Complex and High-Risk Indicated Procedure (CHIP) Percutaneous Coronary Intervention (PCI) Fellowship

Overview

Two CHIP fellows will rotate quarterly between Massachusetts General Hospital and Brigham and Women’s Hospital. At any given time, one fellow will be based at MGH and the other at BWH, providing broad exposure to diverse faculty, procedural techniques, patient populations, and advanced coronary interventions across the Mass General Brigham system.

The fellowship is designed to provide advanced clinical and technical training in complex, high-risk, and chronic total occlusion (CTO) coronary intervention. The program emphasizes the development of independent procedural judgment, advanced wire and device skills, intraprocedural decision-making, complication management, and mastery of contemporary complex PCI techniques. Fellows will participate in the evaluation, selection, and longitudinal management of patients with advanced coronary and structural cardiovascular disease, including chronic coronary syndromes, acute coronary syndromes, ischemic cardiomyopathy, valvular heart disease, heart failure, peripheral vascular disease, and post-operative cardiovascular conditions.

A major focus of the fellowship is technical proficiency in advanced coronary intervention. Fellows will gain extensive hands-on experience with CTO PCI using CT-guided procedural planning, dual coronary injection, antegrade wire escalation, antegrade dissection/re-entry, and retrograde crossing techniques. Training includes advanced techniques in large-bore access, bifurcation PCI, calcium modification, management of complex stent failure and in-stent restenosis, and optimization of PCI using intravascular imaging. Dedicated training is also provided in mechanical circulatory support for high-risk PCI, including pLVAD- and ECMO-supported intervention. Fellows will participate in multidisciplinary CAD Heart Team discussions to develop advanced clinical decision-making skills for patients with complex coronary anatomy and high-risk comorbid disease.

Practice-based learning and continuous procedural improvement are integral components of the program. Fellows will refine their technical and cognitive skills through direct faculty mentorship, case review, multidisciplinary feedback, and outcomes assessment while progressively assuming greater procedural responsibility. In addition, fellows will participate in investigator-initiated and industry-sponsored clinical trials focused on complex PCI, CTO intervention, intravascular imaging, and mechanical circulatory support.

Requirements

Successful completion of a general cardiology fellowship and at least one year of interventional cardiology fellowship.

Curriculum

Two fellows will rotate between the Massachusetts General Hospital (MGH) and Brigham and Women’s Hospital (BWH) on a quarterly basis. One fellow will be at MGH and the other fellow will be at BWH at any given time. If two fellows cannot be recruited, then one fellow will be chosen and will split time evenly between the two institutions.

The program is organized to provide training and experience at a sufficient level for the Fellow to acquire the medical knowledge and competency of a specialist in complex interventional procedures. During training, the Fellow’s clinical experience will include opportunities to diagnose, select therapies, perform high-risk interventional procedures, and manage and judge the effectiveness of treatment(s) for inpatients and outpatients with a broad range of cardiovascular disease including chronic coronary artery disease, acute coronary syndromes, valvular heart disease, congestive heart failure, pericardial disease, adult congenital heart disease, peripheral vascular disease, cardiac arrhythmias, and post-operative patients.

Practice-based learning and improvement is an essential part of the program as fellows continually monitor and augment their clinical and procedural skills based on observations by themselves, clinical faculty, ancillary staff, and patients. Fellows are given opportunities to assume continuing responsibility for both acutely and chronically ill patients to learn the natural history of the cardiac conditions, and through assimilation of scientific knowledge.

Fellows will be exposed to many complex PCI procedures, including CTO PCI (retrograde, dissection/reentry, CT guidance), brachytherapy (laser/mechanical atherectomy), mechanical support (pLVAD/ECMO), intravascular imaging (OCT/IVUS), decision-making for complex coronary artery disease (CAD) using the CAD Heart Team, and leading clinical trials in complex PCI.

Research Experience

Fellows participate in clinical and translational cardiovascular research working with accomplished faculty at both institutions.

How to Apply

• CV.
• 3 Letters of Recommendation (one must be from current Program Director).
• Personal Statement.
• ECFMG Certificate if FMG/IMG.
• Application deadline is mid-September.
• Interviews will take place mid-October.

Faculty Team

Kevin Croce, MD, PhD
Co-Program Director - BWH
Kcroce@bwh.harvard.edu

Farouc Jaffer, MD, PhD
Co-Program Director - MGH
Fjaffer@mgh.harvard.edu

Darshan Doshi, MD
Associate Program Director - MGH

Brian Bergmark, MD
Associate Program Director - BWH

Kiersten Frenchu, MD
Interventional Cardiology - MGH