Cardiology Curriculum

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Cardiology Curriculum

  1. 1. Egyptian Fellowship Board Cardiology Curriculum
  2. 2. Cardiology Egyptian Fellowship Board ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. 2
  3. 3. Preface T he Egyptian Fellowship Board and the cardiology scientific council worked collaboratively and closely to make this curriculum available for trainees’ guidance and support. Postgraduate medical education world wide is now governed by sets of academic standards that describe the qualities and abilities of graduates. In addition, there are standards for The train- ing processes , trainers’ selection and methods of assessment. standards ensure transparency and clarify expectations. The Egyptian fellowship board has already defined and published its standards for the general and professional competencies expected from graduates in different specialties upon successful completion of training. These expectations are clearly reflected in the cardiology curriculum. The curriculum describes what trainees will know and be able to do upon completion of training. In additions, methods of teaching and learning needed to deliver the curriculum are out- lined. The curriculum also describes in details, expectations from trainees during their rotations in “The training rules and regulations section”. Methods of assessment and examination regulations are also available in the last section of the curriculum. All topics covered during practical and theoretical study are outlined in tables. This will help trainees to guide their readings and their choice of learning activities. In addition, all required clinical cases and procedures are listed together with expected performance at various stages of training To help our trainers, supervisors and maximize benefits, we provided a guide for required lec- tures at various rotations and years. Mandatory courses are also mentioned and the Egyptian Fel- lowship Board will work closely with the cardiology scientific council to ensure proper organiza- tion and implementation of mandatory courses at appropriate training stages. We hope that all our trainees, trainers and educational supervisors will follow the guides provided in the curriculum and cooperate with The Egyptian Fellowship Board and the cardiology scientific council to implement the curriculum in the best ways. XáÅtà T{Åxw f{xut Secretary General Higher Committee of Medical Specialties
  4. 4. Cardiology Egyptian Fellowship Board ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. 4
  5. 5. Acknowledgement This curriculum has been created through collaboration between The Cardiology Scientific Coun- cil and The Egyptian Fellowship Curriculum Committee. The following members of the Cardiology Scientific Council have made substantial contribution to the curriculum development as subject matter experts • Professor Dr Khairy Abd El Dayem , Professor of Cardiology , Ain Shams University and Head of The Cardiology Scientific Council The Fellowship Board and The Cardiology Council would like to acknowledge the efforts of the following members of the council who provided constructive feedback regarding the curriculum structure and contents • Prof Dr Esam El Garhey , Professor of Cardiology, El Azhar University • Prof Dr Gamal Abou El Nasr, Professor of Cardiology, National Cardiology Institute • Prof Dr Ahmed Magdy, Professor of Cardiology, National Cardiology Institute The Egyptian Fellowship Curriculum Committee has contributed to the curriculum through provi- sion of consultation regarding the educational structure , copy editing, and formulation of in- tended learning outcomes . The Member who participated in The work is • Professor Dr Eman Abd El Raouf Mohammed ,Educational consultant to The Egyptian Fellow- ship Board The Committees consulted international curricula in cardiology. The external refer- ences for the development of this curriculum are: 1. The cardiology curriculum issued by Joint Royal Colleges of Physicians Train- ing Board 2007 2. The American Council for Graduate Medical Education (Cardiology program requirements ) 3. Recommendations of the European board for the specialty cardiology for edu- cation and training 4. Postgraduate Medical Education and Training Board UK (Guidelines for cur- riculum development 2006)
  6. 6. Cardiology Egyptian Fellowship Board ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. 6
  7. 7. Cardiology Egyptian Fellowship Board …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… CONTENTS ………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. Scientific council …………………………………………………………………………………………………... 8 …………………… ………………….. Entry Requirements for The Egyptian Fellowship of cardiology……... 9 …………………… ………………….. Training rules and regulations ………………………………………………………………………… …………………… 9 ………………….. …………………… Specific Requirements and Obligation………………………………………….………… 11 ………………….. …………………… General rules and regulations………………………………………………………………………….. 9 ………………….. …………………… ………………….. Interruption of the training………………………………………………………………………………… 9 …………………… ………………….. Curriculum rationale statement……………………………………...………………………… 9 …………………… ………………….. …………………… Curriculum aims…………………………………………………………………………………………….. 10 ………………….. …………………… Intended learning outcomes ……………………………………………………………………………. 11 ………………….. …………………… Basic Science Learning Outcomes…………………………………………………………………... ………………….. 13 …………………… ………………….. Clinical Science Learning Outcomes……………………………………………………...……... 24 …………………… ………………….. Clinical problems of cardiology…………………..……………………………………………. 56 …………………… ………………….. …………………… List of required lectures…………………………..…………………………………………………… 60 ………………….. …………………… Teaching and learning methods……………………………………………………………. 64 ………………….. …………………… Regulations and Methods of Assessment …………………………………………………... ………………….. 65 …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… 7
  8. 8. Cardiology Egyptian Fellowship Board ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. 8
