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CLINICAL RESEARCH: CARDIAC MAGNETIC RESONANCE IMAGING

Training cardiovascular fellows in cardiovascular magnetic resonance and vascular imaging

Current status following the core cardiovascular training symposium (COCATS-2) guidelines

Allen J. Taylor, MD^*,*, James E. Udelson, MD, Valentin Fuster, MD, PhD American College of Cardiology Foundation's Cardiovascular Imaging Committee and the Cardiovascular Training Directors Committee

^* Cardiology Service, Walter Reed Army Medical Center, Washington, DC, USA
Division of Cardiology, Tufts-New England Medical Center, Boston, Massachusetts, USA
Cardiovascular Institute, Mount Sinai School of Medicine, New York, New York, USA

Manuscript received July 9, 2003; revised manuscript received October 7, 2003, accepted October 13, 2003.

^* Reprint requests and correspondence: Dr. Allen J. Taylor, LTC MC USA, Program Director, Cardiovascular Medicine, Cardiology Service, Walter Reed Army Medical Center, 6900 Georgia Avenue NW, Building 2, Room 4A, Washington, DC 20307-5001, USA.
allen.taylor{at}na.amedd.army.mil

OBJECTIVES: This survey study sought to characterize the current training environment in cardiovascular magnetic resonance (CMR) and vascular imaging and to quantify the magnitude of any gaps between current training practice and the recommendations of the Core Cardiovascular Training Symposium (COCATS-2) guidelines.

BACKGROUND: The COCATS-2 guidelines published in 2002 newly included specific educational components of CMR and vascular imaging. An understanding of the current capabilities of training programs to meet these guidelines could produce efforts to improve training opportunities.

METHODS: We surveyed all accredited adult cardiovascular training programs by using a 21-question, multiple-response survey. Data were collected on center and program characteristics, clinical activities, control of clinical activities, and needs and attitudes. Parallel data were collected for nuclear cardiology capabilities as a "base case."

RESULTS: Only 13% of training programs reported "ownership" of CMR equipment, compared with 48% for nuclear equipment (p = 0.001). Dedicated fellow rotations in nuclear imaging are nearly universally present, whereas vascular (64%) and CMR imaging (29%) lag behind. A majority of programs do not use formal educational curricula for CMR and vascular imaging. Among centers with CMR training capabilities, the breadth of training opportunities is typically very limited, with most having only aortic imaging as their sole capability, except in predominately large training centers. The greatest need expressed by programs was educational assistance in the form of written and lecture curriculum materials.

CONCLUSIONS: A substantial gap exists between the current training environment in CMR and vascular imaging and the recommendations of COCATS-2. Sharing training opportunities between centers is encouraged, particularly for smaller training programs, in order to capitalize on limited equipment, personnel, and curriculum resources.

Abbreviations and Acronyms   ACCF = American College of Cardiology Foundation   CMR = cardiovascular magnetic resonance   COCATS = Core Cardiovascular Training Symposium

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