Abstract 13846: Shared Curriculum Delivery Gaps Among Advanced Heart Failure and Transplant Cardiology Fellowship Programs

Abstract

Introduction: Nearly 4,000 heart transplants and more than 5,000 LVAD implants were performed in the US in 2021. Medical care for these patients is performed by Advanced Heart Failure and Transplant Cardiology (AHFTC) physicians. Variations in faculty expertise and patient pathology exist between training programs, and some may be unable to provide a curriculum addressing all recommended competencies during the one-year-long fellowship. This study is a targeted needs assessment identifying gaps in curriculum delivery among US AHFTC fellowship programs. Methods: 50 medical knowledge competencies were selected from the 2017 ACC/AHA/HFSA/ISHLT/ACP Training Statement on Advanced Heart Failure and Transplant Cardiology. AHFTC fellowship programs were identified using the AMA’s FREIDA website. A survey was published on Qualtrics. An anonymous link was emailed to all program directors (PDs), while PDs and program coordinators (PCs) were asked to help distribute the survey to current fellows. Results: 17 PDs and 11 fellows completed the survey. The most common areas where little to no training was reported to be provided were: role of lung transplantation in patients with pulmonary arterial hypertension (68%), pathophysiology of cardiac dysfunction associated with portal hypertension (61%), and conditions that may impact mechanical circulatory support strategies in adult patients with congenital heart disease (58%). Respondents most requested a moderate to a significant amount of more training in the following areas: appropriate treatment of patients with each type of pulmonary hypertension (63%), pharmacology of medications available to treat pulmonary arterial hypertension (58%), and role of lung transplantation in patients with pulmonary arterial hypertension (53%). (The information reported is as of June 12, 2022. Data collection is ongoing.) Conclusions: Common gaps in curriculum delivery among US AHFTC fellowship programs appear to exist. The most desired area for additional instruction involves different aspects of the management of pulmonary hypertension. A focused centralized curriculum could be developed to teach these concepts, thereby better preparing AHFTC fellows to care for these types of patients in the future.