Cedars-Sinai Heart Institute has established a reputation for excellent outcomes and clinical guidelines of the highest standard. To promote better outcomes in the medical community at large, the Institute offers a variety of education programs for physicians, nurses, trainees and students.

The following clinical teaching conferences for physicians are held regularly during the year:

• Cardiology Grand Rounds. 9 to 10 a.m., Tuesdays, in Educational Conference Center (ECC) B, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA 90048
• EKG/Electrophysiology Conference. 8 to 9 a.m., Tuesdays, in ECC B, Cedars-Sinai Medical Center
• Cardiac Catheterization Conference. 12 noon, Tuesdays, Harvey Morse Conference Center, Rooms 4 and 5, Cedars-Sinai Medical Center
• Echo Conference. 12 noon, Wednesdays, Cardiology Conference Room, Suite 5413, Cedars-Sinai Medical Center
• Research-in-Progress. 12 noon, every other Thursday, Harvey Morse Conference Center, Room 4, Cedars-Sinai Medical Center
• Fellows' CICU Clinical Conference, 9:30 to 10:30 a.m., every Friday, CICU Conference Room
• Fellows' Clinico-Pathological Conference, noon to 1 p.m., alternate Thursdays

The Division of Cardiology offers Cardiovascular Fellowship Training Programs, which include:

The Division of Cardiology fellowship is three years long and ACGME approved. The first 18 months covers clinical rotations in all seven subsections of cardiology. The last 18 months combines clinical rotations, research and subspecialty electives. Each year three to four fellows are selected from a nationwide pool of 600 to 700 applicants. For more information, please contact Sanjay Kaul, MD, Director of the Fellowship Training Program at (310) 423-4876 or write to Division of Cardiology, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Room 5314, Los Angeles, CA 90048.

The Electrophysiology Fellowship Training Program offers advanced ACGME-approved training to one to three carefully selected applicants for a one- to two-year period. This highly sought-after program is run by William Mendel, MD. The Cedars-Sinai Division of Cardiology also offers a variety of other opportunities for advanced training. One-year fellowships are available for training in echocardiography, invasive cardiology, nuclear cardiology, transplantation cardiology and other areas. Funding for these training spots is individually negotiated. For more information, please contact Prediman K. Shah, MD, Director of the Division of Cardiology at (310) 423-3884 or write to Division of Cardiology, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Room 5347, Los Angeles, CA 90048.

Cedars-Sinai offers a variety of potential research fellowships in basic science and clinical research, focusing on cardiology. For more information, please contact Prediman K. Shah, MD, Director of the Division of Cardiology at (310) 423-3884 or write to Division of Cardiology, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Room 5347, Los Angeles, CA 90048.

Physician assistants (PAs) are an important part of the Cardiac Surgery Program at Cedars-Sinai Medical Center. In addition to the attending surgeon's examination and assessment, PAs perform a medical history and physical exam on patients before the patient is admitted to the hospital and help to examine and follow patients after surgery. The use of PAs is approved by the American Medical Association, and PAs are licensed to practice in the State of California by the Board of Medical Quality Assurance. There are more than 25,000 PAs in the United States. About 1,000 of them practice in Southern California. PAs work in many cardiothoracic practices in the area.

PA training requires two years of instruction in an American Medical Association (AMA)-approved school, which is usually affiliated with a university medical school. Two years of pre-med courses are usually required for acceptance to a PA program. About 90% of those accepted already have a bachelor's degree.

The first year of the program involves lectures on anatomy, physiology, pathology, pharmacology and the various subspecialties of medicine, surgery, pediatrics and obstetrics and gynecology. During the second year, PAs interact with patients and help with patient management. They are taught how to take histories, perform physical examinations, write progress notes and generate discharge summaries. During this training, they rotate in various departments of the hospital, just as medical students do.

On completion of this training, the PA has to pass a board examination that is approved by the AMA and, thereafter, is declared board certified and licensed to practice. To maintain certification, a PA must complete 100 hours of continuing medical education every two years and take the re-certification examination every six years. For PAs who wish to extend their training, there are approved residency programs in surgery, emergency medicine, critical care and other areas.

All the PAs at Cedars-Sinai's Cardiac Surgery Program are both board certified and Advanced Cardiac Life Support (ACLS)-certified. They have varying amounts of experience in cardiothoracic surgery, ranging from several years to more than 10 years. They are members of the medical staff at Cedars-Sinai and must go through the same application and credentialing processes as the medical staff.

PAs help doctors in various ways during and after cardiac surgery. They harvest veins, open the chest, place the patient on cardiopulmonary bypass, close incisions in the chest and legs, insert chest tubes, insert and remove balloon pumps and insert and remove wires used during surgery. In all cases, the PA is directly supervised by staff surgeons. Two PAs are assigned to each operating room.

Once the surgery is complete, the PA primarily assists with record keeping in the form of chart notations. Entries on the patient's record must also be signed by a supervising doctor. Specific duties of the PA on the wards include:

• Perform admitting medical histories and physical examinations on patients assigned to them
• Write daily progress notes in the charts on their patients
• Perform routine dressing changes and wound care under the supervision of the cardiothoracic surgeon
• Remove surgical clips, sutures and temporary pacing wires
• Assist with scheduling special studies upon physician orders
• Assist with cardiopulmonary resuscitation
• Follow standing postoperative orders (but not issue independent orders on any patient without documented discussion with a supervising physician) and the PA is allowed to transmit orders orally or in writing on the patient's record after they have been discussed with the supervising physician