AHH Blog

SCAI Survey Highlights Need for Adv Structural Heart Disease Training Interventional Cardiologists

Jul 30, 2012

Task Force Paper Represents Latest Effort to Advance Training Programs for Interventional Cardiologists

WASHINGTON, D.C.  (July 30, 2012) – New structural heart disease (SHD) interventions over the past decade are driving demand for advanced interventional cardiology training programs, but training in this specialized area remains in its infancy, according to new survey results released today by the Society for Cardiovascular Angiography and Interventions (SCAI)‘s Structural Heart Disease Early Career Task Force and e-published in Catheterization and Cardiovascular Interventions. The survey found that while the majority of interventional cardiology training programs involve structural interventions – such as transcatheter aortic valve replacement, pulmonic valve implantation and mitral valve repair – few offer dedicated SHD fellowships.  

“Structural heart disease care has changed significantly in recent years, and new treatments require specialized training on complex interventions,” said Mehmet Cilingiroglu, M.D., FSCAI, associate professor of Medicine at the University of Pittsburgh Medical Center Heart and Vascular Institute in Pennsylvania and an author of the paper.  “Our survey found SHD training remains in its early stages. As we advance care for patients, it’s essential that we establish structured training programs with standardized requirements that can help new interventional cardiologists build their skills in this important area.”  

The survey of 50 Accreditation Council for Graduate Medical Education (ACGME) accredited interventional cardiology programs found:

• 86 percent of institutions responding to the survey offer percutaneous treatments for SHD
• Among those institutions, 29 percent (n=9) offer a one-year training program in SHD after completion of interventional cardiology training.
• The majority (51.6 percent, n=16) integrate structural training with coronary and peripheral intervention training.
• More than a third of training (39.3 percent) is achieved by assigning cases throughout the year to the fellow, while a quarter takes place through participation in specialized conferences or courses.
• More than half of program directors (58.6 percent) believe time dedicated to SHD training in the first year of interventional cardiology training is not enough.
The paper identified a number of challenges to achieving optimal training, both through current programs and in the pursuit of developing additional training and fellowship programs, including:
• Oftentimes the average number of SHD procedures performed per year in the studied institutions is less than the recommended number of procedures to gain proficiency.
• There are a total of 15 types of SHD procedures and currently no interventional cardiology fellowship programs in the country that can offer sufficient training in all 15 types. One solution identified to overcome this is combining rotations in different institutions so training in all the required types of procedures can be achieved.
• Several types of procedures are trial-restricted and inaccessible to the training fellows.

Based on the survey, the task force called for a structured curriculum for SHD training with uniform requirements. “As interventional cardiology advances, so do our education and training needs,” said J. Jeffrey Marshall, M.D., FSCAI, FACC, SCAI president and medical director of the cardiac catheterization laboratory at Northeast Georgia Heart Center. “SCAI is committed to continuously improving education programs to equip cardiologists with the necessary tools and resources to provide the best care for our patients.” The SCAI Structural Heart Disease Early Career Task Force was established in 2011 to provide a forum for interventional cardiologists who are seeking advanced SHD training or are currently involved in a SHD program.