THE CURRENT LANDSCAPE OF CARDIAC CATHETERIZATION TRAINING IN CANADA: A NATIONWIDE SURVEY OF CORE CARDIOLOGY TRAINEES

Abstract

<h3>BACKGROUND</h3> The Royal College of Physicians and Surgeons of Canada (RCPSC) provides training objectives for cardiac catheterization and hemodynamics for adult cardiology training in Canada. We evaluated current core cardiology trainee perspectives on cardiac catheterization training across Canada and identified potential barriers to pursuing a career in interventional cardiology (IC). <h3>METHODS AND RESULTS</h3> Residents from all cardiology training programs across Canada (n=15 programs) were provided open and closed ended questions regarding the ability of their programs to address the mandatory components of their core angiography rotations. Programs were divided based on size for analysis. A small program was defined as ≤ 10 total trainees, a medium program as 11-15 trainees and a large program as > 15 trainees. Survey responses were received from 82 residents (82/206, 40% response rate). There was equal representation from all three years of training (post-graduate year (PGY)-4: n=24, 30%, PGY-5: n=28, 35%, PGY-6: n=29, 36%) and 39% of respondents were female (n=32). Overall 91% of trainees (n=70/77) felt that their program met the RCPSC requirements for cardiac catheterization. Of the trainees who felt that their training was inadequate, most common reasons indicated were lack of right heart catheterization exposure and lack of structured teaching specifically related to hemodynamics. When stratified by PGY of training or program size, there were no statistically significant differences in comfort with procedural skills or hemodynamic interpretation. The proportion of teaching by faculty was higher in small programs (p=0.039). There was a higher proportion of trainees who indicated that they had no structured cardiac catheterization teaching in medium sized programs (p=0.041). Only 22% of residents (n=18) identified IC as a career goal. Trainee-identified barriers to a career in IC are outlined in Figure 1 and stratified by gender. Lifestyle and family considerations were the two most common barriers with no statistically significant difference between genders (p=1.000 and p=0.18 respectively). Sexism was identified as a barrier only by female trainees (n=12/32, 38%, p < 0.0001) and length of training was identified more frequently as a barrier by male trainees (n=25/50, 50%, p=0.037). <h3>CONCLUSION</h3> Regardless of program size, the majority of Canadian cardiology trainees feel the RCPSC requirements for cardiac catheterization are met by their programs. Lifestyle and family considerations were the most common barriers to interventional training. Sexism was also identified as a common barrier amongst women. Creating an environment that promotes diversity, equity and inclusivity is crucial for all programs across Canada.