CARDIOLOGY  

DEFINITION:Cardiology is a medical subspecialty concerned with the prevention, diagnosis, management, and rehabilitation of patients with diseases of the cardiovascular system. A cardiologist is a specialist who is an expert in the diagnosis and management of all aspects of cardiovascular disease.

GENERAL OBJECTIVES:On completion of the cardiology residency program the cardiologist will be able to function as a consultant in the essential roles and key competencies of cardiologists: medical expert/clinical decision maker, communicator, collaborator, manager, health advocate, scholar, and professional. The graduate cardiologist will have achieved the following general educational objectives and be able to:

• Provide excellent, comprehensive, and evidence based diagnosis and management for patients with cardiovascular disorders.
• Counsel patients and the broader community on prevention and rehabilitation of diseases of the cardiovascular system.
• Communicate effectively and compassionately with patients and their families.
• Communicate constructively and effectively with other physicians (especially referring physicians) and other health care professionals.
• Function as a member of the health care team, and coordinate the team as appropriate.
• Contribute to the education of students, other physicians, other health care professionals, and patients and their families.
• Perform necessary technical skills specific to management of patients with cardiovascular diseases.
• Maintain complete and accurate medical records.
• Be able to undertake accurate self-appraisal, develop a personal continuing education strategy, and pursue lifelong mastery of cardiology.
• Be able to critically evaluate the cardiology literature and apply pertinent information to patient management.

During the cardiology residency program the resident must undertake a broad range of practical clinical experiences including acute and chronic cardiac care, ambulatory care, and prevention and rehabilitation; attend a program of formal education activities; and have exposure to and involvement with current research activities. The resident must demonstrate the knowledge, skills and attitudes relating to gender, culture and ethnicity pertinent to adult cardiology. In addition, all residents must demonstrate an ability to incorporate gender, cultural and ethnic perspectives in research methodology, data presentation and analysis. The resident must assume graduated responsibility for clinical decision making and patient care, and be able to function as an independent clinical decision maker at graduation.

SPECIFIC OBJECTIVES:The educational objectives detail the knowledge, skills, and attitudes essential in the training of the cardiologist.

Medical Expert/Clinical Decision-Maker

General Requirements

• Demonstrate diagnostic and therapeutic skills for ethical and effective patient care.
• Access and apply relevant information to clinical practice.
• Demonstrate effective consultation services with respect to patient care, education, and legal opinions.

Specific Requirements

Cardiologists are experts in all aspects of the diagnosis and management of cardiovascular disease. The cardiologist is able to practice contemporary, evidence based, and cost-effective medicine, and avoid unnecessary or harmful investigations or management. The cardiologist has specific technical skills in diagnostic and therapeutic techniques.

Cardiologists must be able to provide care to diverse communities. Residents must demonstrate the appropriate knowledge, skills, and attitudes relating to gender, culture, and ethnicity, and must understand the importance of these perspectives in research methodology, data presentation, and analysis.

The resident will demonstrate the following knowledge and skills necessary for excellent patient care:

KNOWLEDGE
These objectives are based on the major disease processes encountered in cardiology. Objectives are listed once in the most appropriate category. Each section includes specific domains of knowledge, and clinical problems that should be mastered by the graduate cardiologist.

For each clinical problem the graduate cardiologist is able to perform a complete and accurate cardiovascular history and physical examination, formulate appropriate differential and provisional diagnoses, develop an appropriate plan of investigation and interpret the results, develop a therapeutic plan, develop a plan of secondary prevention, and demonstrate appropriate clinical judgement including consideration of such factors as: the patient's age and other health status; risks, benefits, and costs of diagnostic and therapeutic strategies; and alternative management approaches.

Where the term "pharmacology" is used it refers to mechanisms of action, clinically relevant pharmacokinetics, indications, contraindications, and adverse effects.

1.Coronary Artery Disease

Knowledge

• Normal coronary anatomy
• Physiology of normal and abnormal coronary blood flow
• Normal and abnormal endothelial function
• Pathogenesis of atherosclerosis
• Risk factors for atherosclerosis and their management
• Pathophysiology of acute coronary syndromes
• Non-atherosclerotic causes of ischemia and infarction
• Diagnostic techniques for coronary disease, including their sensitivity and specificity
• Pharmacology of anti-ischemic, antiplatelet, anticoagulant, thrombolytic and lipid-lowering agents
• Revascularization procedures: percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass graft (CABG), their indications, contraindications and benefits.
• Gender differences important in the diagnosis and management of coronary artery disease
• Ethnic differences important in the incidence of coronary artery disease

Clinical problems

• chest pain - acute and chronic
• chronic stable angina
• acute coronary syndromes
• acute myocardial infarction including complications
• hypotension/shock
• post-myocardial infarction management
• asymptomatic coronary artery disease.