  9. 9. ‫‪Cardiology‬‬ ‫‪Egyptian Fellowship Board‬‬ ‫……………………‬ ‫..…………………‬ ‫……………………‬ ‫..…………………‬ ‫……………………‬ ‫..…………………‬ ‫انًجهس انعهًً نتخصص انقهب و األوعيت انذيىيت‬ ‫……………………‬ ‫..…………………‬ ‫……………………‬ ‫..…………………‬ ‫انىظيفت‬ ‫اإلسى‬ ‫هيئت انًجهس‬ ‫……………………‬ ‫..…………………‬ ‫أستبر انقهب بطب عيٍ شًس‬ ‫أ.د. يحًذ خيري عبذ انذايى‬ ‫رئيس انًجهس‬ ‫……………………‬ ‫..…………………‬ ‫استبر انقهب بطب األزهر‬ ‫أ.د/ يحًذ يختبر جًعت‬ ‫َبئب انرئيس‬ ‫……………………‬ ‫..…………………‬ ‫استشبري قهب بًعهذ انقهب‬ ‫أ.د/ جًبل ابىانُصر‬ ‫يقرر اإليتحبَبث‬ ‫……………………‬ ‫..…………………‬ ‫طب عيٍ شًس‬ ‫أ.د. َبيم فرج‬ ‫عضى‬ ‫……………………‬ ‫..…………………‬ ‫أستبر انطب بطب عيٍ شًس‬ ‫أ.د/ عًر عىاد‬ ‫عضى‬ ‫……………………‬ ‫..…………………‬ ‫استشبري انقهب بًعهذ انقهب‬ ‫أ.د/ رؤوف يهراٌ‬ ‫عضى‬ ‫……………………‬ ‫..…………………‬ ‫طب انقبهرة‬ ‫أ.د. شريف انطىبجً‬ ‫عضى‬ ‫……………………‬ ‫..…………………‬ ‫طب األسكُذريت‬ ‫أ.د. وجذي عيبد‬ ‫عضى‬ ‫……………………‬ ‫..…………………‬ ‫طب األزهر‬ ‫أ.د. عسيس يذكىر‬ ‫عضى‬ ‫……………………‬ ‫..…………………‬ ‫طب انقبهرة‬ ‫أ.د. خبنذ سرور‬ ‫عضى‬ ‫……………………‬ ‫..…………………‬ ‫طب األزهر‬ ‫أ.د. أيًٍ أبى انًجذ‬ ‫عضى‬ ‫……………………‬ ‫..…………………‬ ‫……………………‬ ‫طب قُبة انسىيس‬ ‫أ.د. يحًذ فتحً يقهذ‬ ‫عضى‬ ‫..…………………‬ ‫……………………‬ ‫أ. قهب األطفبل ببنقبهرة‬ ‫أ.د. فىزاٌ شهتىث‬ ‫عضى‬ ‫..…………………‬ ‫……………………‬ ‫استبر انقهب بطب األزهر‬ ‫أ.د/ عصبو انجبرحً‬ ‫عضى‬ ‫..…………………‬ ‫……………………‬ ‫إستشبري قهب بًعهذ انقهب‬ ‫أ.د/ أحًذ يجذي‬ ‫عضى‬ ‫..…………………‬ ‫……………………‬ ‫استشبري قهب بًعهذ انقهب‬ ‫أ.د/ هبًَ عبذانرازق‬ ‫عضى‬ ‫..…………………‬ ‫……………………‬ ‫طب انقبهرة‬ ‫أ.د. شريف يختبر‬ ‫عضى‬ ‫..…………………‬ ‫……………………‬ ‫أ. قهب أطفبل عيٍ شًس‬ ‫أ.د. يً حًذي انسيذ‬ ‫عضى‬ ‫..…………………‬ ‫……………………‬ ‫أ. قهب األطفبل انقبهرة‬ ‫أ.د. هىيذا جالل انسيذ‬ ‫عضى‬ ‫..…………………‬ ‫……………………‬ ‫..…………………‬ ‫……………………‬ ‫..…………………‬ ‫……………………‬ ‫..…………………‬ ‫……………………‬ ‫..…………………‬ ‫……………………‬ ‫9‬
  10. 10. Cardiology Egyptian Fellowship Board ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. 10
  11. 11. Cardiology Egyptian Fellowship Board …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… 11
  12. 12. Cardiology Egyptian Fellowship Board ……………………. ……………………. ENTRY REQUIREMENTS FOR THE EGYPTIAN ……………………. ……………………. FELLOWSHIP OF CARDIOLOGY ……………………. ……………………. Any of The following is considered a satisfactory entry requirement for The Egyptian ……………………. ……………………. Fellowship of cardiology ……………………. 1. Diploma in General Medicine ……………………. ……………………. 2. Master in General Medicine ……………………. 3. M.D. in General Medicine ……………………. ……………………. 4. M.R.C.P. ……………………. 5. Fellowship of Egyptian Board of General Medicine ……………………. ……………………. 6. Diploma in Cardiology ……………………. 7. Master in Cardiology ……………………. ……………………. ……………………. Those admitted to the Fellowship training program with qualification in general ……………………. ……………………. medicine (number 1 to 5 above) must attend and pass a course in basic sciences ……………………. relevant to the study of cardiology and in basic cardiology. The course will take ……………………. place during the first year. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. TRAINING RULES AND REGULATIONS ……………………. ……………………. ……………………. The structure of the training program ……………………. ……………………. ……………………. The Egyptian Fellowship Board requires a minimum of three years supervised train- ……………………. ……………………. ing programme that must be conducted in an accredited hospital before sitting for ……………………. the final examination. It also requires the presentation of a short thesis on a subject ……………………. ……………………. approved by the supervisors. A list of accredited hospitals will be announced yearly ……………………. by the Board. ……………………. ……………………. ……………………. The cardiology training programme follows at least two years residency (or equiva- ……………………. ……………………. lent training) in general medicine and consists of three years residency in cardiology. ……………………. ……………………. ……………………. During all the training programme the candidate must be dedicated full time and ……………………. must be fully responsible for patient care. ……………………. ……………………. ……………………. ……………………. ……………………. 12
  13. 13. Cardiology Egyptian Fellowship Board …………………… ………………….. First Year ……………………  The trainee should spend the first year in general cardiology including inpatient ………………….. …………………… care, outpatient clinics, emergency department, and CCU. ………………….. ……………………  The candidate should attend and study the curriculum of basic science related to ………………….. cardiology in the field of anatomy, physiology, pathology, biochemistry and …………………… pharmacology and basic cardiology. he should attend at least 75% of lectures in ………………….. …………………… these subjects (2/week) for 8 months. He should pass successfully through first ………………….. part written exam in these subjects before being promoted to the third year of …………………… ………………….. training. ……………………  He should be actively involved and fully responsible for patient care including ………………….. …………………… sharing in making decisions about diagnosis and management under supervision ………………….. of the consultants. …………………… …………………..  He must attend 75% of weekly departmental meeting including clinical rounds, …………………… ………………….. morbidity and mortality conferences and journal club. ……………………  His performance will be monitored by his trainer and a report made of this per- ………………….. …………………… formance monthly ………………….. …………………… ………………….. Second Year …………………… ………………….. ……………………  The trainee should spend six months in general cardiology including inpatient ………………….. care, outpatient clinics and emergency unit. …………………… …………………..  He should spend two months in coronary care unit, two months in non-invasive …………………… laboratory (including stress testing, tilt table test and nuclear studies) and two ………………….. …………………… months in echocardiography laboratory (including training on stress echo, con- ………………….. trast echo, transesophgeal echo, etc…). …………………… …………………..  He should attend once weekly in the catheterization laboratory as assistant or …………………… operator in diagnostic cases and as assistant in interventional cases. ………………….. ……………………  He should supervise junior trainees in his unit. …………………..  He should do consultations requested from other department. …………………… …………………..  He should attend 70% of weekly departmental meeting. ……………………  He should be responsible under supervision for outpatient clinic once weekly. ………………….. ……………………  He should Take shifts on duty in the medical emergency department as deter- ………………….. …………………… mined by hospital regulations ………………….. …………………… ………………….. Third Year …………………… ………………….. ……………………  During this year the trainee should be fully responsible for patient care in ………………….. outpatient, inpatient and emergency department. …………………… 13
