Kingston, Ontario – Canada

Clinical Fellowship in Cardiac Electrophysiology & Devices – Kingston General Hospital/Queen’s University, Kingston, Ontario, Canada

Supervisor: Dr Adrian Baranchuk MD FACC FRCP (barancha@KGH.KARI.NET)

Current Fellow: Dr Riyaz Somani MB ChB MRCP (UK), PhD (riyazsomani@hotmail.com)

Details

This is a two year training program in cardiac electrophysiology and device implantation.

Entry requirements: Completion of basic training in Cardiology. Some EP exposure beyond that which is encountered in general cardiology training is helpful but not essential.

Number of fellows: 3

Start time:  Flexible – typically July.

Application deadline: I would suggest applying as early as possible (by contacting the program director). Entry into the program is a competitive process with interviews being held either in person in Kingston, at HRS or possibly via teleconferencing. The process of credentialing non-Canadian medical school and post graduate medical training by the provincial college of medicine (www.cpso.on.ca) is lengthy. For fellowships only an educational licence is required and assistance is given to obtaining this.

Training Content

Clinical

Electrophysiology
There is one dedicated EP lab and one pacing lab (which is shared with the interventionalists). Approximately 350 EP cases are performed per year. This breaks down to 150 complex (pulmonary vein isolation, ablation of atrial tachycardias and VT ablation – outflow tract, idiopathic, scar) using 3D mapping systems (CARTO/Velocity) and 200 non-complex (including diagnostic EP studies and catheter ablation for atrial flutter, AVNRT, AVRT and WPW).

Devices
Approximately 600 devices are implanted per year including 250 ICDs and 100 CRTs. Training in the programming of these devices and the management of device related problems plays a central role in the training program.

Lab time is equally divided between the three fellows with an average of three full days in the lab per week.

Consultative EP/On-Call commitment
Inpatient and outpatient consultations for arrhythmia problems are used to enhance training during the program and trainees also provide advice to the device clinics. On-call coverage is predominantly by telephone for arrhythmia problems only that are out of the scope of management of the general cardiology staff. On-calls are shared by the three EP fellows with one week blocks every three weeks. There is no general cardiology on-call commitment.

Research

The Arrhythmia service at Queen’s University is a highly motivated and productive research centre with several areas of interest being actively pursued in both basic and clinical science areas. Fellow’s are actively encouraged to develop research projects with half a day per week given to facilitate this.

Education

In addition to training provided in the clinical setting, there are weekly devices ‘rounds’ and weekly EP ‘rounds’ where fellows are expected to present interesting cases and to be put on the spot to work out diagnoses. These are each one hour in duration and usually very educational. Fellows are also encouraged to attend meetings/courses and conferences. There is also a monthly journal club to help discuss and generate new research ideas.

Social Aspect

Kingston is a small city (population 120,000) in between Toronto and Montreal and is approximately a two and a half hour drive away from Toronto. It sits on the shore of Lake Ontario making it a beautiful location, particularly in the summer. The summers are hot and the winters very cold. There are several good schools and lots of children’s activities throughout the year. The cost of living is a little higher than in the UK (currently). Given the small size of the city, a car is not essential, particularly if accommodation is sought close to the hospital.