2.Valvular Heart Disease

Knowledge

• Normal valve structure and function
• Pathology of valvular disease
• Pathophysiology and hemodynamics of valvular stenosis and regurgitation
• Diagnostic techniques
• Valve surgery: indications, timing, outcome
• Prosthetic valves: types, complications, natural history

Clinical Problems

• Acute and chronic mitral regurgitation
• Mitral valve prolapse
• Acute and chronic aortic regurgitation
• Aortic stenosis
• Mitral stenosis
• Tricuspid valve disease
• Endocarditis: diagnosis, treatment, and prophylaxis
• Rheumatic fever: diagnosis and prophylaxis
• Patients with prosthetic valves: management and follow-up

3.Congenital Heart Disease

Knowledge

• Basic cardiac embryology
• Intracardiac shunting: hemodynamics, pathophysiologic effects
• Congenital lesions in which survival to adulthood is likely
• Congenital lesions in which post-operative survival to adulthood is likely

Clinical Problems

• Atrial septal defect
• Ventricular septal defect
• Patent ductus arteriosus
• Coarctation of the aorta
• Ebstein's anomaly
• Congenital coronary anomalies
• Eisenmenger's syndrome
• Cyanotic congenital heart disease in the adult
• Tetralogy of Fallot

4.Congestive Heart Failure

Knowledge

• Physiology of normal and abnormal ventricular systolic and diastolic function
• Hemodynamic abnormalities in heart failure
• Neurohormonal abnormalities in congestive heart failure
• Ventricular remodeling
• Etiology, prognosis, and natural history of congestive heart failure
• Pharmacology of diuretics, vasodilators, ionotropes, and beta blockers in patients with congestive heart failure

Clinical Problems

• Chronic congestive heart failure
• Acute exacerbation of congestive heart failure
• Congestive heart failure in the patient with coronary artery disease
• Dilated cardiomyopathy
• Myocarditis
• Hypertrophic cardiomyopathy: obstructive and non-obstructive
• Restrictive cardiomyopathy
• Cardiac transplantation: indications, contraindications, prognosis, management of the post-transplant patient

5.Hypertension

Knowledge

• Definition
• Diagnosis
• Effect of hypertension on target organs
• Effect of treatment on mortality and complications
• Secondary causes: screening, diagnosis, and management
• Pharmacology of antihypertensive agents

Clinical Problems

• The "new" hypertensive patient
• Chronic hypertension
• Hypertensive urgencies and emergencies

6.Pulmonary Vascular Disease

Knowledge

• Normal pulmonary vascular physiology
• Hemodynamics of pulmonary hypertension
• Pharmacology of pulmonary vasodilator agents

Clinical Problems

• Pulmonary embolism
• Primary pulmonary hypertension: natural history, diagnosis, and management
• Secondary causes of pulmonary hypertension: etiology, diagnosis, and management

7.Pericardial Disease

Knowledge

• Pericardium: normal anatomy and function
• Effect of pericardial disease on cardiac hemodynamics and function
• Pathology and etiology of pericardial diseases

Clinical Problems

• Pericarditis: acute, chronic, and relapsing
• Post-cardiotomy syndrome
• Pericardial effusion
• Pericardial tamponade
• Pericardial constriction

8.Aortic, Cerebrovascular, and Peripheral Vascular Disease

Knowledge

• Cerebrovascular disease: etiology and risk factors, presentations, cardiac causes of stroke and transient ischemic attack (TIA), treatment options
• Aortic disease: pathology, etiology
• Peripheral vascular disease: risk factors, clinical presentations, treatment options

Clinical Problems

• Aortic dissection: diagnosis, medical management, indications for surgery, and follow-up
• Aortic aneurysms: prognosis, indications for surgery
• Marfan's syndrome
• Acute peripheral arterial occlusion: principles of diagnosis and management
• Claudication: principles of diagnosis and management
• Stroke and transient ischemic attack: principles of diagnosis and management
• Management of patients with combined cardiac disease and carotid or peripheral vascular disease.