  14. 14. Cardiology Egyptian Fellowship Board  He should spend 2 months in the electrophysiology unit (including training on ……………………. ……………………. pacemaker program and pacemaker follow-up) and 2 months in the pediatrics ……………………. unit and 2 months in the post surgical CCU. ……………………. …………………….  He should spend one day per week in the catheterization laboratory. He ……………………. should be able to perform diagnostic coronary and right and left heart cathe- ……………………. ……………………. terization under supervision of the consultant. …………………….  He should independently report ECGs, echocardiograms, stress ECG, and nu- ……………………. ……………………. clear studies and decide what should be done for patients in association with ……………………. consultant responsible. ……………………. …………………….  He should be involved in the research program of the institution and prepare a ……………………. ……………………. short thesis or audit on a subject approved by the supervisor of the fellowship ……………………. training program. ……………………. ……………………. ……………………. ……………………. SPECIFIC REQUIREMENTS AND OBLIGATION ……………………. ……………………. ……………………. ……………………. The admitted patients ……………………. ……………………. A. The trainee will be responsible for admitting the patient from outpatient depart- ……………………. ……………………. ment or emergency room. ……………………. B. He will ascertain the completion of the following documents in each : ……………………. ……………………. • Complete history and physical examination form. ……………………. • Investigation requests, (laboratory, radiology, pathology, etc.). ……………………. ……………………. • Results of the investigations. ……………………. • Plan of management and daily progress notes. ……………………. ……………………. • Order and medication sheets and Order the necessary non-invasive diag- ……………………. nostic procedures such as E.C.G., Echo. X- rays, VIS etc. ……………………. ……………………. • Discuss the indications of invasive diagnostic procedures such as abdomi- ……………………. nal tapping, liver biopsy etc…, with the consultant. ……………………. ……………………. • Discharge summaries. ……………………. • Sick leaves and medical reports. ……………………. ……………………. • The trainee should inform the senior staff of any high risk patient admis- ……………………. sion. ……………………. ……………………. Outpatient Clinics ……………………. ……………………. The trainee should attend the following outpatient clinics : ……………………. ……………………. • General cardiology clinic. ……………………. • Subspecialties clinic (EG, hypertension, arrhythmia and post PCI clinics). ……………………. ……………………. 14
  15. 15. Cardiology Egyptian Fellowship Board …………………… 3. Mandatory Clinical and Academic Activities : ………………….. …………………… The trainee shall be required to attend and participate in the mandatory academic ………………….. …………………… and clinical activities of the department. Attendance and participation should not be ………………….. less than 75% of the total number of activities within and training rotation / period …………………… ………………….. including. ……………………  Daily morning endorsement meeting. ………………….. ……………………  Clinical round presentation, at least once weekly to cover various topics, ………………….. problems, research, etc. …………………… …………………..  Journal club meeting, at least once monthly. ……………………  Clinic-pathological meeting, at least once monthly. ………………….. ……………………  Mortality audits. …………………..  Interdepartmental meeting. …………………… ………………….. …………………… ………………….. 4. The Log Book : …………………… ………………….. The trainee shall be required to keep a log book where he/she shall record all activities …………………… ………………….. and skills performed and learned during the training program. The activities should be …………………… dated and categorized to whether been performed by the trainee him/her self or as ………………….. …………………… an assistant or participant. Each activity registered in the log book should be counter ………………….. signed by the trainer and finally the professor and the supervisor shall sign the com- …………………… ………………….. pleted log book. …………………… ………………….. …………………… 5. The research project : ………………….. …………………… ………………….. The trainee shall undertake al least one research project or audit during the training …………………… program under the guidance and supervision of his/her trainer. Such project or mini ………………….. …………………… thesis should be duly written (not necessarily published) before the trainee is accepted ………………….. for admission to the final certifying examination. …………………… ………………….. …………………… ………………….. 6. At the completion of the training program : …………………… ………………….. The trainee should have completed satisfactorily the rotations described in the struc- …………………… ………………….. ture of the program …………………… ………………….. …………………… 7. The trainee shall ………………….. …………………… maintain the confidentiality and ethics of the profession. He shall maintain healthy ………………….. …………………… relations with patients, their relatives, the medical, nursing and administrative staff. ………………….. …………………… 15
  16. 16. Cardiology Egyptian Fellowship Board ……………………. GENERAL RULES AND REGULATION ……………………. ……………………. A. Holidays and on call duties : ……………………. ……………………. According to Ministry of health and Population regulation. ……………………. B. Evaluation procedures : ……………………. 1. Performance of the trainee shall be evaluated on regular and continuous basis ……………………. ……………………. the evaluation process should involve all aspects of the training including ……………………. theoretical, clinical and investigative procedures skills as well as attendance and ……………………. ……………………. participation. ……………………. 2. The trainers who are required to write confidential reports on the performance ……………………. ……………………. of each trainee should evaluate the trainee periodically. The trainee should not ……………………. be allowed to proceed in the training program and move to the next rotation ……………………. ……………………. unless he/she attains a satisfactory level of performance acceptable to the ……………………. responsible Professor and the head of The cardiology scientific council. ……………………. ……………………. 3. There is annual assessment (theoretical and clinical) for the trainees before ……………………. each pass from one level to the next (year 1 to year 2 to year 3) etc. ……………………. ……………………. 