Vascular Medicine Fellowship

• Gain core competency in pathophysiology, assessment, diagnostics, and treatment of cardiovascular diseases
• Understand the initial inpatient and outpatient workup, management and long-term follow-up of patients with vascular diseases
• Eligible for American Board of Vascular Medicine examination and the Registered Physician in Vascular Interpretation (RPVI) examination

Clinical rotations will provide the trainee with fundamental knowledge about vascular magnetic resonance and computed tomographic imaging; and gain an appreciation for peripheral angiography and catheter-based endovascular interventions used to manage patients with a variety of vascular disorders.

Rotations include:

• Inpatient and outpatient consultation
• Vascular and noninvasive vascular imaging
• Intensive training in the Vascular Diagnostic Laboratory to develop expertise in performing and interpreting noninvasive vascular tests such as duplex ultrasonography, segmental pressure measurements and pulse volume recordings.
• One to two months in the Cardiovascular Imaging Laboratory
• One to two months in the Catheterization and Interventional Radiology Laboratories
• Longitudinal ambulatory vascular medicine practice (year-long).
• Electives in vascular surgery, peripheral vascular intervention (arterial and venous), vascular imaging (MR/CT/PET), chronic venous disease (varicose veins), lymphedema, and pulmonary vascular disease.
• Immersive away-rotations focus on connective tissue disease, fibromuscular dysplasia, vasculitis, and renovascular disease.

An additional one to two months will be spent on the vascular surgery service to develop an appreciation of the complex and extensive nature of vascular surgical procedures, and to participate in the postoperative care of patients undergoing vascular surgery.

Following clinical training, vascular medicine fellows will be eligible to take the American Board of Vascular Medicine’s examination in vascular medicine.

Faculty for the Vascular Medicine Fellowship are part of a multidisciplinary group, bringing together expertise from:

• Advanced Heart Failure/Cardiomyopathy
• Cardiac Surgery
• Cardiovascular Imaging Program
• Congenital Heart Failure and Adult Congenital Heart Disease Program
• Pulmonary and Critical Care Medicine
• Pulmonary Vascular Disease Program
• Thoracic Surgery

Brigham and Women's Hospital is a scientific, clinical, and academic powerhouse with a long history of firsts. We foster a shared commitment to predict, prevent, and treat the world's toughest diseases. Our collaborations are changing the future of medicine, in Boston and beyond.

Our culture in providing excellence in patient care, teaching, and research affords an exceptional environment for clinical training and participation in exciting advances in basic and clinical research.

Committed to teaching and mentoring the next generation of leaders in medicine, our faculty is comprised of experienced clinicians who impart a breadth of knowledge and expertise during clinical rounds and in clinics. In addition, basic and clinical research mentors provide many research opportunities for residents and fellows.

Throughout the year, the fellows conduct Vascular Medicine-focused scientific investigations with the goal of presenting the work at international Scientific Sessions and publishing the results in high-impact, peer-reviewed journals. Program faculty will assist fellows in project support for additional training focused on research and academic career development. Opportunities are available across the spectrum of basic science, translational science, and clinical research in all aspects of pulmonary heart disease.

The Vascular Medicine Section is engaged in diverse research, consensus guideline panels, and policy-making activity.

Dr. Samuel Z. Goldhaber is also the Director of the Thrombosis Research Group. He and Dr. Gregory Piazza are engaged in pivotal randomized and observational trials in pulmonary embolism (PE), deep vein thrombosis (DVT), stroke prevention in atrial fibrillation, and prevention of acute coronary syndromes, including:

• Novel oral anticoagulant drugs to treat PE and DVT.
• Pharmacomechanical (catheter-directed) therapy to treat PE and DVT, in particular, evaluation of ultrasound-facilitated, low-dose, catheter-based fibrinolysis for treatment of acute PE.
• Electronic decision support to increase anticoagulation utilization in patients with AF at increased risk for stroke.
• Improving quality of care in Anticoagulation Management Services.
• Observational studies of nonvalvular atrial fibrillation, stroke risk, and prescription of anticoagulants in particular as the North American Clinical Coordinating Center for GARFIELD-AF.
• Observational studies of venous thromboembolism risk, treatment, and prevention patterns, in particular as the North American Clinical Coordinating Center for GARFIELD-VTE.
• Reduction of inflammation with low-dose methotrexate in patients with myocardial infarction and diabetes or the metabolic syndrome who we enroll in the NIH-sponsored Cardiovascular Inflammation Reduction Trial (CIRT).

