Vallabhajosyula Saraschandra, Mehta Aryan, Bansal Mridul, Jentzer Jacob C, Applefeld Willard N, Sinha Shashank S, Geller Bram J, Gage Ann E, Rose Scott W, Barnett Christopher F, Katz Jason N, Morrow David A, Roswell Robert O, Solomon Michael A
Section of Cardiology, Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI.
Lifespan Cardiovascular Institute, Providence, RI.
JACC Adv. 2024 Mar;3(3). doi: 10.1016/j.jacadv.2024.100850. Epub 2024 Feb 9.
Over the past decade there has been increasing interest in critical care medicine (CCM) training for cardiovascular medicine (CV) physicians either in isolation (separate programs in either order [CV/CCM], integrated critical care cardiology [CCC] training) or hybrid training with interventional cardiology (IC)/heart failure/transplant (HF) with targeted CCC training.
To review the contemporary landscape of CV/CCM, CCC, and hybrid training.
We reviewed the literature from 2000-2022 for publications discussing training in any combination of internal medicine CV/CCM, CCC, and hybrid training. Information regarding training paradigms, scope of practice and training, duration, sequence, and milestones was collected.
Of the 2,236 unique citations, 20 articles were included. A majority were opinion/editorial articles whereas two were surveys. The training pathways were classified into - (i) specialty training in both CV (3 years) and CCM (1-2 years) leading to dual American Board of Internal Medicine (ABIM) board certification, or (ii) base specialty training in CV with competencies in IC, HF or CCC leading to a non-ABIM certificate. Total fellowship duration varied between 4-7 years after a three-year internal medicine residency. While multiple articles commented on the ability to integrate the fellowship training pathways into a holistic and seamless training curriculum, few have highlighted how this may be achieved to meet competencies and standards.
In 20 articles describing CV/CCM, CCC, and hybrid training, there remains significant heterogeneity on the standardized training paradigms to meet training competencies and board certifications, highlighting an unmet need to define CCC competencies.
在过去十年中，心血管内科（CV）医生对重症医学（CCM）培训的兴趣日益浓厚，培训方式包括单独培训（顺序不同的单独项目[CV/CCM]、综合重症心脏病学[CCC]培训）或与介入心脏病学（IC）/心力衰竭/移植（HF）相结合的混合培训以及针对性的CCC培训。
回顾CV/CCM、CCC和混合培训的当代情况。
我们回顾了2000年至2022年的文献，以查找讨论内科CV/CCM、CCC和混合培训任意组合的培训情况的出版物。收集了有关培训模式、实践范围与培训、时长、顺序和里程碑的信息。
在2236条独特引用中，纳入了20篇文章。大多数是观点/社论文章，而两篇是调查。培训途径分为：（i）CV（3年）和CCM（1 - 2年）的专科培训，可获得美国内科医学委员会（ABIM）双重认证；或（ii）CV基础专科培训，具备IC、HF或CCC能力，可获得非ABIM证书。在内科三年住院医师培训后，总 fellowship 时长在4至7年之间。虽然多篇文章评论了将 fellowship 培训途径整合到全面无缝培训课程中的能力，但很少有文章强调如何实现这一点以满足能力和标准要求。
在描述CV/CCM、CCC和混合培训的20篇文章中，在满足培训能力和委员会认证的标准化培训模式方面仍存在显著异质性，凸显了定义CCC能力这一未满足的需求。
