About the Advanced Heart Failure and Transplantation Fellowship Program

The Advanced Heart Failure and Transplantation Fellowship program at Virginia Commonwealth University is fully accredited by the Accreditation Council for Graduate Medical Education (ACGME). The heart transplantation program at VCU has a rich history and was one of the first in the country. The fellowship is designed to provide a comprehensive clinical and academic education that covers the management and diagnosis of cardiomyopathies, heart transplantation and mechanical circulatory support. The fellows will spend their time at the VCU Health Systems Hospital for his or her clinical rotations. Successful completion of this program will result in the fellow being eligible to become a UNOS certified Heart Transplant physician and be eligible for the Subspecialty Cardiovascular Board of Advanced Heart Failure and Transplantation. 

During the 12-month clinical fellowship, the fellow will spend 6 months (non-consecutive) with primary responsibilities in the inpatient setting and 6 months in the outpatient setting. 

During the outpatient rotations, the fellow will work in clinics focused on the ambulatory management of mechanical assist devices and heart transplant patients. These will be in addition to the clinics focused on the ambulatory management of chronic heart failure and disease specific cardiomyopathies. 

During the inpatient rotation, the fellow will lead the inpatient advanced heart failure service. Additionally, the trainee will round on the Heart Failure Consult team, following patients in the cardiology ICU, cardiac surgery ICU and a dedicated the mechanical circulatory support unit. During the fellowship year, the trainee will work closely with 5 dedicated heart failure cardiologists and 5 transplant and mechanical device cardiac surgeons. 

Trainees will become experienced in the patient selection process for advanced mechanical circulatory devices. They will become experienced in the management of left ventricular assist devices, percutaneous biventricular assist devices, extracorporeal membrane oxygenation pumps and the total artificial heart. They will see and follow these patients with assist devices in the inpatient setting and also participate in the ambulatory management of patients with LVADs and artificial hearts with portable drivers. 

The trainee will play an active role during the transplant meetings and multidisciplinary rounds. They will be expected to evaluate and present new patients referred for heart transplantation or assist devices. They will participate in the donor selection and immunological management of these patients after transplantation. 

In addition to clinical responsibilities, there will be a weekly clinical core conference focused on advanced heart failure throughout the entire year. The curriculum will be comprehensive, covering relevant materials in the field of advanced heart failure, heart transplantation and mechanical assist devices. 

Curriculum

The fellow rotates between inpatient and outpatient rotations with 26 weeks each. 

The inpatient service consists of an inpatient team of advanced heart failure patients and a consult service mostly consisting of cardiac ICU, cardiac surgery ICU and general cardiology patients. The fellow runs the consult service while rounding with the attending and APPs on the inpatient advanced heart failure team. 

The outpatient service consists of multiple advanced heart failure clinics. The fellow will cover heart transplant, MCS and new patient clinics with the attendings. We will incorporate disease specific cardiomyopathy clinics like amyloidosis, sarcoidosis, hypertrophic cardiomyopathy, cardio-oncology, adult congenital heart disease and pulmonary hypertension. Outpatient weeks also include one day in the catheterization lab performing endomyocardial biopsies. We will incorporate pathology biopsy reading and CPET reading into the outpatient weeks.  

Conferences

We have a wide range of education opportunities. We have a weekly selection meeting and weekly multidisciplinary meeting to discuss new patients, listed patients and hospitalized patients. We have a weekly cardiology grand rounds, weekly solid organ transplant grand rounds, and a heart failure conference at least two weeks per month. We have a bimonthly heart failure quality meeting alternating with a bimonthly heart failure morbidity and mortality conference. We have 6 heart failure journal clubs a year led by the heart failure fellow. We have four joint heart failure-cardiac MRI conferences per year.

We expect the fellow to participate in one scholarly activity per year which can be submitted to a subspecialty meeting. 

Vacation
The fellow is allowed 3 - 7-day vacations and 5 days off during the December holiday period

Night coverage
There is no night-time call

Weekend coverage
The fellow is expected to cover each Saturday (but not Sunday) of the weeks covering on the inpatient service.

GME Resident & Fellow Well-Being
Graduate Medical Education training is not easy. With the GME Physician Well-being program, we first and foremost assert our commitment to your well-being, resilience and all aspects of a healthy lifestyle. VCU and VCU Health are dedicated to ensuring that you have the tools you need to be your best. (Learn more)

All About VCU, VCU Health, and RVA
First things first. We fondly refer to Richmond as RVA.  People love this city because it’s awesome. And Virginia Commonwealth University is in the middle of it all.  Learn more about VCU, VCU Health, and RVA!