Dr. Marie Gerhard-Herman chairs the ACC/AHA Diagnosis and Treatment of PAD guideline committee. She also serves on the ABIM Cardiovascular Disease Exam committee. She has begun a case-based program to teach value rich, efficient cardiovascular examination to the House Staff as the DOM Macy Scholar. Her current funded research projects include:

• The clinical manifestations of accelerated atherosclerosis in children with Hutchison Gilford Progeria Syndrome (HGPS) and the impact of therapy. 
• Noninvasive testing to predict stroke in a cohort of children with HGPS.
• Factors affecting calcific aortic stenosis in accelerated atherosclerosis of HGPS.
• Angiotensin II and vascular function in patients with prior preeclampsia.
• Preeclampsia: A Marker for Future Cardiovascular Risk in Women.

Dr. Patrick O'Gara serves as the Steering Committee Co-Chair of the NHLBI's Cardiothoracic Surgery Network, which investigates critical questions at the interface between cardiology and cardiac surgery. Since December 2013, the network has published in the New England Journal of Medicine the results of three randomized controlled trials focused on ischemic mitral regurgitation and the surgical approach to atrial fibrillation at the time of mitral valve surgery.

Dr. O'Gara also serves on the Executive Committee of an NIH-funded analysis of oral hygiene in patients with infective endocarditis. Dr. O'Gara shares the special policy and global perspectives he acquired during his recent Presidency of the American College of Cardiology.

Dr. Piotr Sobieszczyk and Dr. Scott Kinlay are conducting several clinical trials in patients undergoing vascular intervention, including:

• Vascular gamma brachytherapy to treat restenosis and preserve patency following infrainguinal stenting.
• Long-term outcomes of percutaneous stenting of the femoral arteries to assess their clinical success.
• The NIH-sponsored BEST-CLI Trial, comparing surgical and endovascular therapies of critical limb ischemia. Both the BWH and VA Boston are sites in this study.
• Long-term outcomes related to prolonged dual-antiplatelet therapy after coronary stenting.
• Endothelial and muscle function in Gulf War Veterans Illness.
• Participation in the ENDOMAX randomized controlled trial comparing bivalirudin versus heparin in patients receiving peripheral endovascular procedures

Applications are invited from physicians who have completed an ACGME accredited fellowship in either pulmonary and critical care medicine or cardiovascular medicine. We require the following documents to be submitted for a complete application to be reviewed:

• Vascular Medicine Fellowship Application
• Curriculum vitae (CV)
• Personal statement
• Three letters of recommendation

Interviews are granted on a rolling basis by receipt date.

Interested fellows should submit the application to magayle@bwh.harvard.edu.

Each application is reviewed in its entirety by our selection committee with an eye toward a combination of overall clinical and academic excellence, leadership ability, career development potential, and personal character.

We interview approximately eight candidates for the program each year. Although we receive applications from many well-qualified candidates, it is not possible to interview all who apply. Those who are invited will be notified on a rolling basis based on the application receipt and review date, and a personal interview date will be arranged.

Applicants start the interview day at 8 am with a meeting with the program director and associate program director, and then will have interviews with faculty and the current fellow. The current fellow will be available throughout the day to answer questions and give tours.

For the purposes of making travel arrangements, please see our hotel accommodations page for more information.

Mounica Yanamandala, MD

I was born in India and moved to U.S. at the age of 5. I grew up in San Jose, California and left sunny weather behind to experience the “Life of the Mind” as an undergraduate at the University of Chicago. My first exposure to research was at UChicago where I worked in a basic science lab studying multiple sclerosis and had the opportunity to help in a small, randomized control trial studying the effect of motivational interviewing on prescription drug compliance. I loved both experiences. They exposed me to a different way of connecting with patients through scientific inquiry that would ultimately help them, or others like them. I got my medical degree at the University of California, Irvine and then completed my residency as well as chief residency in internal medicine at Albert Einstein Medical School/Montefiore Medical Center. I knew I wanted my future career to have a major research component, so there was no question of where I wanted to do my cardiology fellowship given Brigham’s track record in training physician scientists. I am currently doing my post-doctoral research fellowship with Dr. Anthony Philippakis at the Broad Institute studying how to conduct direct-to-participant research and with Dr. Carolyn Ho learning how to develop patient reported outcome measures. My clinical interests are vascular biology with a focus in aortic aneurysms. Outside of lab, I can be found chasing my toddler, hiking, baking, and exploring the food scene in Boston.

Francisco Ujueta, MD, MS