Below is a list of clinical fellowships in the UK that offer specialised training in heart failure. This list is designed to give people interested in heart failure an idea of the opportunities available across the UK and you are advised to approach the local contacts for further information.
GOLDEN JUBILEE NATIONAL HOSPITAL, GLASGOW
This is a one-year fellowship with an option to extend to up to three years. There are usually posts for three fellows including one heart failure and complex devices fellow. Each rotate on to the Scottish National Advanced Heart Failure Unit on a one in three basis. The mainstay of the post is the assessment and management of patients with advanced heart failure who are being considered for (or have received) transplantation or mechanical circulatory support. The remainder of the time is spent on another specialist interest (eg devices, imaging, intervention) and/or research – there are close links with the university and lots of potential opportunities here.
LANCASHIRE CARDIAC CENTRE, BLACKPOOL
Clinical Research Fellow in Heart Failure and Device Therapy
KING’S COLLEGE HOSPITAL, LONDON
King’s College Hospital offers a one-year clinical heart failure fellowship for specialist registrars. The post holder is responsible for contributing, on a full-time basis, to the clinical workload both of the heart failure unit, led by Professor Theresa McDonagh, and the general cardiology service. This involves an on call commitment.
The heart failure team at King’s consists of five consultant cardiologists, four heart failure specialist nurses, a heart failure subspecialty registrar and a research registrar. This unit is a growing, vibrant service providing state-of-the-art, multi-professional inpatient and outpatient care for patients with heart failure. As such, it provides excellent training in heart failure cardiology, suitable for fulfilment of the general curriculum in cardiology (UK and ESC) and advanced training at sub–specialty level.
Specifically, this post-holder will be expected to participate in heart failure inpatient care and the specialist heart failure clinics. Additionally, the post holder will have exposure to community heart failure via our services in Lambeth and Southwark. They will attend the heart failure MDT meeting where complex patients are discussed. Exposure to assessing patients for device therapy and post-device care is also available, as is participation in an inherited cardiomyopathy clinic. Opportunities for learning skills in right and left heart catheterization and biopsy are also available within the department. Heart failure has close links with the excellent imaging facilities at King’s. The clinical fellow can undertake a transthoracic echo session and have access to training in stress echo, TOE and CMR as needed.
The heart failure unit provides input via MDTs to the structural, interventional cardiology and EP programmes. Attendance at these MDTs would be desirable, depending on other commitments. Opportunities also exist to participate in on going and new research in the department.
Contact: Professor Theresa McDonagh ([email protected])
PAPWORTH HOSPITAL, CAMBRIDGE
Papworth Hospital has a large advanced heart failure service and offers a full range of surgical treatments for advanced heart failure including heart transplantation, heart-lung transplantation, implantable left ventricular assist devices, temporary (left and right) ventricular assist devices and extra-corporeal membrane oxygenation. Papworth is the largest volume heart transplant centre in the United Kingdom and delivers some of the best outcomes after heart transplantation. Care is provided by a multi-disciplinary team including four advanced heart failure cardiologists, eight cardiac surgeons, seven transplant/VAD co-ordinators and specialist nurses.
One East of England Deanery specialist trainee in cardiology is attached to the advanced heart failure service for a period of six months. In addition, there are frequently visiting fellows from other parts of the United Kingdom or overseas. These attachments are organised up to one year in advance, in order to ensure a ‘manageable’ number of trainees and avoid excessive dilution of training opportunities. There is no dedicated funding stream for visiting fellows. Most UK trainees are funded by their own deanery and most overseas trainees are funded by their base hospital or national cardiac society.
Trainees will be exposed to all aspects of advanced heart failure, including assessment for heart transplantation or mechanical circulatory support and post-operative care. There are three catheter lab lists per week in which right heart catheterisation and endomyocardial biopsy are performed. Trainees will have the opportunity to learn about ITU management of cardiogenic shock, including use of pulmonary artery catheters, inotropes, intra-aortic balloon pumps and mechanical circulatory support. In addition, there may be opportunities to gain exposure to outpatient management of adult congenital heart disease, cardiac MRI and complex pacing if this is desirable.
PORTSMOUTH HOSPITALS NHS TRUST, PORTSMOUTH
Portsmouth Hospitals NHS Trust is one of the largest acute hospital trusts in the country treating over half a million patients each year. The fellow receives specialist training in acute and chronic heart failure and complex device therapy. The successful applicant is expected to contribute to the management of inpatients and outpatients with heart failure. This includes supporting the inpatient heart failure nurse specialist team, who are increasingly involved in the care of patients with heart failure across all specialties within the Trust. It also includes the assessment and management of patients presenting with acute heart failure, regular heart failure clinics, assessment of potential candidates for complex devices and working within, and leading, the multi-disciplinary team. There are opportunities to pursue other interests including brady pacing, coronary angiography, imaging or device follow-up according to the interests of the fellow. The fellow is also encouraged to develop and implement local research protocols and one session of research per week will be timetabled.