8.Acute Cardiac Care

Knowledge

• Hemodynamics: normal and abnormal systemic and pulmonary flows, pressures, and resistances
• Ventilation in patients with primary cardiac disease: indications, principles of management
• Pharmacology of inotropes, vasopressors, vasodilators
• Systemic and non-cardiac complications in the critically ill patient

Clinical Problems

• Acute pulmonary edema
• Cardiogenic shock
• Cardiac arrest
• Recurrent ventricular arrhythmias ("electrical storm")

9.Electrophysiology

Knowledge

• Normal cellular electrophysiology
• Normal sinoauricular (SA) node, auriculoventricular (AV) node, and conducting system function
• Mechanisms of arrhythmogenesis
• Mechanisms of conduction abnormalities
• Pharmacology of antiarrhythmic agents
• Temporary and permanent cardiac pacing: techniques, indications, and follow-up
• Antitachycardia devices
• Invasive electrophysiology studies: indications, techniques, complications
• Invasive ablative techniques for tachyarrhythmias: indications, complications

Clinical Problems

• Palpitations
• Syncope
• Resuscitated sudden death
• Supraventricular tachyarrhythmias
• Atrial fibrillation
• Wolff-Parkinson-White syndrome
• Ventricular tachyarrhythmias
• Bradyarrhythmias

10.Pregnancy in Patients with Cardiovascular Disease

Knowledge

• Normal cardiovascular physiologic changes in pregnancy and their effect in patients with heart disease
• Use of cardiovascular drugs in pregnancy

Clinical Problems

• High-risk cardiac lesions in pregnancy (cyanotic congenital heart disease, pulmonary hypertension, cardiomyopathy and congestive heart failure, Marfan's syndrome, valvular obstruction)
• Common congenital and valvular diseases
• Patients with prosthetic valves
• Arrhythmias
• Hypertension

11.Other topics

• Perioperative evaluation and management of the patient with cardiovascular disease undergoing noncardiac surgery
• Cardiac trauma: diagnosis and management
• Cardiac tumours: diagnosis, natural history, management
• Cardiac complications of systemic diseases

SKILLS

1.Expertise in the complete cardiovascular history and assessment.

2.Mastery of all aspects of the cardiovascular examination including carotid and peripheral arterial assessment, jugular veins, precordium, auscultation, and systemic manifestations of cardiovascular disease.

3.Problem solving and clinical decision making, including the ability to correlate, evaluate, and priorize information acquired by clinical assessment, formulate an appropriate problem list, and develop and implement a diagnostic and therapeutic plan using appropriate knowledge derived from clinical appraisal of relevant literature.

4.Technical skills: the resident will understand the indications, contraindications, complications, and interpretation and have experience in the performance of the following: electrocardiogram (ECG), exercise stress testing, Holter monitoring, pericardiocentesis, temporary transvenous pacing, hemodynamic monitoring (arterial line and Swan-Ganz catheter), and electrical cardioversion.

The resident will understand the indications, contraindications, complications, and interpretation of the following techniques: cardiac catheterization and angiography, echocardiography (transthoracic, transesophageal, and Doppler studies), percutaneous coronary interventions, invasive electrophysiologic studies, nuclear imaging techniques, permanent pacemaker insertion, and intra-aortic balloon counterpulsation.

5.Consultation skills, including the ability to present clear and pertinent assessments and recommendations in written and verbal form, participate constructively as part of a team of other physicians and other health professionals, ensure appropriate follow-up and reassessment of the patient's progress, and ensure maintenance of appropriate records.

Communicator

General Requirements

• Establish therapeutic relationships with patients and families.
• Obtain and synthesize relevant history from patients, families and their communities.
• Listen effectively.
• Discuss appropriate information with patients and families and the health care team.

Specific Requirements

To provide the best possible care the cardiologist must establish effective relationships with patients, families, other physicians, and other health professionals. Communication skills are essential to obtain a history from and convey information to patients and families, and to establish a relationship characterized by trust, understanding, and compassion.

The resident will demonstrate the ability to:

• Listen carefully, obtain and synthesize relevant history from patients and families.
• Present relevant information clearly, concisely, and accurately, in written and verbal format, and maintain appropriate records.
• Educate patients, families, and other health professionals in formal and informal settings with regard to the patient's condition, management, risk factors, and secondary prevention.
• Demonstrate caring, empathy, understanding, and confidentiality.
• Understand the impact of such factors as age, gender, disability, ethnocultural background, and socioeconomic background on the patient's history, relationships, and ability to comply with a therapeutic program.
• Identify and discuss end-of-life issues with the patient and family, demonstrating compassion, respect, and understanding.