4. The trainee shall not be allowed to proceed to year three before successfully ……………………. passing the Egyptian Board Exam in Basic Science and Basic Cardiology (first ……………………. ……………………. part exam). ……………………. ……………………. INTERRUPTION OF TRAINING ……………………. ……………………. It is not permissible to interrupt such a structural training program except in major ……………………. ……………………. unavoidable circumstances. Such circumstances should be convincing and ……………………. approved by the Secretary General of The higher committee of Medical Specialties. ……………………. ……………………. The interruption once approved should not be for more than one year. ……………………. Interruption of the training program for more than one year shall result in dismissal ……………………. ……………………. from the program and cancellation of the preceding training period. ……………………. ……………………. ……………………. CURRICULUM RATIONALE STATEMENT ……………………. ……………………. The purpose of this curriculum is to describe the knowledge, skills and expertise that ……………………. ……………………. must be gained by trainees in cardiology in order to practice independently and ……………………. safely. The curriculum also describes teaching, learning and assessment methods ……………………. ……………………. that will be used to ensure that the trainees have attained the required ……………………. competencies. We derived the contents of the curriculum from previous Fellowship ……………………. ……………………. curricula together with a review of curricula of other cardiology training programs ……………………. in the European Union, UK and USA. Expert advice has been sought from the ……………………. ……………………. board of the cardiology fellowship and others working in the field. The wide ……………………. participation of experts ensures that the curriculum is up to the international ……………………. accepted standards of practice in The field of cardiology. 16
  17. 17. Cardiology Egyptian Fellowship Board T…………………… RAINING AIMS ………………….. …………………… The educational process in the fellowship of Cardiovascular Medicine aims to equip ………………….. …………………… trainees with the necessary knowledge and skills so that they will be able to : ………………….. …………………… ………………….. 1. Develop management plans for the ―whole patient‖ and maintain knowledge in …………………… ………………….. areas of medicine which impinge on the specialty of cardiovascular medicine. …………………… 2. Apply appropriate knowledge and skill in the diagnosis and management of ………………….. …………………… patient with cardiovascular disorders. ………………….. …………………… 3. Establish a differential diagnosis for patient presenting with cardiovascular ………………….. problems by the appropriate use of the clinical history, examination and …………………… ………………….. investigations. …………………… ………………….. 4. Perform the core investigations required in cardiovascular medicine. …………………… ………………….. 5. Develop clinical practice which is based on analysis of relevant clinical trials and …………………… have an understanding of other research methodologies. ………………….. …………………… 6. Apply the knowledge of biological and behavioural sciences in clinical practice. ………………….. …………………… 7. Identify and take responsibility for their own educational needs and the ………………….. …………………… attainment of these needs. ………………….. 8. Address all aspects of the health care needs of patients and their families. …………………… ………………….. 9. Develop leadership and team working skills, especially with other healthcare …………………… ………………….. professionals. …………………… 10. Maintain the highest standards appropriate in their professional field and able to ………………….. …………………… respond constructively to assessments and appraisals of professional competence ………………….. …………………… and performance. ………………….. …………………… 11. Be aware of current thinking about ethical and legal issues. ………………….. 12. Act as safe independent specialists whilst recognizing the limitation of their own …………………… ………………….. practice and the obligation to seek assistance from colleagues where appropriate. …………………… ………………….. 13. Take appropriate action when things go wrong, both in their own practice and in …………………… that of others. ………………….. …………………… 14. Assess honestly and objectively the performance of those they have supervised ………………….. …………………… and trained. ………………….. …………………… 15. Manage time and resources to the benefit of themselves, their patients and ………………….. colleagues. …………………… ………………….. 16. Take advantages of information technology to enhance all aspects of patient care. …………………… ………………….. …………………… 17
  18. 18. Cardiology Egyptian Fellowship Board ……………………. INTENDED LEARNING OUTCOMES ……………………. ……………………. ……………………. ……………………. A. Generic intended learning outcomes ……………………. ……………………. ……………………. 1. Communicate effectively in daily clinical practice. ……………………. 2. Apply His knowledge of legal and ethical practice in day to day work ……………………. ……………………. 3. Function successfully in a multidisciplinary team. ……………………. 4. Understand The management and service delivery issues in the ……………………. ……………………. Egyptian Governmental Health System. ……………………. ……………………. 5. Teach medical knowledge and skills to junior colleagues and other ……………………. healthcare professionals ……………………. ……………………. 6. Plan, conduct and analyze a research project. ……………………. ……………………. 7. Manage health information. ……………………. ……………………. ……………………. B. Clinical intended learning outcomes ……………………. ……………………. ……………………. 1. Take a relevant and complete history and perform full and focused ……………………. ……………………. clinical examination. ……………………. 2. Choose investigations needed for the patient & interpret the results. ……………………. ……………………. 3. Use information available to reach diagnosis or differential diagnosis. ……………………. ……………………. 4. Competently manage (i.e. assess, diagnose and treat common and ……………………. important cardiac diseases and presentations mentioned in The cur- ……………………. ……………………. riculum case and presentation list. ……………………. 5. Participate effectively in primary and secondary prevention of cardio- ……………………. ……………………. vascular diseases like hypertension, hyperlipidemia and infective en- ……………………. ……………………. docarditis ……………………. 6. Assess and care for cardiac patients before and after cardiac and non ……………………. ……………………. cardiac surgery. ……………………. ……………………. 7. Manage critically ill patient with hemodynamic disturbances. ……………………. 8. Perform cardiopulmonary resuscitation ……………………. ……………………. 9. Select, interpret and appropriately perform under supervision and ……………………. independently The cardiovascular procedures mentioned in The cur- ……………………. ……………………. riculum list. ……………………. ……………………. 10. Refer appropriately his patients for invasive cardiac procedures men- ……………………. tioned in The curriculum list. ……………………. 18
