We are currently in the early stages of developing a system-level cath lab fellowship program to address this gap and build a stronger, more sustainable pipeline of cath lab nurses. The goal extends beyond onboarding to intentionally preparing nurses for specialty practice from the outset. A key component of this fellowship will be integrating structured didactic education with hands-on clinical training. Foundational knowledge, such as hemodynamics, cardiovascular anatomy and procedural flow, is paired with real-time application to bridge the gap between theory and practice. As this program develops, there is a strong emphasis on creating consistency across the system while maintaining flexibility for individual campus needs, particularly given variation in case mix and volume. Although this work is still in its early stages, it represents an important shift in how we approach training in the cath lab. Moving toward a more structured fellowship model better supports nurses entering the specialty and strengthens workforce readiness, consistency and long-term sustainability.