sub speciality pci training in the united kingdom
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Sub speciality PCI training in the United Kingdom. Tim Gray Cardiology SpR Manchester Heart Centre. Current System. Currently no formal arrangements for sub-speciality training: Arrangements for sub-speciality training made at deanery and trust level No formal training programme

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sub speciality pci training in the united kingdom

Sub speciality PCI training in the United Kingdom

Tim Gray

Cardiology SpR

Manchester Heart Centre

current system
Current System
  • Currently no formal arrangements for sub-speciality training:
    • Arrangements for sub-speciality training made at deanery and trust level
    • No formal training programme
    • Often ad hoc start to training
    • No clear end goals
    • No proficiency assessment
current training model
Current Training model
  • Ad hoc apprenticeship based training
proposed training model
Proposed training model
  • Apprenticeship based training
  • DOPS (Directly observed procedural skill) assessment
  • 3 monthly appraisal by Supervisors and exit appraisal by Training director
  • Examination (in association with European Society)
problems now
Problems Now
  • European Working Hours Directive
    • Reduced PCI exposure
    • Reduced continuity of care
    • Reduced emergency experience
  • SpR competition leading to several trainees with partial training
  • Competition for PCI from established consultants re-training
  • Dilution of training with other clinical pressures
problems now6
Problems now

BJCA survey 2005

benefits of change
Benefits of change
  • Minimum standard for clinical competence
  • Higher quality of candidates if competitive selection
  • Higher SpR motivation
  • Stimulates focus on peri-procedural care as well as cath lab time
benefits of change8
Benefits of change
  • Allows focus on sub-speciality
  • Allows for dedicated teaching sessions by motivated trainers.
problems of change10
Problems of change
  • The interview process
    • Huge regional variation in first few years
    • Will there be a national recruitment?
    • Less likely to have higher degree
    • Trainees themselves may be less likely to appreciate sub-specialities
    • Interview process needs to be open and transparent
problems of change11
Problems of change
  • What happens if fail to secure training placement?
    • Forced to choose different sub-speciality?
    • Take time out to find appropriate placement?
  • Will trainees be expected to move around the country to find a programme?
  • ?encourage local vs regional vs overseas fellows
slide12
Possibility of increased training time
  • What happens about overseas fellowships?
conclusion
Conclusion
  • Change to a formal training programme is welcomed
  • Ideal time to instigate change in sub-speciality training
  • Need to decide on recruitment process soon.
slide14
Thank you
  • Questions?
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