Collaborator

General Requirements

• Consult effectively with other physicians and health care professionals.
• Contribute effectively to other interdisciplinary team activities.

Specific Requirements

Cardiologists work in partnerships with other health professionals involved in the care of their patients, and it is essential for cardiologists to collaborate effectively with a multidisciplinary team of health care workers.

The resident will demonstrate the ability to:

• Consult with other physicians and other health care professionals, and to understand their roles and contributions.
• Contribute effectively and constructively to multidisciplinary team activities, contribute to team development, and recognize areas of expertise and value opinions of other team members.

Manager

General Requirements

• Utilize resources effectively to balance patient care, learning needs, and outside resources.
• Allocate finite health care resources wisely.
• Work effectively and efficiently in a health care organization.
• Utilize information technology to optimize patient care, life-long learning, and other activities.

Specific Requirements
Cardiologists function as managers when they make practice decisions involving co-workers, resources, and policies. Cardiologists must priorize and execute tasks, work effectively with colleagues, and make appropriate decisions regarding the location of finite health care resources. Cardiologists  frequently  assume  positions of leadership in the health care system.

The resident will demonstrate:

• Practice and time management skills including punctuality, planning, prioritization, and triage skills.
• Understanding of the advantages and disadvantages of health care in a variety of settings, including hospitals, ambulatory care clinics, offices, homecare, and chronic care and rehabilitation facilities.
• Understanding of the cost and cost-effectiveness of therapeutic and preventive health programs, and the ability to make appropriate decisions based on evidence of benefit to the patient and population served.
• Understanding of quality assurance and quality improvement programs, and the ability to develop appropriate programs in their areas of responsibility.
• The ability to use information technology as an important tool in optimal patient management.
• The ability to organize and coordinate the work of the health care team as a patient's most responsible physician.

Health Advocate

General Requirements

• Identify the important determinants of health affecting patients.
• Contribute effectively to improved health of patients and communities.
• Recognize and respond to those issues where advocacy is appropriate.

Specific Requirements

Cardiologists have an important role in advocating health promotion for individual patients, their practice populations, and the broader community. Health advocacy is undertaken by individual cardiologists and their professional organizations.

The resident will:

• Be able to identify the biologic, psychosocial, environmental, and economic determinants of health, utilize this information in a management and prevention plan, and ensure that the patient accesses appropriate health and social services in the management of individual patients.
• Be able to identify patient groups at risk of cardiovascular disease and its complications within a practice population, and apply available knowledge regarding primary and secondary prevention.
• Identify issues and opportunities for contributing to the improvement of cardiovascular health in the broader community.

Scholar

General Requirements

• Implement, and monitor a personal continuing education strategy.
• Critically appraise sources of medical information.
• Facilitate learning of patients, housestaff/students and other health professionals.
• Contribute to development of new knowledge.

Specific Requirements
Cardiologists undertake a lifelong pursuit of mastery of cardiology, and have the responsibility for ongoing self-directed learning. They contribute to the education of students, patients, and colleagues, and contribute to research and its appraisal and application.

The resident will:

• Be able to develop and utilize a self-directed continuing education strategy.
• Know and be able to apply the principles of critical appraisal to sources of medical information.
• Know and apply the evidence based standards of care to cardiovascular diseases.
• Understand the importance of ongoing research in cardiovascular disease, will participate and contribute to clinical and/or basic research, and will demonstrate a questioning and inquisitive approach to medical information.
• Contribute to the education of students, patients, and other health professionals.

Professional

General Requirements

• Deliver highest quality care with integrity, honesty, and compassion.
• Exhibit appropriate personal and interpersonal professional behaviours.
• Practice medicine ethically consistent with obligations of a physician.

Specific Requirements

Cardiologists have a unique role in society as professionals dedicated to improving the cardiovascular health of patients in their communities. Cardiologists are committed to the highest standards of excellence in clinical care and ethical conduct, and are committed to acting with integrity, honesty, and compassion.

The resident will:

• Understand and apply the basic principles of medical ethics including: informed consent, advanced directives, research ethics, patient autonomy, and justice.
• Understand the nature of professional interpersonal relationships and boundaries with patients, co-workers, and students.
• Understand legal and professional obligations that apply to cardiology including preparation of timely and accurate medical-legal reports, responses to regulatory bodies, notification of coroners, and substitute decision making.

