Proposals for future training in interventional paediatric cardiology.

Training in all medical disciplines is currently undergoing a major overhaul. There is a move away from the old concept of training as an apprentice, towards more structured programmes of training. Proposals have recently been made to shorten higher specialist training to 3-4 years, thus producing "generalist" consultants to meet the growing need for service. Advanced subspeciality training can then be undertaken by those with the ability, and desire, to do so following the core training. In the near future, therefore, subspeciality training will need to meet the needs of those undertaking core training, and those wishing to develop a higher degree of expertise. It will have to be focused, to allow skills appropriate to the future practice to be undertaken as a consultant to be developed efficiently. We propose a new scheme for training in interventional paediatric cardiology as a template for subspeciality training. The scheme proposes training at three levels. The first level, basic training, is required of all trainees. Training for the intermediate level will be required for those proposing to carry out diagnostic cardiac catheterisation and basic intervention. Training at the advanced level will be needed by those who wish to carry out a wide range of interventional procedures. A curriculum is proposed for each level, detailing skills that must be attained. Attendance at procedures needs to be driven by the educational needs of the trainee, rather than the requirements of the service. Objective methods are suggested to allow assessment of competence. These should supersede log-books, which document only procedural numbers. Training may be needed for the trainers to ensure that teaching and assessment achieve agreed standards of excellence.