Cardiology

New Cardiology curricula – 2024

We've implemented a new curricula for Advanced Training in Cardiology. Trainees who started the program in 2024 and beyond will follow the new curricula.

Visit the new curricula page for more details, including changes to the learning, teaching and assessment (LTA) program requirements.

If you started training before 2024, you’ll continue under the PREP curricula and its requirements.

You're viewing the 2025 handbook
This handbook is for trainees who started before 2024.

Program
overview
Re-register
Training
requirements
Forms and
resources

Program overview

Cardiology (Adult) In Advanced Training in Cardiology, you'll explore in-depth specialty training in the prevention, investigation, therapy of, and research into, cardiovascular disease. You will train under supervision and prepare for independent practice as a consultant. The program builds your skills through work-based learning and assessment tools.

Program updates

The Advanced Training in Cardiology (Adult) Program is evaluated biennially by the Advanced Training Committee (ATC) in Cardiology and the Aotearoa New Zealand Advanced Training Subcommittee (ATS) in Cardiology to ensure that it’s in line with educational best practice. Changes in program requirements may occur and could impact your training plan. The College will provide sufficient notice prior to implementing any change. You must always ensure you’re following the correct requirements during your training.

PREP entry requirements

Prospective trainees must have:

completed the RACP Basic Training, including Written and Clinical Examinations
a current medical registration
been appointed to an appropriate Advanced Training position

New and current trainees need to apply for Advanced Training each year.

Trainees who start from 2024 will follow new entry requirements. See the new Cardiology curriculum for more information.

Duration

Advanced Training in Cardiology (Adult) Program requires 3 years (36 months) of full-time equivalent (FTE) training.

Fellowship

Once you've completed all requirements of your training and the ATC or ATS in Cardiology has recommended you for admission, the College will invite you to apply for Fellowship of the Royal Australasian College of Physicians.

See Becoming a Fellow for information on admission to Fellowship.

As a Fellow in active practice in Australia, Aotearoa New Zealand or overseas, you’ll need to meet the annual requirements of the Continuing Professional Development program.

Re-register

Australia

Australian trainees can complete their registration online.

Apply online

If the online registration is closed, email an application form (DOC) to cardiology@racp.edu.au

Aotearoa New Zealand

Aotearoa New Zealand trainees must email an application form (DOC) to cardiology@racp.org.nz

Nominating eligible supervisors

From mid-2023, you’re required to nominate eligible supervisors who meet the supervision requirements of the training program.

You can find a list of eligible supervisors:

in the supervision section of your online registration form
on MyRACP

The MyRACP list is not available for post-Fellowship trainees. Post-Fellowship trainees can check the list in their online registration form or contact us to confirm supervisor eligibility.

Application deadlines

Australia

28 February | first half or whole of the current year

31 August | second half of the current year

Aotearoa New Zealand

15 December | first half or whole of the following year

30 April | May to August rotations

30 June | second half of the current year

You're responsible for organising all necessary documentation for submission by the deadline. We recommend that you keep a copy of your application for future reference.

See program key dates for trainees and supervisors.

Late applications

Late applications will be considered up to 1 month after the deadline.

Applications received 1 month after the deadline won’t be considered unless exceptional circumstances can be demonstrated in line with the Special Considerations for Assessment Policy.

Late applications may incur a fee.

Late fees won't apply if supervisor approval is pending after the deadline.

Fees

The standard annual membership fees apply.

Visit MyRACP to pay or view previous training program payments.

About your training position

Core training must be undertaken at accredited settings.

Once you have secured a training position, you must prospectively apply for approval as per the Progression through Training Policy.

The College is not involved in the recruitment and selection of trainees. Our role is to set and monitor standards for selection and provide advice to settings and their selection committees.

Training approval and certification

Approval of training periods are determined by the Advanced Training Committee (ATC) in Cardiology and Aotearoa New Zealand Advanced Training Subcommittee (ATS) in Cardiology. To be approved, your individual training program must be consistent with the training requirements and appropriate for the stage of training you have reached.

Upon completion of each rotation or calendar year of training, the ATC/ATS reviews your progress according to the training requirements. If you have satisfactorily completed all training requirements, the ATC/ATS will certify that training period.

Training variations

See multi-specialty training options for processes covering dual, joint, conjoint and post-Fellowship training.

See flexible training options for information on part-time training, interruptions to training, withdrawing from training and time limits.

Rotation or supervision changes

Changes to your rotation require you to re-submit an application form (if online registration is closed) to your training committee as soon as possible. This includes any changes to sites, dates of rotations and flexible training arrangements.

Change to your supervision must be notified as soon as possible by submitting a Supervisor Details Amendment Form (DOC).

Some changes may require a review of the approval decision and can affect the certification of your training.

More information

Overseas specialists
Trainee responsibilities

Training requirements

At the end of your Advanced Training in Cardiology, you’ll have completed 36 months of certified training time consisting of work-based learning and assessment tools.

The PREP teaching and learning activities are designed to support you in your reflective practice and self-directed learning. A variety of teaching and learning activities and assessments are used, catering to a range of learning needs, styles and situations that may arise in your workplace training.

See forms and resources for the PREP training program curricula.

Requirements overview

Core training
(36 months)

Supervision

2 x supervisors per rotation, who are Fellows of the RACP

Teaching and learning

2 x Learning Needs Analysis per training year

Assessments

2 x Case-based Discussions per training year

2 x Direct Observation of Procedural Skills per training year

2 x Mini-Clinical Evaluation Exercises per training year

1 x Supervisor’s Report per rotation (2 per 12-month rotation — full-time and part-time trainees)

1 x Trainee’s Report per rotation (Aotearoa NZ only)

Advanced Training summary

After 36 months of certified training time, you will have completed:

36 months of core training
1 x Electrophysiology Training Supervisor’s Report
1 x Cardiothoracic Surgical Training Supervisor’s Report
1 x Cardiac Imaging Training Supervisor’s Report (trainees who commenced in 2022 and 2023)
1 x Transthoracic Echocardiogram Training Progress Report (requirement for trainees who commenced in 2023, recommended for trainees who commenced before 2023)
1 x Logbook
1 x Advanced Training Research Project (trainees who commenced in 2018 onwards)
1 x Cardiology Research Project (trainees who commenced before 2018)
- 1 x publication/presentation
- 2 x quality assurance/audits
Australian Aboriginal, Torres Strait Islander and Māori Cultural Competence and Cultural Safety online course (trainees who commenced in 2023 onwards)

Time-based requirements

The Advanced Training Program in Cardiology allows adequate time for you to gain the necessary learning experiences across a range of relevant rotations during your 3-year total training period (36 months FTE).