• Richard Cooke, MD
• Hamang Patel, MD
• Krishnasree Rao, MD
• Keyur Shah, MD
• Melissa C. Smallfield, MD - Fellowship Program Director
• Inna Tchoukina, MD

Class of 2025

Pengyang Li, MD, MS 
Medical School:  Peking University Health Science Center, China
Residency:  Saint Vincent Hospital-Worcester, MA
Fellowship:  Cardiology Fellowship, Virginia Commonwealth University

Eligibility Requirements

A major aim of the Advanced Heart Failure and Transplantation Fellowship is to offer comprehensive training that will prepare fellows for careers in either academic medicine or clinical practice. 

We offer one Advanced Heart Failure and Transplantation fellowship positions year.

1. Fellows must have U.S. citizenship or a permanent or J1 Visa. YOU MUST POSSESS YOUR PERMANENT OR J-1 VISA AT THE TIME OF YOUR FELLOWSHIP APPLICATION. H-1 Visa will NOT be considered.
2. Graduates of foreign (not U.S. or Canadian) medical schools should have three years of residency in internal medicine in the primary hospital of a university medical school in the U.S. or Canada and be on track to complete an ACGME accredited Cardiology Fellowship.
3. Personal statements should provide background information about you. We are interested in knowing why you have chosen Advanced Heart Failure and Transplant and what you plan to do after fellowship.

How to Apply

Application to the Advanced Heart Failure and Transplantation Fellowship: 

All applications to the Advanced Heart Failure and Transplantation Fellowship Program should go through ERAS. The timeline for application for medical subspecialty fellowships has been modified. This will leave very little time for completion of applications, review of applications, and selection of applicants for interviews. 

Any interested applicants are urged to start their application process early. Requests for USMLE reports, reference letters, and other supporting documentation should be ready for submission on June 6 when you receive your applicant number from ERAS. We would recommend to applicants that they have all of the information required
for the ERAS application form ready for submission. When reference letters are requested, we recommend that faculty members be notified that their letters should be ready for submission to ERAS on June 6, if possible.

*** The majority of the documents described in “Required Documents” are required by ERAS. However, ERAS will not scan several of the documents that we require, i.e. social security card, copy of Virginia medical license (if you have one), ECFMG certificate; copy of your J1 or green card; medical school diploma (and translation where
applicable). **Please have original, notarized or certified notarized original documents ready to be mailed, IF selected. Do not send prior to being selected.

VCU School of Medicine
Department of Internal Medicine
Box 980509
Richmond, VA 23298-0509
Phone: (804) 828-9726
Email: imfellowships@vcuhealth.org

Required Documents

All applicants must apply through ERAS and register with the National Resident Matching Program (NRMP). Along with your application, we require several documents that ERAS does not scan. **A copy of Virginia medical license (if you have one); ECFMG certificate; Certified original and or notarized copy of your J1 or green card; Certified original and or notarized copy of medical school diploma (and translation where applicable); and a fourth reference letter.

Our ideal candidate has completed three years of Residency in an ACGME accredited Internal Medicine in a university hospital and has completed an ACGME accredited Cardiovascular Disease Fellowship Program.

Application Timeline

We plan on interviewing applicants starting in August through September 2025 for the academic year of 2026-2027. We will begin to review applications in mid-July 2025 and priority will be given to applications that are complete.  Our deadline for applications will be August 1, 2025. 

Interview Information

Interview Days will be Mondays between August through September approximately 10:00 am to 3:00pm. This will include a meet and greet, a program overview, interviews with 3 faculty members and current fellow, lunch and a tour by current fellow and a wrap up with the Program Director.

Attention:  In support of our applicants, we will be flexible in providing virtual and on-site fellowship interview opportunities.  We understand that applicants may have restrictions on travel during this time.  Our interview schedule may change as we approach the late summer and fall.

Program Director

Melissa Smallfield, MD
Box 980663
Richmond, Virginia 23298-0204
Email: melissa.smallfield@vcuhealth.org

Fellowship Coordinator

Jeanette Wood
VCU School of Medicine
Dept of Internal Medicine
Box 980509
Richmond, VA 23298-0509 
Phone: (804) 828-9726
Email: imfellowships@vcuhealth.org

For training verification requests, please visit us at https://intmed.vcu.edu/education/verification/