My name is Dan Spevack. I am the director
of the Montefiore Echo lab and I am highly involved in the Montefiore/Einstein Cardiology
Fellowship Program. The fellows all rotate a substantial amount
of time through noninvasive imaging, and we do a lot of echocardiography, transesophageal
echocardiography, and stress testing, and fellows learn a lot about cardiac hemodynamics
while they’re in our lab and this is mainly what we do.
Early on in the fellowship the focus of the fellows’ training is on how to obtain good
echo images, how to become a good stenographer, because it’s important to start from there
and they should know how to obtain images themselves. As the fellowship goes on we concentrate
more on interpretation of the images, and the more senior fellows get heavily involved
in more advanced techniques, transesophageal echo and stress echo interpretation. Those
who are really interested in echo learn more about advanced techniques such as 3D echo,
strain rate imaging, speckle tracking, and things like that.
Like all cardiology fellowships at major academic medical centers, we have all the pieces to
make a solid foundation. We have a strong division of Cardiology but it’s also important
to have a strong overall medical center. You can pick any major organ system and Montefiore
does transplants in those areas. We have a really well developed basic science laboratory
at the medical school. There are lots of opportunities for collaborations between departments, between
the basic science and clinical medicine, and I think the foundation is very strong. Probably
you will find some similar setups at the top-tier programs around the country, but what sets
us apart is that our collaborative efforts are very easy. There’s a nice collaboration
between a lot of the departments, without the turf battles that you hear about at other
centers. There’s a culture at Montefiore of collaboration and cooperation, and to me
that’s made working here very pleasant and it certainly trickles down to the fellow level.
Within cardiology one of the things that has made us famous here is our Arrhythmia department—the
first pacemaker was put in at Montefiore. Our Arrhythmia group is a world-renowned group.
The head of that department, John Fisher, is chair of the major arrhythmia organization,
the Heart Rhythm Society,and he’s editor in chief of Pace, a premier journal on arrhythmia.
That’s sort of what Montefiore cardiology is most famous for. The cath lab is very strong
and the noninvasive imaging has always been very strong and now with our new chief of
Cardiology, Dr. Garcia, noninvasive imaging has become a major focus in our division and
I think we’ll continue to grow. I went to New York University for my fellowship
experience, and I thought it was wonderful there. I certainly felt that I got the tools
I needed to succeed and I was able to come out and get a job working here, working with
Cardiology fellows and publishing research and working with cardiology patients. I feel
like I came from a background and a good program that put me in a position to do what I wanted
to do, I see our fellows graduating and I think that we also provide a lot of that,
that the vast majority our fellows when they graduate are extremely pleased with where they ended
up. The fact that we’re able to provide our fellows with the experience to do what
they want to do when they graduate is fantastic. NYU, for being a great program, did miss certain
things. When I came here I had to virtually train myself in heart failure, transplant,
and left ventricular assist devices because that was something not done at NYU at the
time when I was there. The diversity of experience that we have here may be a little greater
because of programs like that. I think that’s also one of our strengths.
I think that we try to keep avery warm, sort of safe environment for our fellows. We try
to make it so that this is the time in your training when you really get to work one on
one with an attending, much more than you have in the past, and you can feel verycomfortable
with your basics of knowledge because you asked all of the questions you had floating
around that you were afraid to get out earlier in your training. We work hard in all of our
departments here to create this environment of learning and collaboration and I think
that’s one of the things that makes this a fun place to work.