I recently joined Temple University School of Medicine as faculty in the section of Interventional Cardiology after completing an advanced interventional cardiology fellowship at Prairie Heart Institute. I did my interventional cardiology training at Temple and now coming back to Temple after a “Prairie Year” is like a home-coming for me. I have been here at Temple as an attending for 4 weeks now, and I am myself amazed at how comfortable I feel with starting an interventional cardiology career. Numerous folks at Temple have complemented me on my interventional skills. I know it is because of my training at Prairie.
The Advanced Heart and Vascular Fellowship at Prairie is truly a remarkable experience and a unique multidisciplinary program at one of the highest volume interventional programs nationwide, led by Drs. Jeffrey Goldstein, Nilesh Goswami and Gregory Mishkel. Given its’ large catchment area in central and southern Illinois, Prairie fellow is exposed to an incredible volume and variety of endovascular, complex coronary and structural heart interventions. As a Prairie full-year fellow, I participated in over 1200 interventional cases and worked closely with a team of over 20 faculty members with varied skill sets ranging from structural heart interventions, advanced imaging, endovascular specialists, vascular medicine specialists, chronic total occlusion specialists, cardiothoracic surgeons and vascular surgeons. The friendly and collegial nature of the faculty (Drs. Goldstein, Goswami, Hall, Khurana, Scherzel, Issa, Nandish, Pacheco, Dukkipati, Mishkel and Rocha-Singh) is most conducive to stress-free learning.
I was amazed by how invested they were in my education and how “hands-on” it was from the very first day. Honestly, these guys are so good, they make the most complex interventional stuff look so easy and straightforward. My first couple of months at Prairie, I felt “Oh this stuff is easy” only to later realize it was the true class of the operator that made me feel that way. It is a “Master-Class” in every sense. You learn “what to do”, “when to do” and most importantly “when to stop” and always keep “your patients safety and interest first over everything else”. You will master “situational trouble shooting”, “thinking outside the box” and most importantly, getting everything done in an efficient timely manner.
I have never been around better and more invested group of teachers my entire career. Everything is evidence based, and very thoughtful, more so than any other program I have worked at previously. Midway into my year, I was independently performing complex procedures like EVAR, TAVR, Carotid stents with ease and confidence. I was myself amazed with the comfort level I was able to achieve in such a short time at Prairie. In addition, the lab staff is very knowledgeable, friendly and supportive of the fellowship adding to the positive experience. Overall, it is an extraordinary training experience. You will come out highly refined, confident and will be drafted in to a different league of Interventional Cardiologists after a Prairie Fellowship. Decision to spend any time at Prairie, learning from these master operators and clinicians will only help you in your career. I know it positioned me very well to succeed in my career.
There are plenty of opportunities for research and scholarly work. You can literally have a case report to write every week if you are interested. After a few months you will realize a case report for most is just another case at Prairie. There are also numerous ongoing trials at Prairie Education and Research Cooperative, from myocardial stem cell injections, new upcoming endovascular devices to the newest TAVR valves. I was also able to work with the performance improvement team on research projects and angiographic core lab related activities.
I feel my decision to spend another year training at Prairie paid off big time and turned out to be the the best career move I have ever made. I will continue to lean on my mentors at Prairie for advise and guidance over the years. I am extremely thankful for all the education and training I received during my Prairie Fellowship. Overall, I came to Prairie with great expectations and the program still exceeded all my expectations. It is truly a program to seek for: those wanting to take that next step from “good to great” in their careers. It is never too early and never too late to learn from the “Prairie Master Class”.Vikas Agarwal, M.D.
“It’s all true. Read the testimonials from prior fellows and realize it is all true. The Prairie Fellowship offers an opportunity to work with an incredibly talented group of physicians with a large patient population and referral source leading to what seems like a never ending case mix of widely varied and complex procedures, some of which have never been done before or rarely done at any other institution. Creating that list, showing my procedure log, or compiling all the statements from previous fellows would be enough to validate the learning, experience, career development, and “good to great” expectation of the program. However, there are other aspects of the fellowship worth highlighting in addition to the phenomenal operators and large, varied case mix. For an accurate and compelling list of these procedures I encourage you to read all of the other fellow testimonials. What follows are several additional aspects of the Prairie Fellowship that allow the fellows to take full advantage and learn the most possible from the faculty and procedures.
Culturally Prairie Heart and Vascular wants the fellows to learn. It begins with the primary faculty (Drs. Goldstein, Goswami, and Nandish) who set a tone of acceptance, respect, and passion for learning that flows to all the physicians, cath lab personnel, nurses, and administrative staff. Frequently people reach out to make sure you know about schedule changes, text when new cases are added, mark you name down to be called when cases start, call you to scrub into a room to see something unexpected, and encourage your participation and opinion. Everyone involved wants you to scrub in and do as much as you can. As an example, once it was known I was hoping to gain transeptal experience the EP staff would find me and point out the best cases and times for transeptals. The enthusiasm and encouragement for the fellows to see, do, and learn is an added dimension to the fellowship that does not show up in lists of procedures but is equally important and unique.
The entire Prairie Heart and Vascular is open to the fellows. Because each fellow comes with a different experience and skill set, the fellowship is not one size fits all. With the breadth of Prairie Heart and Vascular the fellows can design an experience that fits their need. Whether spending more time in Vascular Medicine, non-invasive testing, venous ablation, focusing on structural heart and spending time in valve clinic on non-structural heart procedure days, needing to focus on procedural numbers for credentialing purposes, or learning coronary CTO. The flexibility of the program, allowing the fellow to focus and learn the specific areas they need, is yet another unique and distinguishing feature of the Prairie Advanced Heart and Vascular Fellowship.
Participation in research is readily available to the fellows. Many cases are done as part of clinical trials through the research arm of Prairie, The Prairie Research and Education Cooperative. This gives the fellows exposure to increased case volume (carotid stenting for example), new devices (four different heart valves were available), and some devices with a very limited number of trial sites. In addition, case reports, data review, and presentations are available for fellows looking to build a resume.
Although it is a big commitment to participate in the Prairie fellowship, especially mid-career, once there you quickly realize how fortunate you are and wish you could stay longer. It is clearly worth it for any fully trained interventional cardiologist that is looking to gain confidence and experience in a much wider range of procedures. At many institutions it would take several different physicians or even specialties to cover what one Prairie Interventionalist covers. They have a passion for wanting their fellows to learn these skills as well, for their fellows to go from “good to great.”Peter Higgins, M.D.