  19. 19. Cardiology Egyptian Fellowship Board …………………… ………………….. …………………… Clinical conditions to be managed competently by trainees ………………….. …………………… ………………….. …………………… Acute Cardiomyopa- Stable angina Arrhythmias Hyperlipidemia ………………….. breathlessness thy …………………… ………………….. …………………… ………………….. Acute coronary Chronic Valvular heart Pericardial Congenital …………………… syndrome breathlessness disease diseases heart ………………….. …………………… ………………….. Myocardial Presyncope …………………… infarction Heart failure Hypertension Endocarditis and syncope ………………….. …………………… ………………….. ……………………Diseases of the Cardiac tumors Heart diseases ………………….. aorta in pregnancy …………………… ………………….. …………………… ………………….. procedures to be performed or interpreted competently by The trainees …………………… ………………….. …………………… ………………….. ECG recording Chest X-ray Basic electro- Cardioversion Pericardiocen- ……………………& interpretation physiology tesis ………………….. …………………… ………………….. Exercise testing, Basic invasive …………………… recording and Echo- Basic nuclear Pacing & interventional ………………….. interpretation cardiography cardiology cardiology …………………… ………………….. …………………… ………………….. Procedures and cases where trainees must seek referral for experts …………………… ………………….. …………………… ………………….. Neonates and infants with Diagnostic and therapeutic …………………… Stress Echo congenital heart diseases invasive electrophysiology ………………….. …………………… ………………….. Cardiac Percutaneous ……………………Advanced Elec- Implantation and programming resynchroniza- coronary ………………….. trophysiology of Intra cardiac defibrillators …………………… tion therapy intervention ………………….. …………………… intra-aortic Trans ………………….. Balloon esophageal Tissue Doppler Computerized tomography and …………………… counter echocardiogra- studies multislice C.T and MRI ………………….. pulsation phy …………………… ………………….. …………………… 19
  20. 20. Cardiology Egyptian Fellowship Board ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. 20
  21. 21. Cardiology Egyptian Fellowship Board …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. Basic Sciences and …………………… ………………….. Basic Cardiology …………………… ………………….. Learning Outcomes …………………… ………………….. …………………… ………………….. …………………… Methods of teaching and learning: ………………….. Lectures, seminars and self study. …………………… ………………….. …………………… ………………….. Methods of assessment: …………………… First part written examination ………………….. …………………… ………………….. …………………… Year of achievement: ………………….. First Year …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… 21
  22. 22. Cardiology Egyptian Fellowship Board ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. 22
  23. 23. Cardiology Egyptian Fellowship Board …………………… ………………….. …………………… Anatomy ………………….. …………………… ………………….. Knowledge …………………… ………………….. By The end of training, trainees should have adequate knowledge and deep under- …………………… ………………….. standing of : …………………… ………………….. 1. The position of all cardiac structures to guide them in performing venous and …………………… ………………….. arterial access and navigate catheter and electrode in the heart. …………………… ………………….. 2. The relevant cardiac and vascular structures & their relationship to each other in …………………… ………………….. order to help them during interpretation & performance of invasive and non- …………………… ………………….. invasive imaging by all imaging techniques (e.g. echo, MSCT, CT, MRI, Angiogra- …………………… phy, etc.) ………………….. …………………… 3. The developmental basis of all congenital cardiac and vascular malformation. ………………….. …………………… ………………….. Skills …………………… ………………….. …………………… 1. Identify anatomic landmarks on postmortem specimens. ………………….. …………………… 2. Identify cardiac chambers and vascular structures in angiograms. ………………….. …………………… 3. Identify normal and abnormal cardiac and vascular structures in X-rays, CT, MRI ………………….. …………………… ………………….. Topics …………………… ………………….. …………………… 1. Embryology of heart and aortic arch. ………………….. 2. Surface anatomy of the heart aorta and great vessels …………………… ………………….. 3. Anatomy of the heart and detailed anatomy of cardiac chamber. …………………… ………………….. 4. Anatomy of the brachiocephalic vessels with special stress on the access to CVP. …………………… ………………….. 5. Anatomy of aorta and its abdominal branches. …………………… ………………….. 6. Anatomy of pulmonary circulation. …………………… ………………….. 7. Histology of the heart and blood vessels. …………………… ………………….. 8. Anatomy of coronary vessels. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… 23
  24. 24. Cardiology Egyptian Fellowship Board ……………………. Physiology & Biochemistry ……………………. ……………………. ……………………. Knowledge ……………………. ……………………. By The end of The module, trainees should have adequate knowledge and ……………………. ……………………. deep understanding of: ……………………. ……………………. 1. The physiologic basis of cardiac action. ……………………. ……………………. 2. The physiology & pathophysiology of systemic and pulmonary circula- ……………………. tion in order to understand various effects of disease. ……………………. ……………………. 3. The various metabolic processes in order to evaluate normal and ab- ……………………. ……………………. normal metabolic disorders affecting the circulation. ……………………. ……………………. ……………………. Skills ……………………. ……………………. 1. Interpret results of physiologic tests such as blood gas analysis, blood ……………………. ……………………. pictures and electrolyte analysis. ……………………. ……………………. 2. Interpret normal intracardiac pressure tracings. ……………………. ……………………. 3. Calculate cardiac axis in ECG. ……………………. ……………………. 4. Interpret respiratory function tests. ……………………. ……………………. 5. Construct diet for different cardiac conditions based on patient’s re- ……………………. quirement and food chemistry. ……………………. ……………………. ……………………. ……………………. Topics ……………………. ……………………. A) General Physiology: ……………………. ……………………. 1. Homeostasis. ……………………. 2. Hemostasis, Coagulation & Fibrinolysis. ……………………. ……………………. 3. Acid – Base Balance. ……………………. ……………………. 4. Water & electrolyte Regulation. ……………………. 5. Blood Elements (RBCs & Anemias, WBCs). ……………………. ……………………. 6. Hypertension & Hypotension. ……………………. 7. Cardiac Performance (Pump Function & Heart Failure). ……………………. ……………………. 8. Capillary Circulation, body fluids Formation & Edema. ……………………. ……………………. 9. Hemorrhage & Shock. ……………………. 10. Glucose Homeostasis & D.M. ……………………. ……………………. 11. Regulation of Respiration (& Types of Breathing). 24