We strongly recommended that you complete your Advanced Training at more than 1 training site.

Core training

A minimum of 36 months (FTE) of core training in accredited core clinical training positions.

Training time

At least 24 months of Advanced Training in Cardiology must be undertaken in Australia and/or Aotearoa New Zealand. This is to ensure that you receive adequate exposure to local practices and health services.

In accordance with the Progression Through Training Policy, all training requirements of a 3-year training program must be completed within 8 years from the date of you commencing training.

Program key dates

Australia

January – March

31 January | Previous year’s Supervisor’s Report and all PREP learning and assessment tools due (trainees not applying for Fellowship in December)
28 February | Applications for Approval of Advanced Training for first half or whole year due
31 March | Advanced Training Research Project may be submitted
Direct Observation of Procedural Skills
Learning Needs Analysis

April – June

15 June | Advanced Training Research Project may be submitted
Case-based Discussion
Learning Needs Analysis self-evaluation
Mini-Clinical Evaluation Exercise

July – September

15 July | Supervisor’s Report due
31 August | Applications for Approval of Advanced Training for the second half of the year due
15 September | Advanced Training Research Project due (trainees who commenced in 2018 onwards)
Case-based Discussion
Direct Observation of Procedural Skills
Learning Needs Analysis

October – December

from 15 October | Supervisor’s Report and all PREP tools and assessments due (trainees eligible for Fellowship in December)
Learning Needs Analysis
Mini-Clinical Evaluation Exercise

Aotearoa New Zealand

December – February

15 December | Applications for Approval of Advanced Training for the first half or whole of the following year due
15 December | Supervisor’s Report and all PREP tools due (trainees not eligible for Fellowship this year)
15 December | Trainee’s Report for the second half or whole year due
15 December | Advanced Training Research Project due (trainees who commenced in 2018 onwards)
Case-based Discussion
Direct Observation of Procedural Skills
Learning Needs Analysis
Mini-Clinical Evaluation Exercise

March – May

31 March | Advanced Training Research Project may be submitted
30 April | Applications for Approval of Advanced Training for May to August rotations due
Learning Needs Analysis self-evaluation

June – August

15 June | Advanced Training Research Project may be submitted
30 June | Applications for Approval of Advanced Training for the second half of the current year due
30 June | Supervisor’s Report due
30 June | Trainee’s Report for the first half of the year due
Case-based Discussion
Direct Observation of Procedural Skills
Learning Needs Analysis
Mini-Clinical Evaluation Exercise

September – November

from 15 October | Supervisor’s Report and all PREP tools and assessments due (trainees eligible for Fellowship in December)
Learning Needs Analysis self-evaluation

Work-based learning and assessment requirements

A work-based learning and assessment tool requirement stipulates what you must achieve as part of your training program.

Type of assessment

Formative: Focuses on learning through feedback and guidance, assisting trainees and supervisors through the formal feedback process, which should prompt discussion of or highlight areas of a trainee’s performance. Assessments are based on existing workplace-based assessment methods and are best practice in medical education.

Summative: Focuses on judgements about trainee progression, resulting in pass or fail decisions on a trainee’s performance.

Advanced Training Research Project

Requirement for trainees who commenced in 2018 onwards

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Overview

The Advanced Training Research Project (ATRP) is a report on a project that you have had significant involvement in designing, conducting of research and analysis of data. It enables you to gain experience in:

research methods
interpretation of research literature
participation in research at some stage of your career
developing quality improvement skills

ATRPs aren't required to be specialty-specific but must be broadly relevant to your area of specialty. ‘Broadly relevant’ is defined as topics that can enhance, complement and inform your practice in the chosen specialty.

The ATRP, introduced to most trainees who started after 2017, addresses wide variations in purpose, type, quantity and assessment criteria across the RACP Training Programs. An ATRP submission provides evidence of the skills of:

considering and defining research problems
the systematic acquisition, analysis, synthesis and interpretation of data
effective written communication

The ATRP requirement must be undertaken and completed during your Advanced Training. If you're dual training, you only need to complete one ATRP over the course of Advanced Training.

Review your training program requirements to confirm whether there are any additional research requirements beyond completing your ATRP.

It's recommended you present your research at the Cardiac Society Annual Scientific Meeting (or equivalent).

For further information regarding ATRP requirments, refer to the Advanced Training Research Project Cover Sheet (PDF)

Submission deadlines and review timelines

There are 3 deadlines that must be followed when submitting an Advanced Training Research Project. Trainees can choose to submit their Research Project on any of these 3 dates during the year.

It's strongly recommended that trainees submit their Research Project in the second last year of training, or at the end of the specialty consolidation phase. This helps avoid delays in progressing through training or being admitted to Fellowship.

Deadline 1: 31 March (Australia and Aotearoa New Zealand)
Deadline 2: 15 June (Australia and Aotearoa New Zealand)
Deadline 3a: 15 September (Australia only)
Deadline 3b: 15 December (Aotearoa New Zealand only)

Any project received between two deadlines will be sent for marking after the next official deadline.

For example, if an ATRP is submitted in May, it will be marked after the 15 June deadline.

For more details about review timelines, see the Advanced Training Research Project Guidelines (PDF)

Resources

Cardiac Imaging Training

Requirement for trainees who commenced in 2022 and 2023

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Overview

Cardiac Imaging Training allows you to gain an understanding of the indications, clinical utility, image acquisition and potential difficulties of Cardiac Magnetic Resonance Imaging (CMR) and Cardiac Computed Tomography (CT) / Computed Tomography Coronary Angiography (CTCA).

You're expected to:

participate in clinical referrals for CMR or CT
observe procedures
participate in analysis and reporting

Resources

Cardiac Imaging Training Supervisor's Report (DOC)

Requirements

Requirement

Complete Cardiac Imaging Training once over the course of your Advanced Training

Deadlines

Due from 15 October in your final year of training.

Submit your Cardiac Imaging Training Supervisor's Report (DOC) to cardiology@racp.edu.au (Australia) or cardiology@racp.org.nz (Aotearoa New Zealand).

