POLICY STATEMENT: Organizational Principles to Guide and Define the
Child Health Care System and/or Improve the Health of ...
AMERICAN ACADEMY OF PEDIATRICS

                                                           POLICY STATEMENT
       Organiz...
can Academy of Pediatrics (AAP) to agree on the final      TABLE 1.        Core Training Recommendations
guidelines and to...
POLICY STATEMENT: Organizational Principles to Guide and Define the
Child Health Care System and/or Improve the Health of ...
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DOI: 10.1542/peds.2005-2097 published online Oct 6, 2005 ...

  1. 1. POLICY STATEMENT: Organizational Principles to Guide and Define the Child Health Care System and/or Improve the Health of All Children • A Report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence (ACC/AHA/AAP Writing Committee to Develop Training Recommendations for Pediatric Cardiology) • ACCF/AHA/AAP RECOMMENDATIONS FOR TRAINING IN PEDIATRIC CARDIOLOGY • Training Guidelines for Pediatric Cardiology Fellowship Programs Thomas P. Graham, Jr, Robert H. Beekman, III, Michael D. Freed, John W. Hirshfeld, Jr, Thomas Kulik, John D. Kugler, Tim C. McQuinn, David J. Sahn, Victoria L. Vetter, William B. Moskowitz, Mark A. Creager, John W. Hirshfeld, Jr, Beverly H. Lorell, Geno Merli, George P. Rodgers, John D. Rutherford, Cynthia M. Tracy, Howard H. Weitz, Thomas P. Graham, Jr and Robert H. Beekman, III Pediatrics published online Oct 6, 2005; DOI: 10.1542/peds.2005-2097 The online version of this article, along with updated information and services, is located on the World Wide Web at: http://www.pediatrics.org/cgi/content/full/peds.2005-2097v1 PEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly publication, it has been published continuously since 1948. PEDIATRICS is owned, published, and trademarked by the American Academy of Pediatrics, 141 Northwest Point Boulevard, Elk Grove Village, Illinois, 60007. Copyright © 2005 by the American Academy of Pediatrics. All rights reserved. Print ISSN: 0031-4005. Online ISSN: 1098-4275. Downloaded from www.pediatrics.org by on July 22, 2010
  2. 2. AMERICAN ACADEMY OF PEDIATRICS POLICY STATEMENT Organizational Principles to Guide and Define the Child Health Care System and/or Improve the Health of All Children A Report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence (ACC/AHA/AAP Writing Committee to Develop Training Recommendations for Pediatric Cardiology) ACCF/AHA/AAP RECOMMENDATIONS FOR TRAINING IN PEDIATRIC CARDIOLOGY Steering Committee: Thomas P. Graham, Jr, MD, FACC, FAHA, FAAP, Chair; Robert H. Beekman III, MD, FACC, FAHA, FAAP, Co-Chair; Michael D. Freed, MD, FACC, FAHA, FAAP; John W. Hirshfeld, Jr, MD, FACC, FAHA; Thomas Kulik, MD; John D. Kugler, MD, FACC, FAAP*†; Tim C. McQuinn, MD, FAAP; David J. Sahn, MD, MACC, FAAP; Victoria L. Vetter, MD, FACC, FAHA; and William B. Moskowitz, MD, FACC, FAAP† Task Force Members: Mark A. Creager, MD, FACC, FAHA, Chair; John W. Hirshfeld, Jr, MD, FACC, FAHA; Beverly H. Lorell, MD, FACC, FAHA‡; Geno Merli, MD, FACP; George P. Rodgers, MD, FACC; John D. Rutherford, MB, ChB, FACC, FAHA; Cynthia M. Tracy, MD, FACC, FAHA; and Howard H. Weitz, MD, FACC, FACP Training Guidelines for Pediatric Cardiology Fellowship Programs Thomas P. Graham, Jr, MD, FACC, FAHA, FAAP, Chair; and Robert H. Beekman, III, MD, FACC, FAHA, FAAP, Co-Chair INTRODUCTION corporation of new information from the clinical P ediatric cardiology is a complex, multifaceted and laboratory sciences. It is important, therefore, specialty composed of diverse clinical and aca- to define the fellowship training required to demic subspecialty areas. It is characterized by launch a successful career in pediatric cardiology. rapid growth of subspecialty areas and swift in- The following document represents the first broad- based effort to do so. In 2000, the Society of Pediatric Cardiology Training * AHA CVDY representative † AAP representative Program Directors (SPCTPD) embarked on the process ‡ Former task force member during writing effort. of defining fellowship training guidelines. The process This document was approved by the American College of Cardiology itself was broad-based and inclusive. All pediatric car- Foundation Board of Trustees in June 2005, by the American Heart Asso- diology training program directors were invited to ciation Science Advisory and Coordinating Committee in July 2005, and by the American Academy of Pediatrics Board in July 2005. nominate members to participate in the training