  25. 25. Cardiology Egyptian Fellowship Board …………………… B) cardiovascular physiology: ………………….. 1. Functional Characteristics of C. V.S & Flow. …………………… ………………….. 2. Physiology of Cardiac Muscles: …………………… …………………..  Electric properties (R.M.P., A. P., Origin & spread of Cardiac Impulse). …………………… …………………..  Mechanical Properties (Contractile Behavior, excitation/contraction …………………… ………………….. coupling. Coupling, types of Contraction, Mechanism of Contraction, …………………… Mechanism of Relaxation, contractility, Elastic Behavior). ………………….. …………………… 3. E. C.G. & Arrhythmias. ………………….. …………………… 4. Cardiac Cycle, pressure/volume loop, JVP, Arterial Pulse & Heart Sounds. ………………….. …………………… 5. Cardiac Function Curves & V.R. Curves. ………………….. …………………… 6. Venous Circulation & Insufficiency. ………………….. …………………… 7. Circulation in arteries. ………………….. …………………… 8. Microcirculation & Tissue Blood Flow. ………………….. …………………… 9. Syncope. ………………….. …………………… 10. Pulmonary Circulation ………………….. 11. Respiratory changes in Heart Failure. …………………… ………………….. 12. Circulatory Changes during Exercise & training. …………………… ………………….. 13. Coronary & Cerebral Circulations. …………………… ………………….. 14. Respiratory failure, hypoxia and cyanosis …………………… ………………….. 15. O2 therapy. …………………… ………………….. 16. Basic kidney physiology …………………… ………………….. c) Biochemistry …………………… 1. Introduction to metabolism 7. Mineral metabolism ………………….. …………………… 8. Vitamins and disease 2. Carbohydrate metabolism ………………….. …………………… 3. Lipid metabolism 9. Purine metabolism & Hyperuricemia ………………….. …………………… 4. Lipoproteins 10.Diagnostic enzymology (+ troponin) ………………….. …………………… 5. Cholesterol metabolism 11.Free radicals and disease ………………….. …………………… 6. Hormones 12.Food chemistry and principle of dietetics ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… 25
  26. 26. Cardiology Egyptian Fellowship Board ……………………. Pathology ……………………. ……………………. Knowledge ……………………. ……………………. By The end of training, trainees should have adequate knowledge and deep ……………………. ……………………. understanding of the pathological basis of different forms of heart disease. ……………………. ……………………. Skills ……………………. ……………………. 1. Identify important pathological findings in pathological specimens. ……………………. 2. Identify histopathological changes in arteries and correlate it to gross pa- ……………………. thology and IVUS pictures. ……………………. ……………………. ……………………. ……………………. Topics ……………………. 1. Inflammation. ……………………. 2. Degenerative diseases: ……………………. 2. a. Disturbance of carbohydrate metabolism ……………………. ……………………. 2. b. Disturbance of protein metabolism ……………………. 2. c. Lipid storage diseases. ……………………. 2. d. Glycogen infiltration ……………………. ……………………. 2. e. Diabetes mellitus ……………………. 2. f. Nutritional disturbances. ……………………. 2. g. Malnutrition—Thiamin—Deficiency & vitamin C deficiency- ……………………. ……………………. 2. h. Disturbance of mineral metabolism (calcium & potassium). ……………………. 3. Thrombosis. ……………………. 4. Embolism. ……………………. ……………………. 5. Pulmonary embolism. ……………………. 6. Ischemic heart diseases. ……………………. ……………………. 7. Myocardial infarction. ……………………. 8. Pericarditis. ……………………. 9. Myocarditis. ……………………. ……………………. 10. Endocarditis. ……………………. 11. Cardiomyopathy. ……………………. 12. Congenital heart diseases. ……………………. ……………………. 13. vascular diseases: ……………………. A. Arteriosclerosis (degenerative) …………………….  Atherosclerosis. ……………………. …………………….  Medial calcific sclerosis …………………….  Arteriolosclerosis (Hypertension). ……………………. B. Vasculitis or vasculitides (inflammatory). ……………………. ……………………. C. Aneurysms and dissecting aneurysm ……………………. 14. Cardiac Tumors ……………………. ……………………. ……………………. 26
  27. 27. Cardiology Egyptian Fellowship Board …………………… Pharmacology ………………….. …………………… ………………….. Knowledge …………………… By The end of training, trainees should have adequate knowledge and deep un- ………………….. …………………… derstanding of : ………………….. …………………… 1. The classification, mode of action , indications, contraindications, interactions ………………….. and adverse effects of drugs used in The field of cardiology (with emphasis on …………………… ………………….. angiotensin—converting enzyme inhibitors angiotensin-receptor blockers aldos- …………………… ………………….. terone antagonists, antiarrhythmic drugs, beta-blockers, calcium antagonists, …………………… diuretics, lipid-lowering drugs, antiplatelet agents, anticoagulants, inotropes, ………………….. …………………… digitalis, nitrates. Other vasodilation drugs, drugs with cardiac toxicity and other ………………….. drugs with novel mechanisms of action). …………………… ………………….. 2. The drugs pharmacokinetics (absorption, bioavailability, distribution, biotrans- …………………… ………………….. formation, excretion). …………………… 3. Pharmacogenetics.. ………………….. …………………… Skills ………………….. …………………… 1. Take a relevant history of a patient’s medication regimen including purchase of ………………….. over the counter medicines. …………………… ………………….. 2. Assess the risks and benefits of prescribing an individualized drug treatment …………………… ………………….. regimen for a given cardiovascular condition. …………………… 3. Monitor the desired effects of a patient’s drug therapy and also the side effects. ………………….. …………………… From this he should be able to make appropriate modifications to the treat- ………………….. ment regimen. …………………… ………………….. 4. Recognize and manage possible drug interactions (including treatments of …………………… ………………….. concomitant diseases). …………………… 5. Identify and interpret the importance of herbal remedies taken by patients ………………….. …………………… 6. Perform and interpret diagnostic tests to assess drug efficacy and safety ………………….. …………………… (laboratory test, EGC and hemodynamic monitoring, echocardiography). ………………….. 7. Incorporate the principles of current evidence-based therapeutic guidelines …………………… ………………….. into clinical practice. …………………… 8. Communicate with patients and their family members to improve treatment ………………….. …………………… compliance and to ensure early recognition of possible adverse effects. ………………….. …………………… 9. Consider the cost effectiveness & feasibility of the prescribed treatment regi- ………………….. men. …………………… ………………….. …………………… ………………….. …………………… 27