Procedures

You’re expected to complete and record evidence in a logbook of these procedures and activities during your training.

Cardiac Magnetic Resonance Imaging (CMR)

Requirement: Review, analyse and co-report 5 cases minimum. Attend and observe the acquisition of at least 2 CMR scans.

Your logbook must demonstrate:

understanding the indications for CMR
understanding the limitations of CMR
preparation for CMR safety questionnaire/contraindications, need for eGFR, CIED management during scan, ability of patient to tolerate scan and indications for general anaesthesia
basic protocol for image acquisition and views obtained
potential imaging difficulties (arrhythmia, need for breath-holds, claustrophobia, artefacts)
how to:
- analyse ventricular volumes
- interpret tissue characterisation sequences
- interpret flow data obtained by CMR
- interpret a CMR report, particularly with a sequential segmental approach to the anatomy

You should observe a variety of different indications including congenital and acquired heart disease.

Cardiac Computed Tomography (CT) / Computed Tomography Coronary Angiography (CTCA)

Requirement: Review 5 cases minimum. Attend and observe the acquisition of at least 1 CTCA scan.

Your logbook must demonstrate:

the indications for CTCA and Coronary Artery Calcium (CAC) Scoring
understanding the limitations CTCA
participate in decision-making for CTCA referral and management of patients undergoing Cardiac CT
preparation for CTCA including pre-test bloods, heart rate control, withholding drugs
basic protocol for Image acquisition
how to:
- use CT workstation
- analyse the raw images, and reconstruct coronary images
- interpret a CTCA and CAC report

Resources

Cardiac Imaging Training Supervisor's Report (DOC)

Cardiology Research Project

Requirement for trainees who commenced before 2018

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Overview

The Cardiology Research Project requirement enables you to gain experience:

in research methods
in interpretation of research literature
in participation in research at some stage of your career
to develop quality improvement skills

Your research project should demonstrate:

evidence of the skills of considering and defining research problems
the systematic acquisition, analysis, synthesis and interpretation of data
effective written communication

Project formats

Publication/presentation

You must present or be a principal author of a published article at the Cardiac Society Annual Scientific Meeting (or equivalent) and/or prepare an article accepted by a peer-reviewed journal.

Quality assurance/audits

You’re required to present your quality assurance/audits to your training setting during your training period. Your supervisor must certify your presentations in your Supervisor’s Report.

Resources

Cardiology Supervisor's Report (DOC)
RACP Online Learning Resources: Research Projects
Research Project Checklist and Planner (XLS)

Requirements

Requirement

1 x Published article and/or presentation

2 x Quality assurance/audit presentations

Deadline

Due from 15 October in your final year of training.

Resources

Cardiology Supervisor's Report (DOC)
Research Project Checklist and Planner (XLS)

Cardiothoracic Surgical Training

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Overview

Cardiothoracic Surgical (CTS) Training allows you to gain an awareness of the nature of cardiothoracic surgery, the management of patients before, during and after surgery and to gain an appreciation of the nature of the collaboration between cardiologists and cardiac surgeons involved in assessing and managing their patients.

You’re expected to complete and record evidence of the minimum requirements in:

coronary artery bypass grafting
valve surgery
ward rounds
unit meetings
case presentations

A clinical and surgical supervisor is required to provide formal feedback on your performance.

Resources

Cardiothoracic Surgery Supervisor's Report (DOC)

Requirements

Requirement

Complete Cardiothoracic Surgical (CTS) Training once over the course of your Advanced Training

Training time

You must complete 2 x quarantined full weeks’ attachment to a cardiothoracic surgical unit at a minimum. CTS Training can be completed through a 1-week attachment across 2 years of training. Variations can be made to suit staffing requirements of individual cardiology and surgical units.

Aotearoa New Zealand can complete the requirement during their CTS rotation.

Deadline

Due from 15 October in your final year of training.

Submit your CTS Supervisor’s Report (DOC) at the conclusion of your training to cardiology@racp.edu.au (Australia) or cardiology@racp.org.nz (Aotearoa New Zealand).

Resources

Cardiothoracic Surgery Supervisor's Report (DOC)

Procedures and activities

You’re expected to complete and record evidence of these procedures and activities during your training.

Coronary artery bypass grafting

Requirement: 3 cases minimum.

Assess patients and their imaging studies pre-operatively.
Explain the indications for surgery.
Be present during surgery.
Participate in the immediate post-operative management.
Where off-pump operations are performed, an off-pump case should be included in your recorded cases.

Valve surgery

Requirement: 2 cases minimum.

Assess the patient and the pre-operative imaging studies.
Explain the indications for surgery.
Be present during surgery.
Participate in the immediate post-operative management.

You must include 1 mitral valve operation and 1 aortic valve operation as the surgical approach to these is quite distinct.

ICU/CICU ward rounds

Requirement: Daily.

Participate in the daily ward rounds for the duration of the attachment.
You’re expected to achieve an understanding of the management issues surrounding post-operative surgical care, including the management of ventilated patients and of hemodynamic issues, arrhythmias and post-operative emergencies.

Unit meetings

Requirement: As required.

Attend and participate in multidisciplinary meetings within the surgical unit, including unit meetings and combined meetings with cardiology and radiology when these occur.

Brief case presentations

Requirement: 2 cases (1 per week), 10 minutes each case.

Present cases to a cardiothoracic unit meeting where both the acute and long-term management issues of the patient are discussed with supervising surgeons.

Resources

Cardiology Cardiothoracic Surgery Supervisor's Report (DOC)

Case-based Discussion

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Overview

A Case-based Discussion (CbD) is a work-based assessment and Advanced Training Program requirement used to evaluate your professional judgement in clinical cases.

A CbD involves a comprehensive review of a clinical case or cases between you and an assessor. After the CbD, the assessor provides constructive feedback to help you improve and structure your future learning.

The CbD aims to:

guide your learning through structured feedback
improve clinical decision making, clinical knowledge and patient management
provide you with an opportunity to discuss their approach to the case and identify strategies to improve your practice
enable your assessor to share their professional knowledge and experience

An assessor can choose any case or cases where you'll play a significant role in clinical decision-making and patient management. The discussion should reflect your level of experience and be linked to your Advanced Training Curriculum.

The discussion may focus on a single complex case or a series of cases covering a wide range of clinical areas. Areas may include:

record keeping
history taking
clinical findings and interpretation
management plan
follow-up and future planning

Step-by-step: Case-based Discussion

Arrange a CbD with your assessor.

