Multidisciplinary training in cardiovascular fellowship programs

Abstract

The management of complex cardiovascular disease is rapidlyshifting from individual physician based practice towards a multidisci-plinary team approach. The plethora of scientific data and the develop-ment of new strategies of care led to the wide adoption of the ‘HeartTeam’ or the ‘Cardiovascular Team’ concept, where cardiologists workclosely with cardiacsurgeons, vascular surgeons, neurologists, anesthe-siologists, radiologists, interventional radiologists and other specialiststo deliver a high-quality cardiovascular care. The importance of this‘patient-centered’ and not ‘specialty-centered’ approach is well recog-nizedbymultiplesocietiesanditsadoptionisthereforestronglyrecom-mended in most contemporary guidelines [1]. The evolution of thiscollaborative team approach has transformed how cardiovascularspecialists interact and provide patient care, and possibly resultedin improved outcomes. Unfortunately, educational models have notkept pace with these changes. In most cardiovascular fellowshiptraining programs, fellows' exposure to other key specialtiesislimit-ed to didactic lectures, and scattered patient-care related interac-tions. In the era of multispecialtyteam approach, this exposure ofcardiovascular fellows to their future team collaborators is far fromadequate.The most recent guidelines for Training in Adult CardiovascularMedicine acknowledge the importance of multidisciplinary trainingbutdonotprovidespecificrecommendationswithregardtoitsapplica-tion [2]. The guidelines states that ‘specialists in cardiovascular diseasemust interact with generalists and specialists in other areas and haveknowledge of other specialties to provide excellent patient care. Close