title: Can diagnostic and procedural skills required to practice cardiology as a specialist be mastered in 3 years?
abstract: Cognitive and procedural skills required of cardiologists have increased in the past 10 years. What is unknown is whether residents consistently meet recommended volumes during training and what their own subjective assessments of their competency are after training. The purpose of this study was to (1) determine whether current training provides residents with opportunities to develop skills to function independently and (2) identify whether residents perceive gaps in their skills. We surveyed current and recent graduates of adult cardiology programs in Canada. One hundred ten responses from 425 surveys were received. Procedural and diagnostic test interpretation volumes were recorded, as were the optimum number the respondents believed were important to complete to function independently. These volumes were compared with the 2008 American College of Cardiology Core Cardiology Training Symposium (COCATS 3) and the Canadian Cardiovascular Society (CCS) recommendations for training. The proportion of residents meeting recommended volumes for diagnostic test interpretation ranged from 7% (Holter monitors) to 91% (echocardiograms). For procedures, the range was from 71% (echocardiography) to 100% (cardioversion). The ratio of residents' perceived minimum numbers believed to be required for proficiency for diagnostic test interpretation to those recommended ranged from 14% (electrocardiograms) to 116% (echocardiograms), and for procedures, the ratio was 66% (temporary pacemaker placement) to 116% (echocardiography). Recent graduates' perception of minimum required numbers to achieve competency is underestimated compared with COCATS 3 and CCS recommendations. Few graduates achieved the recommended volume targets suggested for diagnostic test interpretation.
authors.affiliation: Division of Cardiology, University Health Network, Toronto, Ontario, Canada. Electronic address: eric.yu@uhn.on.ca.
authors.forename: Eric H C
authors.initials: EH
authors.lastname: Yu
authors.affiliation: Division of Cardiology, University of British Columbia, British Columbia, Canada.
authors.forename: Parvathy
authors.initials: P
authors.lastname: Nair
authors.affiliation: Division of Cardiology, University Health Network, Toronto, Ontario, Canada.
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Sibbald
authors.affiliation: Division of Cardiology, University Health Network, Toronto, Ontario, Canada; Institute for Clinical and Evaluative Sciences, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Lee
authors.affiliation: St. Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Dorian
mesh_terms: D002309:Cardiology / Q000193:education*; D002983:Clinical Competence / Q000592:standards*; D004502:Education, Medical, Continuing; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D009864:Ontario; D015397:Program Evaluation