Your assessor will choose an appropriate case or cases.

Confirm the chosen case or cases with your assessor.

Provide your assessor with a CbD rating form (PDF).

Discuss the case or cases with your assessor – allow for at least 30 minutes.
Note: Your assessor will be making notes and ratings on the CbD rating form during this discussion.

Your assessor provides you feedback following your CbD – allow for at least 10 minutes.

You and your assessor sign the CbD rating form.

Enter the data from your completed CbD form into the online CbD tool via your relevant training portal:
Advanced Training Portal | AFRM Portal | AFPHM Portal | AFOEM Portal

Submit a copy of your completed form to your assessor through the online CbD tool in your training portal.

Requirements

Requirement

2 x Case-based Discussions (CbD) to be completed each training year

Deadlines

Australia: 31 January in the following year.

Aotearoa New Zealand: Due at the end of each training rotation.

In your final year, CbDs are due from 15 October.

Submit your CbD rating form data via the Advanced Training Portal.

Resources

Case-based Discussion rating form (PDF)

Cultural Safety

Requirement for trainees who commenced in 2023 onwards

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Overview

Specialist training requires you to:

examine your own implicit biases
be mindful of power differentials
develop reflective practice
undertake transformative unlearning
contribute to a decolonisation of health services for Indigenous peoples

The Australian Aboriginal, Torres Strait Islander and Māori Cultural Competence and Cultural Safety online course teaches best practice medicine for Aboriginal, Torres Strait Islander and Māori patients through reflection on your own cultural values and recognition of their influence on professional practice.

Resources

RACP Online Learning: Australian Aboriginal, Torres Strait Islander and Māori Cultural Competence and Cultural Safety

Requirements

Requirement

1 x Australian Aboriginal, Torres Strait Islander and Māori Cultural Competence and Cultural Safety online course^*

^* If not completed during Basic Training.

Certification

You immediately receive your certificate on RACP Online Learning when you complete the course.

Deadline

You must complete the course by the end of your Advanced Training however it’s recommended you complete it within your first year.

Resources

RACP Online Learning: Australian Aboriginal, Torres Strait Islander and Māori Cultural Competence and Cultural Safety

Direct Observation of Procedural Skills

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Overview

The Direct Observation of Procedural Skills (DOPS) is an evidence-based assessment used to guide your learning and competency.

You'll perform a procedure on a patient in the workplace, while an experienced and knowledgeable assessor observes your performance.

Trainees are permitted to complete the Intubation (ETT oral/nasal) procedure in a simulated environment (e.g. with use of mannequin) where an appropriate patient isn't available. The simulated procedure must be observed by an assessor.

Step-by-step: Direct Observation of Procedural Skills

Negotiate a procedure with your supervisor for the DOPS assessment.

Provide your assessor with a copy of the DOPS rating form (PDF).

Your assessor observes you while you perform a procedure.

The assessor provides you with immediate feedback on the procedure.

You and your assessor both sign the DOPS rating form.

Enter the data from your completed DOPS rating form online via the Advanced Training Portal.

Once submitted, your assessor will receive a copy of the DOPS form. Your supervisor can also view your DOPS rating form online.

Assessment areas

During a DOPS, you can be assessed across up to ten assessment domains:

Understanding of indications, relevant anatomy, technique of procedure
Obtains informed consent
Appropriate pre-procedure preparation
Patient and risk awareness
Aseptic technique
Technical ability
Seeks help where appropriate
Post-procedure management
Communication skills
Consideration for patient

Feedback

An assessor provides feedback to help identify learning needs and plan future learning opportunities for your training, as well as identify your observed strengths.

The feedback should be given in a structured manner by breaking up the procedure into skill-related areas. This will help you focus your future learning.

You’ll have the opportunity to comment on the assessor’s feedback and with them develop an action plan for future skill development.

Your learning plan should be reviewed by your supervisor (if they’re not your assessor) following its development and reviewed again at your next meeting to see your progress against the action plan.

Resources

Direct Observation of Procedural Skills rating form (PDF)

Requirements

Requirement

2 x Direct Observation of Procedural Skills (DOPS) each training year

You cannot count 2 instances of the same procedure in each training year.

Deadlines

Australia: 31 January in the following year.

Aotearoa New Zealand: Due at the end of each rotation.

In your final year, DOPS are due from 15 October.

Submit your DOPS via the Advanced Training Portal.

Resources

Direct Observation of Procedural Skills rating form (PDF)

Procedures

Cardiac catherisation

The Cardiac Catherisation assessment guide is to be used in conjunction with the Direct Observation of Procedural Skills (DOPS) rating form (PDF) and information in this handbook. Observable behaviours are listed for each DOPS criterion. These behaviours are considered to be markers of satisfactory performance of the cardiac catherisation and should be considered as a guide to assist assessors in discriminating between different levels of rating.

1. Demonstrates understanding of indications, relevant anatomy, technique of procedure	Assess the case, including identification of appropriateness and individual risk
2. Obtains informed consent	Explain the procedure, emphasise potential adverse effects prior to procedure and answer any patient questions
3. Demonstrates appropriate pre-procedure preparation	-
4. Demonstrates patient and risk awareness	-
5. Aseptic technique	-
6. Technical ability/interpretation	– Apply correct puncture technique – Acquire images – Report on study
7. Seeks help where appropriate	Recognise their own limitations and seek assistance
8. Post-procedure management	Provide knowledgeable management of complications
9. Communication skills	Speak clearly at a patient-appropriate level, avoiding jargon
10. Consideration for patient	Ensure that the patient is as comfortable as possible throughout the procedure and in the immediate post-procedure phase

Resources

Direct Observation of Procedural Skills rating form (PDF)

Echocardiography

The Echocardiography assessment guide is to be used in conjunction with the Direct Observation of Procedural Skills (DOPS) rating form (PDF) and information in this handbook. Observable behaviours are listed for each DOPS criterion. These behaviours are considered to be markers of satisfactory performance of the echocardiography and should be considered as a guide to assist assessors in discriminating between different levels of rating.

