The program includes ACC's COCATS4 recommendation for procedural volume and training time to achieve competency. Clinical rotations emphasize autonomy and clinical decision-making through direct interaction enabling fellows to gain independence in clinical judgment and procedural skills in structural heart disease, Cardiology consult service, Cardiac catheterization lab, Cardiac imaging, Coronary care, Echocardiography, Electrophysiology, Heart failure, Nuclear, Preventive and vascular medicine.