All of the resident's clinical care, education, and research activities will be characterized by integrity and honesty.

CONTENT AND ORGANIZATION OF THE RESIDENCY PROGRAM:

There must be an organized program of rotations and other educational experiences, both mandatory and elective, designed to provide each resident with the opportunity to fulfill the educational requirements and achieve competence in the specialty.

Adult cardiology is based on certification in internal medicine which should include a clinical core experience, organized to include mandatory components (those elements essential for all residents) and elective components (those elements dependent upon the resident's interest and career plans). In some cases these experiences may be offered concurrently rather than in sequential blocks of time.

The content and organization of each accredited program in adult cardiology must be consistent with the specialty training requirements as outlined in the document.

The program must be organized such that residents are given graded responsibility, under appropriate supervision, according to their level of training, ability and experience.

It must be recognized that the usual three years of residency does not permit the resident to achieve competence in all subspecialty areas of cardiology. To achieve expertise in highly specialized facets of cardiology, the resident will require additional training.

RESOURCES:There must be sufficient resources including teaching faculty, the number and variety of patients, physical and technical resources, as well as the supporting facilities and services necessary to provide the opportunity for all residents in the program to achieve the educational objectives and receive full training as defined by the specialty training requirements in adult cardiology.

In those cases where a university has sufficient resources to provide most of the training in adult cardiology but lacks one or more essential elements, the program may still be accredited provided that formal arrangements have been made to send residents to another accredited residency program for periods of appropriate prescribed training.

1. Teaching Faculty

There must be:

1. a sufficient number of qualified and dedicated teaching staff to supervise residents at all levels and in all aspects of cardiology and provide teaching in the basic and clinical sciences related to cardiology.
2. a member of the faculty specified as the person responsible for each rotation and, whenever possible, this should be a cardiologist.
1. Number and Variety of Patients

There must be a sufficient number and variety of patients available to the program to provide each resident registered in the program with the opportunity to meet the following specific objectives:

a.       to provide each resident extensive opportunity for exposure to major cardiac diseases, including coronary artery disease, valvular heart disease, rheumatic heart disease, pericardial heart disease, congenital heart disease, arrhythmias, cardiomyopathies, hypertensive heart disease, heart disease in diabetics, heart disease in patients with renal disorders, heart disease in pregnancy and congestive heart failure;

2. to provide each resident extensive opportunity in the initial assessment and consultative service to patients presenting with emergency cardiac conditions.
2. Clinical Services Specific to Adult Cardiology

There must be:

1. a coronary care unit organized as a clinical teaching unit under the direction of an appropriately qualified cardiologist. This must have the facilities for the complete management of seriously ill cardiac patients including invasive hemodynamic monitoring and temporary pacemaker insertion. Facilities for ventilatory support should be available in the unit or in an adjacent facility. Access to a medical intensive care unit with expertise in management of multi-system disease is also essential. All necessary consultative and laboratory services must be available;
2. a cardiology service organized for teaching for the investigation and treatment of patients with a wide variety of cardiac pathologies;
3. a consultation service to provide experience in elective and emergency consultations in patients with cardiac diseases;
4. Laboratories appropriately organized for teaching and dedicated to:
   1. cardiac catheterization and interventional cardiology
   2. echocardiography including transesophageal echocardiography
   3. electrophysiology/pacemaker
   4. electrocardiography including stress testing and ambulatory electrocardiography
   5. nuclear cardiology
5. ambulatory care facilities to provide residents with experience in the broad range of non-hospitalized patients with cardiac problems. This experience should include, but not be limited to, pre-admission work-up and post-discharge follow-up care.
6. an active clinical teaching service in pediatric cardiology;
7. access to a cardiac rehabilitation program is desirable.
3. Supporting Services — Clinical, Diagnostic, Technical

There must be:

1. an active clinical teaching service in cardiac surgery, given the importance of cardiac surgery in the management of patients with heart disease and the need for cardiologists to manage these patients in the early and late post-operative period;
2. an active clinical teaching service in internal medicine;
3. an Emergency Department;
4. a Department of Pathology - able to provide gross anatomical, histological, biochemical and microbiological services for the study of cardiovascular problems;
5. a Department of Radiology - with a radiologist experienced in the basic investigative techniques in cardiovascular radiology, and access to newer investigative techniques such as MRI, PET, fast CT;
6. university expertise in basic sciences related to adult cardiology, particularly biochemistry, pharmacology and physiology;
7. a respiratory medicine service with a pulmonary function laboratory;
8. other supporting services including nuclear medicine, genetics, immunology, nutrition, psychology and biomedical electronics.
4. Resources For Community Learning Experiences

In order for residents to develop experience with the community practice of clinical cardiology, wherever possible linkages should be developed with community cardiologists who are willing and able to provide an excellent learning experience.