1. Demonstrates understanding of indications, relevant anatomy, technique of procedure	Recognise normal and abnormal cardiac anatomy
2. Obtains informed consent	Explain the procedure, emphasise potential adverse effects prior to procedure and answer any patient questions
3. Demonstrates appropriate pre-procedure preparation	Select and use appropriate probe, machine and image settings to obtain and optimise image quality
4. Demonstrates patient and risk awareness	-
5. Aseptic technique	-
6. Technical ability/interpretation	– Acquire images – Interpret and correlate obtained data with the clinical problem
7. Seeks help where appropriate	Recognise their own limitations and seek assistance
8. Post-procedure management	Discuss the echocardiography findings with sonographers, patients and consultants
9. Communication skills	Speak clearly at a patient-appropriate level, avoiding jargon
10. Consideration for patient	Ensure that the patient is as comfortable as possible throughout the procedure and in the immediate post-procedure phase

Resources

Direct Observation of Procedural Skills rating form (PDF)

Pericardiocentesis

The Pericardiocentesis assessment guide is to be used in conjunction with the information in this handbook. Observable behaviours are listed for each DOPS criterion. These behaviours are considered to be markers of satisfactory performance of the pericardiocentesis and should be considered as a guide to assist assessors in discriminating between different levels of rating.

1. Demonstrates understanding of indications, relevant anatomy, technique of procedure	Awareness of: absolute vs relative indications different approaches i.e. apical vs subcostal (rarely parasternal). Utilising different imaging modalities like echocardiography, fluoroscopy, or a combination of both (rarely CT guided).
2. Obtains informed consent	Risks and benefits of the procedure and those of not doing the procedure. The relative contraindication of the ‘diagnostic tap’ particularly in small minimally symptomatic pericardial effusions.
3. Demonstrates appropriate pre-procedure preparation	Different preparation for different approach and imaging modality.
4. Demonstrates patient and risk awareness	Confident with ultrasound guidance including USS to determine individual patient’s anatomy for safest route for drainage (Apical, parasternal and subxiphoid).
5. Aseptic technique	Awareness of different techniques to use to increase confidence of being in pericardial space checking haemoglobin use of dye/agitated saline haeodynamics safe path taken of the wire required to subsequently monorail pigtail catheter.
6. Technical ability/interpretation	Awareness of steps to be undertaken if pigtail not inserted appropriately.
7. Seeks help where appropriate	If pigtail catheter is to remain in for an extended period of time, appropriate monitoring of fluid collection and treatment plan for pigtail removal. Appropriate diagnostic testing of fluid, m/c/s, histology and difference between exudate and transudate.
8. Post-procedure management	Expectations and appropriate management of pain relief. Expectation for length of time and plan for ongoing monitoring pericardial fluid drainage.
9. Communication skills	Education regarding diagnosis and ongoing management of recurrence. Analgesia if needed.
10. Consideration for patient	Awareness of: absolute vs relative indications different approaches i.e. apical vs subcostal (rarely parasternal). Utilising different imaging modalities like echocardiography, fluoroscopy, or a combination of both (rarely CT guided).

Resources

Direct Observation of Procedural Skills rating form (PDF)

Temporary Pacing Wire

The Temporary Pacing Wire assessment guide is to be used in conjunction with the Direct Observation of Procedural Skills (DOPS) rating form (PDF) and information in this handbook. Observable behaviours are listed for each DOPS criterion. These behaviours are considered to be markers of satisfactory performance of the temporary pacing wire and should be considered as a guide to assist assessors in discriminating between different levels of rating.

1. Demonstrates understanding of indications, relevant anatomy, technique of procedure	Indications reflective of temporary nature of requirement i.e. post myocardial infarction, coronary spasm testing, coronary rotablator use or for rapid pacing during transcutaneous aortic valve implantation. Minimise use for ‘awaiting permanent pacemaker insertion’. Different approaches and associated risks for femoral access or internal jugular venous access. Awareness of ‘balloon floated’ wires.
2. Obtains informed consent	Risks/benefits awareness including patient risk factors for right ventricular perforation (age, female, late presentation RV infarct, length of time inserted).
3. Demonstrates appropriate pre-procedure preparation	Safe access including the use of ultrasound guided venous puncture of femoral or internal jugular vein.
4. Demonstrates patient and risk awareness	Fluoroscopic landmarks associated with safe and effective pacing from the pacing wire.
5. Aseptic technique	How to secure temporary pacing wire and sheath to minimise risks of device migration and/or infection.
6. Technical ability/interpretation	How to establish pacing thresholds.
7. Seeks help where appropriate	Particularly aware of managing complications such as perforation of right ventricle, heart failure, infection, vascular access issues.
8. Post-procedure management	Secure wire and timing of removal.
9. Communication skills	Setting patient expectations.
10. Consideration for patient	Analgesia if needed.

Resources

Direct Observation of Procedural Skills rating form (PDF)

Electrophysiology Training

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Overview

Electrophysiology (EP) Training will assist you in building your level of competency in the evaluation of cardiac arrhythmias and gain:

an awareness of the nature of clinical cardiac electrophysiology
an understanding of the anatomical, physiological and pathological basis for cardiac arrhythmias
experience in the management of patients with brady and tachyarrhythmias
an appreciation of the different treatment modalities available to patients with these conditions
knowledge of ion channel physiology and the genetics and pathophysiology of inherited arrhythmia disorders
an understanding of the important role that clinical cardiac electrophysiology plays in the treatment of patients with heart failure

Resources

Electrophysiology Training Supervisor's Report (DOC)

Requirements

Requirement

Complete Electrophysiology (EP) Training once over the course of your Advanced Training

Training time

Fulfilling your training time requirement will vary between cardiology units depending on the presence or absence of a comprehensive EP unit within the hospital as well as staffing and rostering circumstances.

Your EP Training can be achieved by a single dedicated attachment to an EP unit for at least 3 weeks or through a series of attachments, such as one session or day, over a training period.

Deadline

Due from 15 October in your final year of training.

Submit your EP Training Supervisor's Report (DOC) at the conclusion of your training to cardiology@racp.edu.au (Australia) or cardiology@racp.org.nz (Aotearoa New Zealand).

Resources

Electrophysiology Training Supervisor's Report (DOC)

Procedures and activities

You’re expected to complete and record evidence of these procedures and activities during your training.

Electrophysiology studies

Requirement: 20 cases minimum.

Assess the patients and their prior investigation results, such as ECGs, Holter, treadmill stress test, echocardiography, coronary angiography.
Explain the indications for the EP study and be present during the EP study.
Explain the details of the study itself and the possible complications.
Participate in the immediate post-procedure management and in the discussions regarding subsequent treatment.