Contact: Dr Geraint Morton ([email protected])
QUEEN ELIZABETH HOSPITAL, BIRMINGHAM
The Queen Elizabeth Hospital Birmingham offers a senior clinical fellowship in advanced heart failure in the advanced heart/lung failure service. The unit offers a supra-regional service for the management of patients with advanced heart failure including heart transplantation and mechanical circulatory support. On-site cardiology sub-specialty services at QEHB include adult congenital heart disease, coronary/structural heart intervention, advanced imaging, electrophysiology and cardiac devices. The post offers the opportunity to develop further sub-specialty experience in advanced heart failure including transplantation and acute and long-term mechanical circulatory support. This post is suitable for an individual who is nearing completion of their cardiology training and would like to gain further experience in this field prior to consultant appointment.
Contact: Dr Sern Lim ([email protected])
ROYAL BROMPTON AND HAREFIELD HOSPITALS NHS FOUNDATION TRUST, LONDON
Harefield Hospital has an extremely well established transplantation and mechanical circulatory support programme. As a senior clinical fellow you will be part of a medical team of three fulltime advanced heart failure/mcs/transplant consultants, seven middle grades and three core trainees, and part of a wider, vastly experienced, multi-disciplinary team. The duties of the post include management of inpatients with advanced heart failure including HDU/ITU patients requiring inotropic and short term mechanical circulatory support, patients in the peri-transplant/VAD implantation period, and those presenting with late complications. Outpatient duties include attendance at advanced heart failure, post-transplant, and VAD clinics. You are part of a 1 in 7 on call rota (resident evening and weekend, non-resident at night) during which time you are also responsible for managing lung transplant patients. There are opportunities to develop skills in right heart catheterisation, invasive angiography and endomyocardial biopsy, and to attend imaging sessions in echo and MRI. There are two MDT meetings per week, which are a chance to develop case presentation skills.
Contact: Dr Owais Dar ([email protected])
ST GEORGE’S HOSPITAL, LONDON
The St George’s Clinical Academic Group have opened a pioneering acute heart failure unit, the first of its type in the United Kingdom. The acute heart failure unit has 15 beds including a four-bedded HDU staffed by a dedicated team of nurses, therapists, pharmacists and junior medical staff. The fellow works alongside the three heart failure consultants providing cover for the ward and delivering the inpatient and outpatient heart failure and cardiac imaging service. The candidate will have the opportunity to gain further accreditation in CMR, TOE and DSE and the opportunity to be part of the multidisciplinary CRT optimization service. The candidate, along with the heart failure consultants will be involved as an investigator in acute heart failure trials on the unit and in the training and education of staff and students on the unit. This post is appropriate for a senior cardiology trainee, committed to a career in heart failure and imaging and with an interest in clinical research and heart failure service development.
Contact: Dr Lisa Anderson ([email protected])
UNIVERSITY HOSPITAL OF SOUTH MANCHESTER, MANCHESTER
ADVANCED HEART FAILURE FELLOW
Wythenshawe Hospital offers a clinical fellowship in the full spectrum of heart failure from the ambulatory, stable outpatients to patients in critical cardiogenic shock requiring intensive care, mechanical circulatory support (including ECMO) and cardiac transplantation. The cardiology department contains all tertiary services including EP, PCI, structural and advanced imaging (echo, CT and CMR). The fellow will also gain training in the long-term management of cardiac transplant recipients, including immunosuppression, right heart catheterisation and cardiac biopsies. The fellow will work alongside three full-time heart failure consultants as part of an extensive multi-disciplinary team and there is a commitment to the on-call rota. The department also includes a dedicated heart failure and transplant research unit, which can provide opportunities for research projects. Opportunities are available for training in devices or imaging depending on the requirements of the fellow.
Contact: Dr Steven Shaw ([email protected])
COMPLEX DEVICE FELLOW
A further fellowship is available specializing in complex devices. Wythenshawe Hospital is a high volume (>1000 procedures) device centre and the fellow will gain training in the full spectrum of pacing therapies including bradycardia pacing, ICDs, CRT, transvenous lead extraction and lead revisions. The fellow can expect to perform over 300 procedures per year. The fellow will be involved in selecting and optimizing patients for device therapy and subsequent outpatient follow-up including device programming and troubleshooting. If not already achieved, gaining international accreditation in devices (HRUK, EHRA or IBHRE) is encouraged and supported. Additional heart failure exposure is also available within the advanced heart failure and transplant service. The post includes a commitment to the cardiology on call rota.
Contact: Dr Simon Williams ([email protected])
WESSEX CARDIOTHORACIC CENTRE, SOUTHAMPTON
Wessex Cardiothoracic Centre is a large surgical centre covering a population of approximately 2.8 million in South East England, and is a tertiary centre for heart failure, EP, intervention, cardiac imaging, paediatric cardiology, and adult congenital heart disease. The heart failure (HF) clinical fellowship is a 1-year post under the supervision of Drs Peter Cowburn and Andrew Flett. There is a dedicated team of HF nurse specialists both in hospital and in the community. There is also a dedicated HF day unit, where outpatients can be reviewed by the HF team as required. The fellow can expect to obtain experience in the investigation and management of patients at all stages of heart failure. There is opportunity to gain expertise in right and left heart catheterisation, echo and cross-sectional imaging, and complex device therapies. In addition, there is a programme utilising ultrafiltration in patients with decompensated heart failure with which the fellow will be directly involved.
The fellow post does involve some commitment to the general cardiology on-call rota, which does include nights. The post is advertised in the medical press, usually in Autumn, with a start date in January each year.
Contact: Dr Peter Cowburn ([email protected])