Physicians, particularly those in an academic setting, have an obligation to teach those who follow them. At the Mayo Clinic, we have had a highly successful training programme in paediatric cardiology for many years. Our trainees uniformly pass the board examination for subspecialty training in paediatric cardiology and secure very good jobs.

Our curriculum (Table 1) for the 2 years of clinical training is quite standard. The 12 months of research can be quite variable. Some trainees interspace research months throughout their 3 years of training, whereas other students take the 12 months in a block, particularly if they are doing basic research. All of our fellows are expected to publish at least one first author, peer-reviewed paper. Most fellows in the programme publish three to five peer-reviewed papers, and some fellows have published in excess of 10 manuscripts during the 3 years of training.

Table 1 Paediatric cardiology curriculum.

An issue that has changed over the years is the concept of “after hours” research. Some trainees in the modern era believe that their clinical research should be carried out only during “working hours”. We try to emphasise that there is no reason that clinical research cannot be carried out at other times.

We believe that there are several keys to developing and maintaining a successful fellowship programme. Most important is to hire smart, motivated fellows. It is important to foster a milieu of inquisitiveness and to identify clinical problems that need further research. These provide projects for fellows that will result in publications. In order for this to occur, one has to have faculty members who are inquisitive and who have a successful record of publication.

It is important to have financial resources available to support both clinical and basic research; one must have the availability of statistical support to assist the trainees with the analysis of data. It is critical to have faculty with excellent editing skills. It is also important to have rapid turnaround time when a fellow submits a draft of a manuscript to a faculty member.

An integral part of our training programme is a weekly board review conference. Fellows are asked to write three to four questions each in the format of board examination questions. These questions are then discussed at a formal meeting usually on Wednesday evenings. These questions have been edited and incorporated into a book that is used at the Mayo Clinic Pediatric Cardiology Board Review Course held every other year (Fig 1).

Figure 1 Pediatric Cardiology Board Review textbook, Eidem, B, Cannon, B., Chang, A., and Cetta, F, editors.

It is important to have a well-developed schedule of didactic lectures. These are summarised in Table 2. On Mondays, there are ECG conferences and review of hospitalised cases and upcoming operations for the week. On Tuesday mornings, Medical/Surgical Case Conferences are held. At this conference, fellows present one or two interesting cases and is attended by all cardiology and cardiothoracic surgical trainees and staff. On Wednesdays, imaging conferences, angiography/physiology conferences, Internal Medicine Grand Rounds, and Board Review Conferences are held. On Thursdays, core curriculum conferences are held. During a 24-month period, at such conferences, all important aspects of paediatric cardiology are discussed. These lectures are given by fellows and staff. On Fridays, echocardiography, case/exercise physiology conferences, and Paediatric Grand Rounds are held.

Table 2 Training of residents and fellows conferences.

From a standpoint of a General Pediatric Residency rotation, the goals of the rotation are clearly outlined (Table 3) and each resident is provided a complimentary copy of the book Fundamentals of Pediatric Cardiology (Fig 2). In general, the general paediatric resident rotation is a 2–4-week rotation. The residents accompany the cardiology staff on hospital rounds in the morning and they see outpatients in the afternoon. We administer a computer-generated pre-test when they begin the rotations and a post-test when they complete the rotations. This is a 25-question test. The average post-test score of 81.6% is statistically significantly better than the average pre-test score of 71.7%.

Figure 2 Fundamentals of Pediatric Cardiology textbook, Driscoll, D author.

Table 3 General pediatric resident cardiology training goals.