Catheter ablation

Requirement: 10 cases minimum, can be included as part of the 20 Electrophysiology studies.

Assess the patients and their prior investigation results, such as ECGs, Holter, treadmill stress test, echocardiography, coronary angiography.
Explain the indications for ablation and the potential complications of ablation.
Understand alternatives to ablation as treatment for arrhythmia and explain them to the patient.
Be present during the ablation procedure.
Participate in the immediate post-procedure management.

Pacemaker implantation

Requirement: 10 cases.

Assess patients and their prior investigation results (ECG, Holter, previous EP studies).
Explain indications for pacing.
Understand possible procedural and long-term complications of pacemaker implantation.
Be present at pacemaker implantation, ideally participate in both single chamber and dual chamber pacemaker implantation.
Participate in immediate post-implantation management.

Implantable Cardioverter Defibrillator implantation

Requirement: 3 cases.

Assess a patient’s suitability for Implantable Cardioverter Defibrillator (ICD) implantation.
Understand the possible procedural and long-term complications of ICD implantation.
Understand the basics of the programming of the ICD.
Be involved in post-procedure care.

Cardiac resynchronisation devices

Requirement: 3 cases.

Be involved in the assessment of patients for consideration of cardiac resynchronisation therapy (CRT).
Understand the indications for CRT and the principles underlying this mode of treatment for patients with congestive cardiac failure.
Be present at the implantation of the device.
Understand the technical issues both during and after implantation.
Understand the principles of optimisation of CRT settings.

Operational skills for temporary pacing wire insertion

Requirement: As required. Your clinical or electrophysiology training supervisor must sign off as completed on the supervisor’s report.

Acquire the operational skills to perform right heart catheterisation via the femoral vein – these skills can be acquired through direct participation in EP studies.
Know how to manage a temporary pacing wire post-insertion.

Attend pacemaker clinic

Requirement: 20 patients minimum, can be included in the 75 pacemaker reviews for the logbook requirement.

Demonstrate an understanding of the pacemaker programming modes.
Recognise and troubleshoot pacemaker dysfunction.
Understand the principles of resynchronisation therapy.

Ward rounds

Requirement: Daily.

Participate in the daily review of patients admitted for investigation and management of arrhythmias as well as patients found to have significant arrhythmia complications their admission.

Your clinical or electrophysiology training supervisor must sign off as completed on the supervisor’s report.

Brief case presentation

Requirement: 2 cases, 10 minutes each case.

Present cases to a working meeting of the cardiology unit.
Each case should include discussion of both acute and long-term arrhythmia management strategies.

Resources

Electrophysiology Training Supervisor's Report (DOC)

Learning Needs Analysis

Open all

Overview

A Learning Needs Analysis (LNA) embeds the process of planning and evaluating learning in the trainee’s practice.

The LNA is designed to help you:

tailor your learning experiences and build on clinical knowledge and skills
enhance face-to-face communication with your supervisor
provide information on your learning needs and progress
reflect on your strengths, limitations and future learning strategies

Your ward/service consultant or supervisor are responsible for:

advising you of available learning opportunities and resources
ensuring you have set appropriate goals and identified achievable learning objectives
reviewing your completed LNA and providing you feedback

Step-by-step: Learning Need Analysis

You need to complete a specified number of LNAs each year, per rotation. Refer to the training program requirements for the required number.

Prepare for your LNA

To plan the learning objectives for each training period, discuss the learning opportunities and resources available with your ward/service consultant or supervisor.

Meet with your consultant/supervisor to discuss:
- career goals
- personal strengths and weaknesses
- strengths and constraints of the training site/rotation, including the expertise of the medical staff and the resources available
- requirements established in the curriculum, the Professional Practice Framework and Professional Standards (PDF)

Create your LNA: Part 1

Log into your online training portal and create a new LNA
Basic Training Portal^* | Advanced Training Portal | AFOEM Portal | AFRM Portal

You'll be prompted to enter:
- learning goals for the training period
- self-evaluation on current competency for the goals identified
- learning objectives from the curricula that map to your goals (optional)
- strategies and resources that will assist your learning
- contact details of additional supervisors (optional)

Submit Part 1 of your LNA

You and your consultant/supervisor can meet to review and improve your LNA

Begin implementing your LNA over your training period

Complete your LNA: Part 2

At the end of your training period, you'll complete a self-evaluation of your LNA.

Provide your input on:
- competency in the areas specified in the learning plan
- evidence of learning
- reflection on training period

Complete your LNA by submitting LNA Part 2

Your consultant/supervisor can access your completed LNA

^* New trainees who don't currently have access to the Basic Training Portal can complete a Learning Needs Analysis form (DOC). You don't need to submit this to your supervisor. When you have access to the portal, fill in your LNA online.

Requirements

Requirement

2 x Learning Needs Analysis (LNA) each training year (1 per 6-month period), early in the rotation

Deadline

Australia: 31 January in the following year.

Aotearoa New Zealand: Due at the end of each rotation.

In your final year, LNAs are due from 15 October.

Submit your LNA via the Advanced Training Portal.

Logbook

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Overview

Keeping a logbook ensures that you have adequate exposure to a range of clinical procedures and techniques in preparation for physician practice.

You're to record and maintain a logbook with a mix of clinical procedures performed, including information about the level of supervision for each procedure.

The accuracy and currency of the logbook are of the utmost importance. Use the prescribed logbook template (XLS) and ensure your logbook is available for review at all times.

Your supervisors will be required to confirm in their reports that your logbook is a true and accurate record of your experience and that all training requirements have been fulfilled.

Resources

Cardiology Logbook template (XLS)
Cardiology Supervisor's Report (RACP login required)

Requirements

Requirement

1 x Logbook to be maintained over the course of your training

All completed procedures must be logged even after the minimum number has been reached.

Certification

A summary of procedure numbers is to be verified by your supervisor and submitted with every Supervisor's Report (RACP login required)

Resources

Cardiology Logbook template (XLS)
Cardiology Supervisor's Report (RACP login required)

Procedures

You must log all completed procedures, not just the minimum requirement, over the course of your training. All numbers specified are the expected minimum.