guide- When citing this document, the American Academy of Pediatrics would lines task forces; in turn, each task force was comprised appreciate the following citation format: Beekman RH III, Graham TP, et al. of all nominated members who agreed to participate. ACCF/AHA/AAP recommendations for training in pediatric cardiology: a Therefore, all training programs were provided an op- report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Com- portunity to actively participate. petence (ACC/AHA/AAP Committee on Pediatric Cardiology). Pediatrics. In 2002, the American College of Cardiology (ACC) 2005;116:1256 –1278. approved and published the Revised Recommenda- Copies: This document is available on the Websites of the American College of Cardiology (www.acc.org), the American Heart Association (www.american- tions in Adult Cardiovascular Medicine Core Cardiol- heart.org), and the American Academy of Pediatrics (www.aap.org). Single ogy Training.1 As the SPCTPD was concluding its copies of this document may be purchased for $10.00 each by calling 1-800- training guideline development, plans were formalized 253-4636 or by writing to the American College of Cardiology, Resource to use a similar process through the ACC Pediatric Center, 9111 Old Georgetown Road, Bethesda, Maryland 20814-1699. Permissions: Multiple copies, modification, alteration, enhancement, Cardiology/Congenital Heart Disease Committee and and/or distribution of this document are not permitted without the express the ACC Training Program Directors Committee. Ac- permission of the American College of Cardiology Foundation. Please cordingly, a steering committee was developed with direct requests to copyright_permissions@acc.org. original authors of the Pediatric Cardiology Training doi:10.1542/peds.2005-2097 PEDIATRICS (ISSN 0031 4005). Copyright © 2005 by the American College Guidelines to form a liaison with the ACC, the Amer- of Cardiology Foundation, the American Heart Association, Inc., and the ican Heart Association (AHA), and the Section on Pe- American Academy of Pediatrics. diatric Cardiology and Cardiac Surgery of the Ameri- 1256 PEDIATRICS Vol. 116 No. 11 November 2005 Downloaded from www.pediatrics.org by on July 22, 2010
  3. 3. can Academy of Pediatrics (AAP) to agree on the final TABLE 1. Core Training Recommendations guidelines and to publish them widely. Experience Time Commitment These guidelines are written with the planned goal (in months) of serving as a practical resource for directors of General experience (inpatient) 3–6 pediatric cardiology training programs. We also Echocardiography/imaging 4–6 hope that this document will prove useful to the Cardiac catheterization 3–4 (estimate*) Residency Review Committee (RRC) for pediatric Electrophysiology 2–3 training programs in the revision of requirements Cardiac intensive care 2–4 Adult congenital heart disease 0–2 (estimate*) for the accreditation of pediatric cardiology pro- Research 12–18 grams. The general requirements, clinical compe- Total 36 tencies, and oversight for fellows in pediatric car- * Task Force identified experience-based recommendations. See diology would remain the same as outlined by the individual section for numbers. Accreditation Council for Graduate Medical Edu- cation (ACGME). The training program must possess the faculty GENERAL CONSIDERATIONS expertise, patient volume, and inpatient/outpatient The guidelines proposed in this document address facilities to provide meaningful trainee experiences overall recommendations for training in pediatric car- as outlined in this document. All faculty should be diology and important subspecialties within the field of board certified or possess suitable equivalent quali- pediatric cardiology. Although we understand that the fications. Recommendations for trainee and faculty pediatric RRC sets minimum standards for accredita- evaluation are those outlined in the “general and tion of fellowship programs, this document endeavors special requirements” as published by the ACGME, to define a more comprehensive set of guidelines for and training should take place within a program that pediatric cardiology fellowship training. Fellowship is accredited by the ACGME. training guidelines are presented for: general pediatric A comment about trainee research participation is cardiology (including inpatient care and consultations); appropriate. The field of pediatric cardiology is ab- echocardiography and noninvasive imaging; electro- solutely dependent upon research (basic and clinical) physiology; cardiac