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Vocational Training
Cardiology
Supervising
Committee
Specialist Advisory Committee (SAC) in Cardiology.
Definition
of Specialty
Paediatric cardiology is a branch of paediatric medicine
concerned with investigation of, prevention of, therapy of and research into diseases
involving the cardiovascular system in infants, children and adolescents and frequently
also involves congenital heart defects that require ongoing assessment/treatment
in adult life.
General Principles
- In Australia, advanced training in paediatric cardiology will be for
at least 3 years following satisfactory completion of basic paediatric training
and the FRACP Examination in Paediatrics. This 3-year program will comprise a
minimum of 2 years (full time equivalent) of core and one year (full time equivalent)
of non core training.
- Upon entry to advanced training in paediatric cardiology,
each candidate will receive:
- training guidelines in paediatric cardiology
- a
logbook
- names of the paediatric members of the SAC in Cardiology.
-
The aim of the training program is to produce a highly competent, broad based,
and supported by excellent technical skills.
- At least one year of paediatric
cardiology training must occur in Australia or New Zealand.
- All subspecialty
paediatric trainees must complete the community and child health requirements
for paediatric training.
Note that the guidelines differ between Australia
and New Zealand.
Components of Training
Core Training- congenital cardiac pathology/physiology;
- clinical
assessment and management;
- non invasive techniques:
- electrocardiography
- Echo/Doppler
cardiography (see below)
- interpretation of chest X-ray
- exercise
testing
- familiarity with 24-hour ECG recordings and arrhythmia analysis;
- invasive
investigations:
- cardiac catheterisation and angiography (see below);
- therapeutic
procedures:
- balloon atrial septostomy
- DC cardioversion;
- postoperative
intensive care;
- adolescent and adult congenital heart disease-follow up
and management;
- teaching.
Echocardiography
(NB:
refer to the document Standards of Practice in Paediatric Echocardiography)- familiarity
with the physics of echocardiography, and its applications in cross-sectional,
M-mode and Doppler studies;
- familiarity with the special views used in
paediatric echocardiography, particularly subxiphoid, suprasternal and right and
left parasternal views;
- completion of 300 self conducted paediatric echocardiography
studies (at least 250 with congenital or acquired heart disease), with the production
of a provisional report, which will have been checked by a paediatric echocardiographer.
At least 300 echocardiography studies (at least 250 with congenital acquired heart
disease) should be performed in conjunction with and under the supervision of
a paediatric echocardiographer.
Cardiac Catheterisation and Angiography
Trainees
are expected to perform a minimum of 100 cardiac catheter procedures, of which
at least 20 should have been as the primary operator. Trainees should have experience
of right heart catheterisation, left heart catheterisation, and should have assisted
at interventional procedures including balloon dilation of pulmonary valve stenosis
and balloon dilatation of recoarctation of the aorta.
In addition trainees
should have carried out 5 balloon atrial septostomies (either under fluoroscopy
or echocardiographic control).
Non
Core Training
May include further core training or one or more of the
following:- nuclear cardiology;
- electrophysiological investigation
and/or radio frequency ablation for arrhythmias;
- interventional catheter
procedures including balloon valvuloplasty, balloon angioplasty, coil embolisation,
implantation of ductus/ASD devices;
- fetal echocardiography;
- investigation
and management of acquired heart disease, including ischaemic heart disease (e.g.
coronary arteriography, etc).
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