Note: the procedures list and the prescribed logbook template were updated in 2025. You're encouraged to complete the procedures in this updated list but won’t be penalised if you're unable to meet the new requirements and instead continue to use the previous version of your logbook.

Cath lab

Procedure	What is required?	Minimum
Coronary angiograms
a) Coronary angiograms (primary operator)	Perform and report	75
b) Coronary angiograms (non-primary operator)	Perform and report	No minimum
Total (a+b)		150

Right heart catheterisation and haemodynamic studies	Perform and report	15
Temporary transvenous pacemaker insertion (this may include EP studies or wire insertion in EP studies)	Perform	10
Permanent pacemaker (PPM) implantation (can be primary or secondary operator)	Perform and report	10

Device testing in pacemaker clinic (or remote device testing)
a) Dual chamber	Perform	50
b) Other devices including single chamber, ICD, CRT	Perform	No minimum
Total (a+b)		75

Observe the insertion and/or participate in the management of percutaneous mechanical support device (includes IABP, Impella, ECMO)	Observe/participate	3
Observe the insertion and/or participate in the management of transcatheter aortic valve implantation (TAVI)	Observe/participate	5
Observe the insertion and/or participate in the management of interventional structural cases of your choice (e.g., PFO closure, ASD closure, mitral intervention, LA appendage closure)	Observe/participate	5

Pericardial effusion management
a) Pericardiocentesis (pericardial aspiration)	Observe/participate	5
b) Management of pericardial effusion (post-aspiration)	Observe/participate	No minimum
Total (a+b)		10

Non-invasive

Procedure	What is required?	Minimum
Echocardiography
Transthoracic echocardiograms (TTEs) performed and reported
a) Comprehensive TTEs performed and reported under supervision of sonographer	Perform and report	100
b) TTEs performed and subsequently reviewed/reported with a cardiologist	Perform and report	100
c) Other TTEs performed (e.g. including point of care echocardiograms in the ward)	Perform and report	No minimum
Total (a+b+c)		300
d) TTEs reported (not performed) under supervision (excluding above)	Report (not perform)	225
e) Transoesophageal echocardiograms (TOEs) under supervision	Perform and report	50
f) Supervision and reporting of stress echocardiograms	Perform and report	25
Total echocardiograms (a–f)		600

Exercise electrocardiograms (ECG)	Participate in	50
Direct current cardioversion	Perform	10
Holter monitor under supervision	Report	50

Electrophysiology (EP)

Procedure	What is required?	Minimum
Electrophysiology studies (EPS)
a) EPS	Participate in	10
b) Catheter ablation study	Participate in	5
Total (a+b)		15

Cardiac resynchronisation therapy (CRT) and implantable cardioverter defibrillator (ICD)
a) Involvement in the referral for CRT and/or ICD devices	Participate in	10
b) Involvement in the insertion and post procedural care of CRT	Participate in	5
c) Involvement in the insertion and post procedural care of ICD	Participate in	5
Total (a+b+c)		20

Ambulatory care

(Manage patients in an ambulatory care (outpatient) setting under supervision)

Procedure	What is required?	Minimum
a) New outpatients (in-person)	Perform	150
b) Outpatients by video/telehealth consultation (new or review)	Perform	30
c) Review outpatients (in-person)	Perform	No minimum
Total outpatients reviewed (a+b+c)		400

Cardiac imaging

Procedure	What is required?	Minimum
Cardiac MRI studies (reporting and/or scanning)	Participate in	5

Cardiac CT
a) CT coronary angiogram (reporting and/or scanning)	Participate in	20
b) CTs performed for evaluation of potential TAVI procedures (reporting and/or scanning)	Participate in	No minimum
Total (a+b)		25

Nuclear cardiological investigations (can include stress MIBI scan, PET scan, cardiac blood pool scan) (reporting and/or scanning)	Participate in	5

Resources

Cardiology Logbook template (XLS)
Cardiology Supervisor's Report (RACP login required)

Mini-Clinical Evaluation Exercise

Open all

Overview

The Mini-Clinical Evaluation Exercise (Mini-CEX) is a formative assessment for trainees to receive timely, structured feedback on their performance in real clinical situations.

A Mini-CEX aims to:

evaluate your clinical performance in a real-life setting
guide your learning and improve clinical performance through structured feedback from an assessor
identify ways for you to improve your practice in areas such as communication, history taking, physical examination and professional practice

Areas of assessment

You must complete encounters on a range of cases, each focusing on specific parts of the clinical encounter:

History taking
Medical interviewing skills
Physical examination skills
Professional qualities
Counselling skills
Clinical judgement
Organisation and efficiency

Step-by-step: Mini-Clinical Evaluation Exercise

You need to complete a specified number of Mini-CEXs each year to meet the program requirements. Refer to the Mini-CEX requirements for the specified number per training year.

Arrange a Mini-CEX with your assessor – discuss and agree on curriculum areas that require focus and your assessor will then choose an appropriate consultation.

Provide your assessor a Mini-CEX rating form:
Basic Training (PDF) | Advanced Training (PDF) | AFOEM (PDF)

Undertake a patient consultation while being observed by your assessor – allow for 15 to 20 minutes.

Your assessor will complete the Mini-CEX rating form and provide you with feedback – allow for 10 to 15 minutes.

Once you have received feedback, both you and your assessor sign the rating form.

Enter data from your completed Mini-CEX rating form into the online Mini-CEX tool in your training portal.
Basic Training Portal
Advanced Training Portal
AFOEM Portal
AFPHM Portal
AFRM Portal

Submit a copy of your completed form to your assessor using the online Mini-CEX tool.

Requirements

Requirement

2 x Mini-Clinical Evaluation Exercises (Mini-CEX) to be completed each training year

Deadlines

Australia: 31 January in the following year.

Aotearoa New Zealand: Due at the end of each training rotation.

In your final year, your Mini-CEXs are due from 15 October.

Submit your Mini-CEX via the Advanced Training Portal.

Resources

Mini-Clinical Evaluation Exercise rating form (PDF)

Supervisor's Report

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Overview

A Supervisor's Report provides a comprehensive overview of your progress and achievement during the training year. It provides you with structured feedback on your performance from your supervisor and will inform the decision on the certification of your training.

How to complete your Supervisor’s Report

Your nominated supervisor(s) are listed in your online Supervisor’s Report and must complete their section of the report.

Using a laptop or desktop PC, open a new Microsoft Edge or Google Chrome browser.