catheterization and intervention; for meaningful progress. There is a critical need for cardiac intensive care; adult congenital heart disease; the development of physician-scientists in our spe- and research participation. Each section other than gen- cialty to assure such future progress. Therefore, it is eral pediatric cardiology specifies “core” and “ad- key that training programs begin to prepare trainees vanced” training experiences. Core recommendations for a successful investigative career. Such prelimi- are intended to be common training experiences for all nary research training will in most instances require pediatric cardiology trainees regardless of long-term 18 months or more. The balancing of clinical and career goals. Advanced recommendations are additional research training will continue to be a major issue for training experiences for trainees intending to develop a training programs. It is highly probable that train- clinical or academic area of special competence. All ees who want to pursue a physician-scientist ca- guidelines are recommended experiences, and not ab- reer will require at least four years of fellowship to solute mandates, as it is recognized that each training begin the academic process and to finish training program has unique strengths and that clinical and in the clinical areas. The authors are in complete academic variation across training programs provides agreement with the newly published American important diversity for the specialty. Board of Pediatrics (ABP) Training Requirements Table 1 summarizes the approximate time commit- for subspecialty certification concerning scholarly ment (in months) recommended for core training in activity, meaningful accomplishments in research, the task force reports that follow. Variations in these scholarship oversight, and differing pathways to time commitments should be allowed, as pediatric train physician-scientists. cardiology programs vary widely in size, organiza- APPENDIX tion, and emphasis. For example, in some programs, The authors of this section declare they have no fellows may get considerable cardiac intensive care relationships with industry pertinent to this topic. unit training during their general inpatient experi- ences and not require a two- to four-month stand- REFERENCE alone rotation. Thus, the training guidelines must 1. Beller GA, Bonow RO, Fuster V. ACC revised recommendations for provide programs with flexibility to address individ- training in adult cardiovascular medicine Core Cardiology Training II ual trainee clinical and/or research training needs (COCATS 2) (revision of the 1995 COCATS training statement). J Am Coll during a core fellowship of 36 months’ duration. Cardiol 2002;39:1242–1246. AMERICAN ACADEMY OF PEDIATRICS 1257 Downloaded from www.pediatrics.org by on July 22, 2010
  4. 4. POLICY STATEMENT: Organizational Principles to Guide and Define the Child Health Care System and/or Improve the Health of All Children • A Report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence (ACC/AHA/AAP Writing Committee to Develop Training Recommendations for Pediatric Cardiology) • ACCF/AHA/AAP RECOMMENDATIONS FOR TRAINING IN PEDIATRIC CARDIOLOGY • Training Guidelines for Pediatric Cardiology Fellowship Programs Thomas P. Graham, Jr, Robert H. Beekman, III, Michael D. Freed, John W. Hirshfeld, Jr, Thomas Kulik, John D. Kugler, Tim C. McQuinn, David J. Sahn, Victoria L. Vetter, William B. Moskowitz, Mark A. Creager, John W. Hirshfeld, Jr, Beverly H. Lorell, Geno Merli, George P. Rodgers, John D. Rutherford, Cynthia M. Tracy, Howard H. Weitz, Thomas P. Graham, Jr and Robert H. Beekman, III Pediatrics published online Oct 6, 2005; DOI: 10.1542/peds.2005-2097 Updated Information including high-resolution figures, can be found at: & Services http://www.pediatrics.org/cgi/content/full/peds.2005-2097v1 Supplementary Material Supplementary material can be found at: http://www.pediatrics.org/cgi/content/full/peds.2005-2097v1/DC 1 Citations This article has been cited by 2 HighWire-hosted articles: http://www.pediatrics.org/cgi/content/full/peds.2005-2097v1#ot herarticles Permissions & Licensing Information about reproducing this article in parts (figures, tables) or in its entirety can be found online at: http://www.pediatrics.org/misc/Permissions.shtml Reprints Information about ordering reprints can be found online: http://www.pediatrics.org/misc/reprints.shtml Downloaded from www.pediatrics.org by on July 22, 2010

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