Am Heart Hosp J. 2011;9(2):99–106
Lozenge Reference
Special Report
Cardiology Fellowship Education in the Era of High-density Training, Data Tracking, and Quality Measures
Alex J Auseon, DO1 and Albert J Kolibash, Jr, MD2
Background: Educating trainees during cardiology fellowship is a process in constant evolution, with program directors regularly adapting to increasing demands and regulations as they strive to prepare graduates for practice in today’s healthcare environment. Methods and Results: In a 10-year follow-up to a previous manuscript regarding fellowship education, we reviewed the literature regarding the most topical issues facing training programs in 2010, describing our approach at The Ohio State University. Conclusion: In the midst of challenges posed by the increasing complexity of training requirements and documentation, work hour restrictions, and the new definitions of quality and safety, we propose methods of curricula revision and collaboration that may serve as an example to other medical centers.
n 2000, Drs Hill and Kerber, then of the University of Iowa Fellowship Training Program, published a manuscript exploring the state of specialty training in cardiology both nationally and at their institution.1
I They
described a comprehensive self-evaluation of their program and their approach to managing the many challenges faced by academic medical centers and cardiology faculties when training fellows. In an environment of diminishing economic resources, more demands on faculty time, and an exponential increase in medicine’s complexity, they identified eight key areas of focus and outlined their strategy for each:
• clarify the mission of the training program; • inspire fellows to consider academics; • revitalize interactions between faculty and fellows; • maximize effectiveness of didactic teaching; • optimize on-the-job training of fellows; • provide adequate orientation of incoming fellows; • take advantage of the Internet as a learning tool; and • maintain a critical mass of fellows in an era of decreasing trainee positions.
While the pressures on academic medicine remain relatively consistent 10 years later, the overall healthcare
landscape has undergone additional major changes since 2000.
Within the cardiovascular medicine fellowship at The Ohio State University Medical Center, we now find ourselves in a similar position to that of Drs Hill and Kerber 10 years ago. In reflecting on the state of our educational programs in 2010, we noted that it would be necessary to reiterate the context in which cardiovascular medicine training now exists. Plus, while still works-in-progress, our strategies for navigating these challenges might prove instructional for other institutions. Our review centered on four major topic areas: revisions in cardiology training requirements issued by the American College of Cardiology (ACC); the Accreditation Council for Graduate Medical Education (ACGME) Outcome Project; trainee duty hour restrictions; and the era of performance measures and quality metrics.
Changes in Cardiology-specific Training Requirements
The first ACC Guidelines for Training in Adult Cardiovascular Medicine (COCATS) were published in 1995 with task forces and requirements in 10 specific areas of cardiology.2
Since that initial document, general
• 1. Associate Professor of Clinical Medicine and Director, Cardiovascular Medicine Training Program; 2. Associate Professor of Clinical Medicine and Associate Director, Cardiovascular Medicine Training Program, Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State Medical Center
• Disclosure: The authors have no conflicts of interest to declare. • Correspondence: Alex J Auseon, DO, 473 West 12th Avenue, Suite 200, Columbus, OH 43210. E:
alex.auseon@
osumc.edu
Winter 2011 Cardiology Fellowship Education 99
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