CLINICAL RESEARCH: ADULT CONGENITAL HEART DISEASE
Variations in Adult Congenital Heart Disease Training in Adult and Pediatric Cardiology Fellowship Programs
Michelle Z. Gurvitz, MD*, ,*,
Ruey-Kang Chang, MD, MPH, FACC*,
Fernando J. Ramos*,
Vivekanand Allada, MD, FACC*,
John S. Child, MD, FACC and
Thomas S. Klitzner, MD, PhD, FACC*
* Division of Cardiology, Department of Pediatrics, Mattel Children’s Hospital at UCLA, David Geffen School of Medicine at UCLA, Los Angeles, California
Ahmanson Adult Congenital Heart Disease Center, Division of Cardiology, Department of Internal Medicine, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California
Manuscript received October 16, 2004;
revised manuscript received May 7, 2005,
accepted May 17, 2005.
* Reprint requests and correspondence: Dr. Michelle Z. Gurvitz, Children’s Hospital and Regional Medical Center, Children’s Heart Center, 4800 Sand Point Way NE, Seattle, Washington 98105. (Email: mgurvitz{at}mednet.ucla.edu; michelle.gurvitz{at}seattlechildrens.org).
OBJECTIVES: The purpose of this study was to evaluate adult congenital heart disease (CHD) training among U.S. cardiology fellowship programs.
BACKGROUND: Although training recommendations for caring for adults with CHD exist, the educational patterns and numbers of specialists remain unknown.
METHODS: We surveyed U.S. directors of 170 adult cardiology and 45 pediatric cardiology (PC) fellowship programs. Adult program surveys contained 1 single-response and 10 multiple-choice questions; pediatric program surveys contained 1 single-response and 13 multiple-choice questions.
RESULTS: Ninety-four adult cardiology fellowship directors (55%) and 34 PC directors (76%) responded. Of adult programs, 70% were in university hospitals and 40% were associated with PC groups. Those with PC-affiliation had more adult CHD clinics (p < 0.02) and more adult CHD inpatient (p < 0.02) and outpatient (p < 0.002) visits than those without PC affiliation. Most PC programs were in children’s hospitals (38%) or children’s hospitals within adult hospitals (50%). Eighty-two percent had associated adult cardiology programs. Pediatric programs followed adult CHD patients in various care settings. Over one-third of adult and pediatric programs had  3 lectures annually regarding adult CHD. Nine adult and 2 pediatric programs offered adult CHD fellowships, and only 31 adult and 11 pediatric fellows pursued advanced CHD training in the last 10 years.
CONCLUSIONS: Adult CHD didactic and clinical experiences for cardiology fellows vary widely. Few programs offer advanced CHD training, and the number of specially trained physicians is unlikely to meet projected workforce requirements. Adult cardiology programs with PC affiliation have increased CHD experience and might provide good educational models.
|
Abbreviations and Acronyms
| | CHD = congenital heart disease | | COCATS = Core Cardiology Training (Recommendations for Training in Adult Cardiovascular Medicine) | | PC = pediatric cardiology |
|
This article has been cited by other articles:
|
|
|
|
 
J. S. Child, M. D. Freed, C. Mavroudis, D. S. Moodie, and A. L. Tucker
Task Force 9: Training in the Care of Adult Patients With Congenital Heart Disease
J. Am. Coll. Cardiol.,
January 22, 2008;
51(3):
389 - 393.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Z. Gurvitz, M. Inkelas, M. Lee, K. Stout, J. Escarce, and R.-K. Chang
Changes in Hospitalization Patterns Among Patients With Congenital Heart Disease During the Transition From Adolescence to Adulthood
J. Am. Coll. Cardiol.,
February 27, 2007;
49(8):
875 - 882.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Driscoll
Training in Cardiology Fellowship Programs
J. Am. Coll. Cardiol.,
May 16, 2006;
47(10):
2128 - 2128.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Gurvitz, R.-K. Chang, F. Ramos, V. Allada, J. Child, and T. Klitzner
Reply
J. Am. Coll. Cardiol.,
May 16, 2006;
47(10):
2128 - 2129.
[Full Text]
[PDF]
|
|
|
|
