission statement of the hospital:
Mission statement of the Adult Congenital Heart Disease Program:
Geographic area served:
Year ACHD Program was founded:
Name of anticipated Fellowship Director
Number of ACHD physicians:
Full time –
Part time -
Number of ACHD registered nurses:
Full time –
Part time -
Number of ACHD patients seen in 2016:
Number of ACHD patients seen in 2015:
Location(s) of outpatient services:
Number of half-day sessions:
Number of pediatric CHD operations performed in 2016:
Number of ACHD operations performed in 2016:
Number of cardiologists currently performing interventional Catherization:
Number of surgeons performing more than 75 CHD and/or ACHD operations in 2016:
Service availability – please check the box indicating services available at the ACHD Program. As needed, please provide additional information in the ACHD Program Narrative:
☐ / Diagnostic Electrophysiology / ☐ / Interventional Electrophysiology
☐ / Cardiac MRI / ☐ / Multi-Slice Cardiac CT
☐ / High-Risk Obstetric/Perinatology / ☐ / Contraceptive Counseling
☐ / Geneticist/Genetic Counseling / ☐ / Cardiac Rehabilitation Service
☐ / Psychologist/Psychiatrist / ☐ / Financial/Medical Insurance Counseling
☐ / Medical Social Worker / ☐ / Pulmonary Arterial Hypertension in ACHD is evaluated
☐ / PAH in ACHD is managed Medically
When lung transplant is considered in ACHD patient with PAH, where are they referred:
Please add the ACHD Program Narrative and Fellowship Training Plan
Use separate documents.

Application Check List

The following items must be included or your application will be considered incomplete:
☐ / Cover Sheet
☐ / Budget
☐ / Letter of Support from Medical Director of Hospital
☐ / ACHD Program Narrative Internal Medicine and/or Head of Graduate Medical Education
☐ / Fellowship Training Plan
☐ / Letter of support from Medical Director of Cardiovascular Disease
☐ / Curriculum Vitae (for Program Director, and potential fellow)
☐ / Letter of support from Medical Director of Pediatric Cardiology
☐ / Additional letters of support
☐ / Recent photo of applicant

By signing this form, I certify that the information provided in this application is complete and correct to the best of my knowledge. I understand that any false or missing information may disqualify the organization for this fellowship.

______

Print Name and Title of Person Completing the Application

______

Signature of Person completing Application

Once complete, please send the entire application to .

If you have any questions, Danielle Hile, Director of Programs, ACHA – or 267-339-0511

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