ACADEMIC AND SCHOLARLY ASPECTS OF THE PROGRAM:

The academic and scholarly aspects of the program must be commensurate with the concept of a university postgraduate education. The quality of scholarship in the program will in part, be demonstrated by a spirit of enquiry during clinical discussions, rounds, and conferences. Scholarship implies an in-depth understanding of basic mechanisms of normal and abnormal states and the application of current knowledge to practice. Service demands must not seriously interfere with the ability of the residents to follow the academic program.

1.      Organized Scholarly Activities

There must be a regular series of rounds including such topics as cardiology grand rounds, case conferences, mortality rounds, journal club, research rounds, diagnostic rounds, etc. The program should endeavour to have a seminar program or clinical half day where topics can be discussed for the benefit of the residents alone in an in-depth fashion. Service demands must not seriously interfere with the ability of the residents to follow the academic program.

2. Basic and Clinical Sciences Relevant to Adult Cardiology

The educational program must provide opportunities for residents to learn and demonstrate:

a.       cardiac metabolism and biochemistry

b.      cardiocirculatory physiology

c.       cardiovascular anatomy

d.      cardiovascular electrophysiology and electrocardiology

e.       cardiovascular pathology

f.        cardiovascular pathophysiology

g.       cardiovascular pharmacology

h.       cardiovascular rehabilitation principles

i.         congenital heart disease

j.        heart disease in pregnancy

k.      hypertension

l.         imaging, especially chest radiography, echo/Doppler, nuclear techniques and cardiac catheterization

m.     lipid disorders

n.       prevention of cardiovascular disease

The program must also provide teaching in the following areas:

o.      cardiovascular epidemiology

p.      molecular biology as it relates to the cardiovascular system

q.      peripheral and cerebral vascular disease

r.        principles of newer techniques such as MRI, fast CT, PET scanning etc.

s.       pulmonary vascular disease

t.        principles and application relating to the improvement of quality of care and resource utilization

u.       transplantation

v.       medical-legal issues as they apply to cardiology

3. Biomedical Ethics

Mechanisms must be in place to ensure that issues related to biomedical ethics as applied to cardiology are incorporated in the program.

4. Communication Skills

Residents must receive instruction, feedback and evaluation regarding their ability to communicate in a formal setting such as in delivering a lecture. They must also be given instruction, feedback and evaluation in their use of informal communication skills with patients and their families, peers and allied health personnel.

5. Teaching Skills

Opportunities for residents to carry out teaching must be developed and appropriate constructive feedback given. Residents should be expected to demonstrate teaching effectiveness.

6. Quality Assurance/Improvement

Residents must be provided with opportunities to gain an understanding of the principles and practice of quality assurance/improvement. Residents should be involved in the performance of quality assurance projects during their training.

7. Research Opportunities for Residents

The program must provide the opportunity for residents to learn biostatistics and the critical appraisal of research methodology and medical literature. Each resident should be encouraged to carry out an appropriately sized research project during their residency program. Protected time needs to be developed to carry out the project and faculty should provide appropriate supervision. Faculty support for hypothesis generation, study design and data analysis should be available.

8. Faculty Research

There must be sufficient faculty research ongoing to develop an atmosphere of thoughtful inquiry sufficient to stimulate residents to acquire new knowledge. Residents need to be stimulated to continue the learning process throughout their academic careers.

9. Outside Conferences

The program should provide opportunities for residents to attend conferences outside their own university.

SPECIALTY REQUIREMENTS:

1.       Certification in Internal Medicine.

2.       Approved residency in an approved Adult Cardiology residency program.

PROGRAMS (WITH TRAINING REQUIREMENTS):

Diplomas(Dip):

Six months of approved residency training.

Doctor of Medicine(M.D):

Eighteen months of approved residency training.

Doctor of Philosophy(Ph.D):

Forty eight months(four years)of approved residency training.