Model of postgraduate training in cardiology in Central Europe.

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1 Model of postgraduate training in cardiology in Central Europe. Lukasz Chrzanowski II Chair and Department of Cardiology, Medical University of Lodz, Poland Speaker disclosure information: no confilct of interest exists related to this presentation

2 Poland Hungary Russia Germany

3 Poland a uniform model across entire country regulated by law at general level supervised administratively by a board of experts including National Consultant, representatives of Central Postgraduate Medical Training Office, Polish Cardiac Society, Principal Board of Physicians cardiology training directly after graduation and obligatory internship available since 2007 (direct programme) previous option: only as a sequential specialty following internal diseases (sequential programme), currently also an alternative

4 Direct programme in Poland prepared according to recommendations of European Society of Cardiology, European Union of Medical Specialists - Cardiology Section, European Board for the Specialty of Cardiology 6 years (72 months) to complete 2 years of internal medicine included as a first component (intensive medical care, pulmonogy, endocrinology, diabetology, gastroenterology, nephrology, rheumatology and rehabilitation, hematology, infectious diseases, neurology)

5 Direct programme in Poland 4 years of training in cardiology as a continuation Core Syllabus by the ESC theoretical courses (1 to 10 days each): advances in diagnostic and therapeutic approach to congenital heart disease advances in diagnostic and therapeutic approach to valvular heart disease acute coronary syndromes oncology in cardiology public health overview

6 Direct programme in Poland clinical practice (including on duty work at night) rotation system (1 to 6 months) intensive cardiac care unit cath lab echo lab pediatric cardiology ward cardiac surgery diagnostic imaging modalities implantable devices and invasive arrhythmia management

7 Direct programme in Poland last 12 months intended for expanding competences in one specific area: intensive cardiac care interventional cardiology electrophysiology noninvasive diagnostic modalities general and ambulatory cardiac care

8 Direct programme in Poland entire postgraduate training only in accredited centres knowledge, skills and behaviours educational tools: books, guidelines, publications, in addition to pre-specified requirements: optional activities scientific meetings congresses research

9 Practical skills implantation of intracardiac lead for temporary pacing central venous cannulation tracheal intubation pericardial puncture advanced life support ECG Echo (transthoracic) excercise test 24 hour ECG monitoring

10 Practical skills transoesophageal echo coronary angiography programming of pacemaker/icd PTCA right and left heart catheterisation PCM/ICD implantation EPS/ablation cardiac nuclear, CT, MRI studies assisted procedures

11 Practical skills foreign language certification English German French Spanish reading skills, especially medical resources ability to communicate with patients and medical professionals writing skills, especially in medical field

12 Examination in Poland National Specialty Examination necessary to complete the programme two sessions a year managed by Central Office for Medical Examinations general reading list success confirmed by a certificate allows to demonstrate knowledge in cardiological specialty required for consultant level activities, accreditation, supervision of postgraduate training

13 Examination in Poland multiple choice test: 1 best answer out of 5 distracters 120 questions 120 to 180 minutes depending on the text volume each correct answer earns one point toward a total rank lack of answer earns no point incorrect answers do not remove any points from a total score > 71 points required to pass all candidates at the same time and place

14 Example of a test item

15 Examination in Poland oral examination: new regulations since to 6 problems to solve several examinating boards across country talking points include clinical case analysis, diagnostic test results, therapeutic strategy each problem must be solved correctly to pass both test and oral component must have a pass status for the examination to be succesfully completed

16 Examination in Poland previously (until 2011) oral examination included 5 questions concerning different areas of cardiology additional clinically-oriented component diagnostic and therapeutic management of a patient interpretation of 5 ECGs 5 echo studies 5 angiography studies

17 Completed programme and succesful examination in Poland

18 Sequential programme in Poland only for physicians with internal diseases specialty 4 years (48 months) to complete similar requirements as with direct programme (theoretical courses, clinical practice, rotation system, competences, skills, procedures) identical examination

19 Hungary uniform model at a national level 6 years (72 months) 2 years of internal diseases component followed by 4 years of cardiology different rotations in comparison to Poland: timing, content (for example cardiac rehabilitation) examination: oral and practical components

20 Russia general recommendations at a national level hospitals set their own programmes accordingly 2 years (24 months) of general cardiology following 2 years of internal diseases additional 1 year (12 months) training for interventional cardiologists echocardiography imaging: 2 years of special training preceeded by 2 years of internal disease specialty (different from cardiology)

21 Russia the structure of cardiology programmes includes theoretical and practical training in a range of common and important areas in-hospital activities, educational seminars, scientific meetings, congresses examination required to complete the programme 3 components: written format test, oral format theory exam and clinical case presentation

22 Germany models defined by regional associations in Saarland: 6 years (72 months) 3 years (36 months) of general internal medicine component followed by 36 months of cardiology rotation structure may vary between hospitals (for example no cardiac surgery) additional activities: congresses, scientific meetings, research oral examination