  28. 28. Cardiology Egyptian Fellowship Board ……………………. ……………………. Basic Cardiology ……………………. ……………………. Knowledge ……………………. ……………………. ……………………. By The end of training, trainees should have adequate knowledge and deep ……………………. understanding of the basic principles underlying procedures and instruments ……………………. ……………………. used in the cardiovascular field ……………………. ……………………. ……………………. Skills ……………………. ……………………. 1. Identify different instruments, catheters, etc. used in cardiac procedures. ……………………. 2. Interpret normal and abnormal hemodynamic measurement and tracings. ……………………. ……………………. 3. Interpret results of oxymetry from different cardiac chambers. ……………………. ……………………. ……………………. Topics ……………………. ……………………. ♦ Principles of hemodynamics. ……………………. ……………………. ♦ Pressure measurement : techniques, instruments and limitations. ……………………. ♦ Flow measurement : including thermo and dye dilution : techniques, in- ……………………. ……………………. struments and limitations. ……………………. ……………………. ♦ Quantitative angiography. ……………………. ♦ Arrhythmogenesis : basic mechanisms. ……………………. ……………………. ♦ Principles of radiation physics, X-rays and CT scan. ……………………. ……………………. ♦ Radiation safety : radiological anatomy of the heart and major vessels. ……………………. ♦ Principles of nuclear medicine. ……………………. ……………………. ♦ Principles of magnetic resonance and PET imaging. ……………………. ……………………. ♦ Principles of electrocardiography: the waves, leads, electric axis, etc... ……………………. ♦ Principles of infection control, sterilization and re-sterilization. ……………………. ……………………. ♦ Principles of ultrasound, and Doppler : physics, probes, machines. ……………………. ……………………. ♦ Contrast materials in the catheterization and echo lab. ……………………. ♦ Contrast nephropathy mechanisms, diagnosis and prevention. ……………………. ……………………. ♦ The cell membrane : channels and receptors. ……………………. ……………………. ♦ Medical ethics and medicolegal aspects of the practice of cardiology. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. 28
  29. 29. Cardiology Egyptian Fellowship Board …………………… Genetics ………………….. …………………… ………………….. Knowledge …………………… ………………….. 1. Describe the incidence and prevalence of inherited cardiovascular disorder in the …………………… local community. ………………….. …………………… 2. State the basic knowledge of cardiac embryology and major gene families involved ………………….. …………………… in cardiogenesis. ………………….. 3. Describe the principles of mendelian inheritance. …………………… ………………….. 4. Describe the principles of polygenic cardiovascular diseases (such as hypertension, …………………… diabetes and dyslipidemia). ………………….. …………………… 5. Outline The general features of major monogenic cardiovascular diseases, hyper- ………………….. …………………… trophic cardiomyopathy, familial aortopathies such as Marfan syndrome, Ehlers ………………….. Danlos syndrome and Williams syndrome, familial dilated cardiomyopathies, familial …………………… ………………….. channelopathy, familial disorders of septation, familial basis of conotruncal anoma- …………………… ………………….. lies, trisomies, in particular trisomy 21, familial dyslipidemia, in particular disorders of …………………… the low density lipoprotein receptor. ………………….. …………………… 6. Explain the familial basis of inherited cardiac tumors ………………….. …………………… ………………….. …………………… Skills ………………….. …………………… 1. Take full history and perform appropriate clinical examination for patients with in- ………………….. …………………… herited or familial cardiovascular disease and construct a family pedigree when in- ………………….. …………………… dicated ………………….. 2. Distinguish autosomal dominant , autosomal recessive, X-linked and mitochondrial …………………… ………………….. inheritance. …………………… ………………….. 3. Counsel index cases and family members at risk on the probability of being affected …………………… by a genetic cardiovascular disorder. ………………….. …………………… 4. Recognize problems with pedigree interpretation such as incomplete penetrance, ………………….. variable expressivity and age-related patterns of expressivity. …………………… ………………….. 5. Manage the uncertainties associated with genetic testing. …………………… ………………….. 6. Direct patients and families when appropriate to major centers with a specialized …………………… interest in their particular disorder and cooperate with genetic specialists ………………….. …………………… 7. Use appropriate counseling skills to explain, educate and inform patients fully of the ………………….. …………………… nature of their disease and the diagnostic tests used to make a diagnosis. ………………….. 8. Consult with patients and their family members in improving the recognition and …………………… ………………….. management of familial cardiovascular disease. …………………… 29
  30. 30. Cardiology Egyptian Fellowship Board ……………………. Radiation use and safety ……………………. ……………………. Knowledge ……………………. ……………………. 1. Define the physics and hazards of ionizing radiation to patients and staff. ……………………. 2. Define the current statutory requirements concerning the medical use of ……………………. ……………………. ionizing radiation. ……………………. ……………………. 3. Know how to operate the equipment involved in the use of ionizing ……………………. radiation. ……………………. ……………………. 4. Define the factors that affect radiation exposure to both patients and staff. ……………………. 5. Outline the important aspects of cardioradiology. ……………………. ……………………. ……………………. Skills ……………………. ……………………. 1. Use radiation equipment appropriately and safely for the diagnosis, ……………………. ……………………. assessment and treatment of patients with cardiac disease according to ……………………. ……………………. recent. ……………………. 2. Operate radiation equipment safely and effectively. ……………………. ……………………. ……………………. Attitudes ……………………. ……………………. Appreciate the risks and benefits to patients and staff of using ionizing ……………………. ……………………. radiation. ……………………. ……………………. ……………………. ……………………. Cardiovascular Disease Prevention, ……………………. ……………………. Risk Assessment and Management ……………………. ……………………. Knowledge ……………………. ……………………. ……………………. 1. Define the incidence, prevalence and risk factors of cardiovascular dis- ……………………. ……………………. eases in the local community. ……………………. 2. Explain risk assessment in primary prevention, multifactorial interaction ……………………. ……………………. and risk scoring charts. ……………………. ……………………. 3. Explain diet and nutrition in relation to cardiovascular risk management. ……………………. 4. Describe treatment & prevention strategies for smoking, dyslipidemia, dia- ……………………. ……………………. betes mellitus , hypertension , physical inactivity, left ventricular hypertro- ……………………. ……………………. phy, obesity. metabolic syndrome, psychosocial factors. ……………………. 5. Recognize that risk factors often cluster and require a comprehensive ap- ……………………. ……………………. proach. 30
