PCI volume rivals that of all California hospitals with over 1000 cases a year leading to a strong cardiac cath rotation component for fellow training. Other strengths include high end subspecialty rotations in premier hospitals/programs across the region including a UCSD Advanced Heart Failure Rotation, Harbor-UCLA Coronary CT rotation, and a Loma Linda Cardiac MRI/Congenital Heart disease rotation. Coronary CT volume is high and opportunities exist to improve workflow with QI projects.