Open the report for your current training period.

Complete the active fields in each report tab. Some fields are for supervisors only and will appear inactive to trainees.

After your supervisor(s) have completed their assessment, you should meet with them to discuss their assessment of your performance.

Following your discussion, your supervisor submits the report.

You and your supervisor(s) can add comments and complete declarations in the ‘Submit report’ tab.

Your report is complete only after you and your supervisor(s) have completed the declarations.

Late submission

The Training Committee may not certify training if your Supervisor’s Report is submitted after the specified deadline.

Late reports will not be accepted unless you’ve been granted an extension through an Application for Special Consideration^* (DOC).

Special Consideration must be applied for prior to the Supervisor’s Report deadline. You can also submit a letter of explanation to support your application.

Applications will be assessed against the criteria outlined in the Special Consideration for Assessment Policy (PDF).

^* As outlined in the Progression Through Training Policy (PDF), section 4.6.9:
‘Training will not be certified where the trainee has not satisfactorily completed all training requirements for the prospectively approved training period by the relevant deadline(s), or during an extension period if granted by the committee.’

Resources

Online Supervisor's Report
Multi-factor authentication
Education policies

Requirements

Requirement

Australia

12-month position (full-time and part-time trainees)

1 x Supervisor’s Report for the first 6 months of the training year due by 15 July
1 x Supervisor’s Report for the last 6 months of the training year due by 31 January in the following year

6-month position or less (separate supervisors or separate sites)

1 x Supervisor’s Report completed for each rotation:
- Due 15 July for rotations in the first half of the year
- Due 31 January for rotations in the second half of the year

In your final clinical training year, we recommend submitting your last Supervisor's Report before the 31 January deadline to avoid delaying certification of the training period.

Aotearoa New Zealand

12-month position (full-time and part-time trainees)

1 x Supervisor’s Report for the first 6 months of the training year due by 30 June
1 x Supervisor’s Report for the whole 12 months of the training year due by 15 December

6-month position or less (separate supervisors or separate sites)

1 x Supervisor’s Report completed for each rotation:
- Due 30 June for rotations in the first half of the year
- Due 15 December for rotations in the second half of the year

If your supervisor hasn’t directly supervised you throughout the whole rotation, your supervisor should obtain individual reports from those who have and submit a composite report.

You are to ensure all supervisors receive a copy of the Supervisor’s Report. Previous copies of Supervisor’s Reports must be provided to your next supervisor.

Resources

Cardiology online Supervisor's Report (RACP login required)
Online Supervisor's Report FAQs
Supervisor Details Amendment Form (DOC)

Trainee's Report

Requirement for Aotearoa New Zealand trainees only

Open all

Overview

Your Trainee’s Report engages you to provide a detailed account of your learning experience in each training rotation, not just a list of your training activities.

The College uses feedback in the Trainee’s Report for future training program evaluations, so we encourage you to reflect on your training rotations and embed reflection and review into your practice.

Your Trainee’s Report is forwarded along with your Supervisor’s Report to the Training Committee. It is these two reports that form the principal basis upon which your training certification is determined.

The Advanced Training Subcommittee can delay final certification if they’re unsatisfied that you've met all training program requirements.

Resources

Trainee's Report cover sheet (DOC)

Requirements

Requirement

1 x Trainee’s Report each rotation

Deadline

Due by 30 June and 15 December.

Submit your Trainee’s Report with your Supervisor’s Report at the end of each rotation to advancedtraining@racp.org.nz

Resources

Trainee's Report cover sheet (DOC)

Submission guidelines

Your Trainee’s Report must clearly outline your training for the year under these headings:

Clinical responsibilities
Teaching
Education program
Research, publications, formal presentations
Diagnostic techniques
Other relevant information

Ensure your report includes enough detail for the Training Committee to determine that you have achieved adequate experience in your rotation.

Your report should be 3 pages maximum in length and be in word document format.

You must have your supervisor read and certify your Trainee’s Report before you submit to the Training Committee.

Resources

Trainee's Report cover sheet (DOC)

Transthoracic Echocardiogram Training

Requirement for trainees who commenced in 2023
Recommended for trainees who commenced before 2023

Open all

Overview

Transthoracic Echocardiogram (TTE) is a commonly performed cardiac procedure and will assist you in building your level of competency in the evaluation of:

left and right ventricular structure and function
common valvular pathologies
diastolic function
pericardial disease
prosthetic valve function and intra-cardiac device assessment
pulmonary hypertension
evaluation of cardiac sources of emboli
intracardiac shunts

You're required to perform complete comprehensive TTE studies under the supervision of a sonographer (100 minimum) as part of your dedicated TTE training time. These will count towards the total 300 TTE studies required for your logbook.

An assessor should provide feedback on each case to help identify learning needs and focus future skill development.

Resources

Transthoracic Echocardiogram Training Progress Report (DOC)

Requirements

Trainees who commenced in 2023

Requirement

Complete a Transthoracic Echocardiogram (TTE) Training Progress Report once over the course of your Advanced Training

Trainees who commenced before 2023

Deadline

Due from 15 October in your final year of training.

Submit your Transthoracic Echocardiogram Training Progress Report (DOC) to cardiology@racp.edu.au (Australia) or cardiology@racp.org.nz (Aotearoa New Zealand).

More information

Education policies
RACP Online Learning resources
Trainee support

Forms and resources

Curricula

PREP Cardiology (Adult Medicine) Advanced Training Curriculum (PDF)
Professional Qualities Curriculum (PDF)

Advanced Training Portal

Forms and reports

Specialty societies

Cardiac Society of Australia and New Zealand

The Cardiac Society of Australia and New Zealand is the peak professional body representing cardiology physicians and paediatricians in Australia and Aotearoa New Zealand.

RACP resources

Trainee support is available through the Training Support Pathway, assisting you in navigating the progression through training process and reporting on your progress to your training committee.

RACP Online Learning resources is home to all online learning opportunities for trainees, with its range of online learning courses, resources and interactive learning content. It also hosts:

College Learning Series is an interactive online resource specifically targeted to the needs of Basic Trainees.
Curated collections are learning resource guides based on the contributions and peer review of RACP Fellows and other experts.

Pomegranate Health podcast is a monthly medical podcast created by physicians, for physicians.

Evolve is a physician-led initiative to ensure the highest quality patient care through the identification and reduction of low-value practices and interventions.

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