  31. 31. Cardiology Egyptian Fellowship Board …………………… 6. Explain risk assessment in secondary prevention including drug therapy. ………………….. 7. Recognize the complications and consequences of specific risk factors. …………………… ………………….. Skills …………………… ………………….. …………………… 1. Assess and treat patients with risk factors for cardiovascular disease. ………………….. …………………… 2. Evaluate how different prevention methods work. ………………….. …………………… 3. Contribute to the global efforts in reducing cardiovascular morbidity and mortality ………………….. by communicating the prevention message to the public. …………………… ………………….. 4. Manage risk factors appropriately and communicate their importance to patients …………………… and their families ………………….. …………………… 5. Evaluate the risk of CVD for an individual patient. ………………….. …………………… 6. Evaluate the benefit of risk factor intervention for the individual patient. ………………….. …………………… Attitudes ………………….. …………………… ………………….. 1. Appreciate the importance of risk factor management. …………………… 2. Appreciate variation in CVD risks across population, socioeconomic, gender and ………………….. …………………… racial group. ………………….. 3. Through patient education, encourage a healthier lifestyle with specific emphasis …………………… ………………….. on risk factor. …………………… ………………….. 4. Offer advice and support to family members with inherited CVD. …………………… 5. Cooperate with other specialists such as dieticians, dialectologists and specialist ………………….. …………………… nurses. ………………….. …………………… 6. Participate actively in CVD prevention programmers. ………………….. 7. Consider the cost effectiveness of the prescribed treatment regimen. …………………… ………………….. …………………… ………………….. Resuscitation - Basic & Advanced Life Support …………………… ………………….. …………………… ………………….. Knowledge …………………… ………………….. …………………… ………………….. 1. Describe current guidelines on resuscitation. …………………… 2. Discuss the principles of cardiopulmonary resuscitation. ………………….. …………………… 3. Outline the cardiac and non-cardiac causes of cardiac arrest. ………………….. …………………… ………………….. …………………… ………………….. …………………… 31
  32. 32. Cardiology Egyptian Fellowship Board ……………………. Skills ……………………. ……………………. 1. Carry out effectively and supervise resuscitation of patients suffering from ……………………. ……………………. cardiac arrest in The hospital and in The field. ……………………. 2. Supervise pre hospital care of critically ill. ……………………. ……………………. 3. Show proficiency in advanced life support. ……………………. ……………………. 4. Show proficiency in advisory defibrillation. ……………………. ……………………. ……………………. ……………………. Attitudes & behaviors ……………………. ……………………. 1. Support relatives in critical situations . ……………………. ……………………. 2. Break bad news in a empathetic manner. ……………………. 3. Appreciate legal and ethical considerations of resuscitation. ……………………. ……………………. 4. Be Familiar with the legal and ethical issues associated with ―do not resus- ……………………. ……………………. citate‖ orders. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. ……………………. 32
  33. 33. Cardiology Egyptian Fellowship Board …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… Clinical Cardiology ………………….. …………………… Learning Outcomes ………………….. …………………… ………………….. …………………… ………………….. …………………… of teaching and learning: Methods ………………….. seminars, on The Job training and self study. Lectures, …………………… ………………….. …………………… ………………….. of assessment: Methods Trainer evaluation, logbook, final written exam …………………… ………………….. at The end of training and Clinical and oral exam …………………… ………………….. Year of achievement: …………………… Throughout the training program ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… ………………….. …………………… 33
  34. 34. Cardiology Egyptian Fellowship Board ……………………. Acute and Chronic Breathlessness ……………………. ……………………. Knowledge ……………………. ……………………. 1. Outline the causes of acute and chronic breathlessness. ……………………. ……………………. 2. Discuss the management of cardiac and non-cardiac disease present- ……………………. ……………………. ing with acute or chronic breathlessness. ……………………. ……………………. Skills ……………………. ……………………. ……………………. 1. Take a focused or complete history and perform appropriate examina- ……………………. ……………………. tion for patients presenting with acute or chronic breathlessness. ……………………. ……………………. 2. Select and use investigations appropriately. ……………………. ……………………. ……………………. Attitudes & Behaviors ……………………. ……………………. ……………………. 1. Appreciate the importance of consulting other specialists e.g. respira- ……………………. ……………………. tory physicians and intensivists. ……………………. ……………………. 2. Appreciate the importance of lifestyle, exercise and weight loss. ……………………. ……………………. ……………………. Syncope ……………………. ……………………. ……………………. Knowledge ……………………. ……………………. ……………………. 1. Define syncope. ……………………. ……………………. 2. Describe the epidemiology, pathophysiology and the prevalence of dif- ……………………. ……………………. ferent causes of syncope. ……………………. ……………………. 3. Classify causes of loss of consciousness e.g. neural mediated reflex syn- ……………………. ……………………. cope, Adams - Stokes attack, orthostatic hypotension. ……………………. ……………………. 4. Identify the prognosis of different causes of syncope. ……………………. ……………………. 5. Describe diagnostic evaluation : ……………………. a. Strategy of evaluation. ……………………. ……………………. b. Initial evaluation (history, physical examination. Baseline ECG). ……………………. ……………………. c. Echocardiogram. ……………………. ……………………. ……………………. 34
  35. 35. Cardiology Egyptian Fellowship Board …………………… d. Exercise stress testing. ………………….. …………………… e. Tilt testing. ………………….. …………………… f. Electrocardiography monitoring (long-term ECG, external and implantable ………………….. …………………… loop recorders). ………………….. …………………… g. Electrophysiological test. ………………….. …………………… ………………….. ……………………Describe treatment, device based or pharmacological : 6. ………………….. …………………… a. Neurally mediated (reflex) syncope. ………………….. …………………… b. Orthostatic hypotension. ………………….. …………………… c. Cardiac arrhythmias as primary cause. ………………….. d. Structural cardiac or cardiopulmonary disease. …………………… ………………….. …………………… ………………….. Skills …………………… ………………….. Differentiate syncope from the other causes of Loss of consciousness. 1. …………………… ………………….. Assess syncope cases through history and clinical examination 2. …………………… ………………….. Treat patients with syncope. 3. …………………… ………………….. Perform or interpret : 4. …………………… ………………….. a. Electrocardiogram. …………………… ………………….. b. Echocardiogram. …………………… ………………….. c. Carotid sinus massage. …………………… d. Tilt testing. ………………….. …………………… e Electrocardiographic monitoring (long-term ECG, external and implant- ………………….. …………………… able lop recorder). ………………….. …………………… f. Electrophysiological test. ………………….. …………………… g. Exercise stress test. ………………….. …………………… h. Cardiac catheterization and coronary angiography. ………………….. ……………………Perform a risk stratification. 5. ………………….. ……………………Select appropriate treatment including education and reassurance, physical 6. ………………….. …………………… maneuvers, Drug therapy or device implantation ………………….. …………………… ………………….. …………………… 35

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