From the Division of Cardiac Anesthesia, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Department of Anesthesiology and Pain Management, UT Southwestern Center, Dallas, Texas.
Anesth Analg. 2023 Aug 1;137(2):313-321. doi: 10.1213/ANE.0000000000006299. Epub 2023 Jul 14.
Pediatric cardiac anesthesiology has developed as a subsubspecialty of anesthesiology over the past 70 years. The evolution of this specialty has led to the establishment in 2005 of a dedicated professional society, the Congenital Cardiac Anesthesia Society (CCAS). By 2010, multiple training pathways for pediatric cardiac anesthesia emerged. Eight programs in the United States offered advanced pediatric cardiac anesthesia with variable duration, ranging from 3 to 12 months. Other programs offered a combined fellow/staff position for 1 year. The need for a standardized training pathway was recognized by the Pediatric Anesthesia Leadership Council (PALC) and CCAS in 2014. Specifically, it was recommended that pediatric cardiac anesthesiology be a second, 12-month advanced fellowship following pediatric anesthesia to acquire skills unique from those acquired during a pediatric anesthesia fellowship. This was reiterated in 2018, when specific pediatric cardiac anesthesia training milestones were developed through consensus by the CCAS leadership. However, given the continuous increasing demand for well-trained pediatric cardiac anesthesiologists, it is essential that a supply of comprehensively trained physicians exists. High-quality training programs are therefore necessary to ensure excellent clinical care and enhanced patient safety. Currently, there are 23 programs offering one or more positions for 1-year pediatric cardiac anesthesia fellowship. Due to the diverse curriculum and evaluation process, formalization of the training with accreditation through the Accreditation Council for Graduate Medical Education (ACGME) was the obvious next step. Initial inquiry started in April 2020. The ACGME recognized pediatric cardiac anesthesia as a subsubspecialty in February 2021. The program requirements and milestones for the 1-year fellowship training were developed in 2021 and 2022. This special article reviews the history of pediatric cardiac anesthesia training, the ACGME application process, the development of program requirements and milestones, and implementation.
儿科心脏麻醉学在过去 70 年中作为麻醉学的一个亚专业发展起来。该专业的发展导致 2005 年成立了一个专门的专业协会，即先天性心脏病麻醉协会（CCAS）。到 2010 年，出现了多种儿科心脏麻醉培训途径。美国有 8 个项目提供高级儿科心脏麻醉，持续时间不同，从 3 个月到 12 个月不等。其他项目提供为期 1 年的联合研究员/工作人员职位。2014 年，儿科麻醉领导委员会（PALC）和 CCAS 认识到需要标准化的培训途径。具体来说，建议儿科心脏麻醉学是在儿科麻醉学之后的第二个为期 12 个月的高级奖学金，以获得与儿科麻醉学奖学金期间获得的技能不同的技能。这在 2018 年再次得到强调，当时 CCAS 领导层通过共识制定了具体的儿科心脏麻醉培训里程碑。然而，鉴于对训练有素的儿科心脏麻醉师的需求不断增加，存在全面培训的医生供应至关重要。因此，高质量的培训计划对于确保出色的临床护理和增强患者安全性是必要的。目前，有 23 个项目提供一个或多个为期 1 年的儿科心脏麻醉学奖学金职位。由于课程和评估过程的多样性，通过研究生医学教育认证委员会（ACGME）认证来正式化培训是显而易见的下一步。2020 年 4 月开始初步调查。ACGME 于 2021 年 2 月承认儿科心脏麻醉为亚专业。2021 年和 2022 年制定了 1 年奖学金培训的计划要求和里程碑。这篇专题文章回顾了儿科心脏麻醉培训的历史、ACGME 申请流程、计划要求和里程碑的制定以及实施情况。
