Educational Experience of Interventional Cardiology Fellows in the United States and Canada

Bahadir Simsek; Spyridon Kostantinis; Judit Karacsonyi; Abdul Hakeem; Abhiram Prasad; Anand Prasad; Anna E Bortnick; Basem Elbarouni; Hani Jneid; J Dawn Abbott; Lorenzo Azzalini; Louis P Kohl; Mario Gössl; Rajan A G Patel; Salman Allana; Tamim M Nazif; Usman Baber; Olga C Mastrodemos; Tarek Chami; Madeline Mahowald; Athanasios Rempakos; Bavana V Rangan; Yader Sandoval; Emmanouil S Brilakis

doi:10.1016/j.jcin.2022.11.034

Educational Experience of Interventional Cardiology Fellows in the United States and Canada

JACC Cardiovasc Interv. 2023 Feb 13;16(3):247-257. doi: 10.1016/j.jcin.2022.11.034.

Authors

Bahadir Simsek¹, Spyridon Kostantinis¹, Judit Karacsonyi¹, Abdul Hakeem², Abhiram Prasad³, Anand Prasad⁴, Anna E Bortnick⁵, Basem Elbarouni⁶, Hani Jneid⁷, J Dawn Abbott⁸, Lorenzo Azzalini⁹, Louis P Kohl¹⁰, Mario Gössl¹, Rajan A G Patel¹¹, Salman Allana¹, Tamim M Nazif¹², Usman Baber¹³, Olga C Mastrodemos¹, Tarek Chami¹, Madeline Mahowald¹, Athanasios Rempakos¹, Bavana V Rangan¹, Yader Sandoval¹, Emmanouil S Brilakis¹⁴

Affiliations

¹ Minneapolis Heart Institute Foundation and Minneapolis Heart Institute, Minneapolis, Minnesota, USA.
² Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA; National Institute of Cardiovascular Diseases, Karachi, Pakistan.
³ Department of Cardiovascular Medicine, Mayo Clinic, Minneapolis, Minnesota, USA.
⁴ Department of Medicine, Division of Cardiology, University of Texas Health Science Center, San Antonio, Texas, USA.
⁵ Department of Medicine, Division of Cardiology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA; Department of Medicine, Division of Geriatrics Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA.
⁶ University of Manitoba, Winnipeg, Manitoba, Canada.
⁷ Division of Cardiology, Baylor College of Medicine, Houston, Texas, USA.
⁸ Department of Internal Medicine, Division of Cardiology, Brown University, Providence, Rhode Island, USA.
⁹ Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA.
¹⁰ Hennepin Healthcare, Minneapolis, Minnesota, USA.
¹¹ Ochsner Medical Center, New Orleans, Louisiana, USA.
¹² Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA.
¹³ University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
¹⁴ Minneapolis Heart Institute Foundation and Minneapolis Heart Institute, Minneapolis, Minnesota, USA. Electronic address: esbrilakis@gmail.com.

Abstract

Background: The COVID-19 pandemic and iodinated contrast shortage may have affected interventional cardiology (IC) fellowship training.

Objectives: The aim of this study was to investigate the educational experience of first-year IC fellows in the United States and Canada.

Methods: A 59-question online survey was conducted among 2021-2022 first-year IC fellows in the United States and Canada.

Results: Of the 360 IC fellows invited to participate, 111 (31%) responded; 95% were from the United States, and 79% were men. Participants were mostly from university programs (70%), spent 61 to 70 hours/week in the hospital, and had an annual percutaneous coronary intervention case number of <200 (5%), 200 to 249 (8%), 250 to 349 (33%), 350 to 499 (39%), 500 to 699 (12%), or ≥700 (3%). For femoral access, a micropuncture needle was used regularly by 89% and ultrasound-guided puncture by 81%, and 43% used vascular closure devices in most cases (>80%). Intravascular ultrasound was performed and interpreted very comfortably by 62% and optical coherence tomography (OCT) by 32%, and 20% did not have access to OCT. Approximately one-third felt very comfortable performing various atherectomy techniques. Covered stents, fat embolization, and coil embolization were used very comfortably by 14%, 4%, and 3%, respectively. Embolic protection devices were used very comfortably by 11% to 24% of IC fellows. Almost one-quarter of fellows (24%) were warned about their high radiation exposure. Eighty-four percent considered IC fellowship somewhat or very stressful, and 16% reported inadequate psychological support.

Conclusions: This survey highlights opportunities for improvement with regard to the use of intravascular imaging, atherectomy techniques, complication prevention and management strategies, radiation awareness and mitigation, and psychological support.

Keywords: case numbers; femoral access; interventional cardiology fellowship; intravascular imaging; mental health; percutaneous coronary intervention.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / epidemiology
Canada
Cardiology* / education
Education, Medical, Graduate / methods
Female
Humans
Male
Pandemics
Surveys and Questionnaires
Treatment Outcome
United States