Specialist training programme in cardiology - malta · S p e c i a l i s t T r a i n i n g P r o g r a m m e C a r d i o l o g y – M a l t a P a g e | 5 Definition of Roles Cardiology

Maltese Cardiac Society

Specialist Training Programme in Cardiology

Malta

1st May 2018

S p e c i a l i s t T r a i n i n g P r o g r a m m e C a r d i o l o g y – M a l t a P a g e | 1

Contents

Introduction ............................................................................................................................................ 2

Background and Overview ...................................................................................................................... 3

Definition of Roles ................................................................................................................................... 5

Entry Criteria ........................................................................................................................................... 6

Duration of the STPC ............................................................................................................................... 6

The Components of the STPC ................................................................................................................. 7

Theoretical Knowledge of Core curriculum topics .............................................................................. 7

The EEGC ............................................................................................................................................. 8

Workplace-based assessments ........................................................................................................... 9

Clinical Case Logbook ...................................................................................................................... 9

Practical Cardiology Skills .............................................................................................................. 11

Patient Safety Logbook ................................................................................................................. 14

360° Appraisals.............................................................................................................................. 17

Requirements for developing the clinical leader .............................................................................. 18

Requirements for developing the clinical teacher ............................................................................ 19

Requirements for developing the clinical scientist ........................................................................... 20

Requirements for developing the Heart Team member .................................................................. 21

Mandatory Certificates ......................................................................................................................... 22

Role of experience in foreign centres ................................................................................................... 22

Frequency of trainer/trainee encounter and ARCPs ............................................................................ 22

Pattern of clinical assignments during the STPC ................................................................................... 23

The STPC Timeline ................................................................................................................................. 24


Introduction

The Maltese Cardiac Society (MCS) is the professional body overseeing the process of selecting

candidates for the Specialist Training Programme in (Adult) Cardiology (STPC), ensuring high quality

training whilst fulfilling the demands of service provision, and nominating trainees who have

successfully completed the STPC for a Certificate of Completion of Specialist Training (CCST), as

recognised by the Specialist Accreditation Committee (SAC).

The organisation directly responsible for running the STPC is the Cardiology Post-Graduate Training

Committee, which currently consists of the Training Director, the National Training Co-ordinator and

MCS representative. The Cardiology Post-Graduate Training Committee is responsible for updating

this document, running the e-portfolio, reviewing evidence of trainees’ progress, receiving

suggestions, appeals and complaints from both trainers and trainees, and liaising with both national

and international professional and certifying bodies.

This document outlines the minimum requirements for successfully completing a STPC in Malta. We

hope that, with publication of this document, the training process can be rendered as transparent

and equitable as possible, and that we can deal more effectively with appeals to the Cardiology Post-

Graduate Training Committee.

The evolution of European educational programmes and the increasing role of technology in

monitoring and facilitating trainee progress will lead to changes to this document in the near future.

In addition, the field of Cardiology, like all other medical specialties, is constantly evolving, a typical

example being the emphasis on the Heart Team in daily clinical decision making, and the recent

expansion in the repertoire of new devices, percutaneous interventions, imaging technology and

drugs.

The Cardiology Post-Graduate Training Committee reserves the right to amend and develop this

programme in the future, based on changing circumstances and experience gained, whilst

recognising that the SAC must endorse any proposals for substantial alterations as submitted

through the appropriate official channels.

Dr Alexander N Borg, National Training Coordinator, Cardiology Post-Graduate Training Committee

Dr Robert G Xuereb, President, Maltese Cardiac Society, and Training Director, Cardiology Post-

Graduate Training Committee

May 2018


Background and Overview

The STPC in Malta is intimately linked with the European Society of Cardiology (ESC) Core Curriculum

2013 (Gillebert et al. European Heart Journal 2013;34:2381-2411) and online e-portfolio (known as

ESC e-learning platform or ESCel – https://learn.escardio.org). The former stipulates the skills and

knowledge required for being recognized as a specialist in Cardiology, while the latter (Maltese

participation invited and accepted in June 2016, initially piloted for free and then provided against

payment) provides guidance and logbook facilities during the process of acquiring theoretical

knowledge, practical clinical case mix, procedural skills, 360° appraisals, experience in patient safety

issues and professional development. All sections are accessible in 3 modules: Knowledge, Skills and

Professional Development. We have opted to adhere closely to this system primarily because the

ESC has established a rigorous set of benchmarks which are thought to represent the optimal

standard of care across European countries, whilst allowing each individual country to adapt the

recommendations to local circumstances. Secondly the MCS is a member and active contributor in

the ESC, including the training subcommittees and activities. Thirdly Malta is one of the first

countries to adopt the European Exam in General Cardiology (EEGC), which was piloted locally in

June 2016. Finally, it is the explicit aim of the ESC to harmonise the quality of training and cardiac

care across Europe, whilst recognizing that there each country has its own challenges, and that there

are many obstacles to achieving a single pan-European curriculum (such as language, organisation of

certifying bodies, political situation, etc…).

The duration of the STPC in Malta is 4 years. The first 3 years should be spent in active rotation

through all the cardiology subspecialties, while the last 1 year should be dedicated to training and

experience in a chosen subspecialty.

In this document, we aim to provide an outline of the year-by-year, and final summative

requirements to be eligible for a CCST in Cardiology in Malta, ie the STPC. The components of the

STPC which will be presented are as follows:

(a) Theoretical knowledge of core curriculum topics

(b) The EEGC

(c) Workplace-based assessments

(i) Procedures

(ii) Clinical cases

(iii) 360° appraisals

(iv) Patient safety logbook

(d) Requirements for developing the clinical leader

(e) Requirements for developing the clinical teacher

(f) Requirements for developing the clinical scientist

(g) Requirements for developing the Heart Team member

Points (a) to (c) are covered in the ESCel e-portfolio platform, as are components of (e) and (f).

https://learn.escardio.org/


We will also stipulate the frequency of informal trainer/trainee encounters, formal review of

competence and performance, and put it all in context in the STPC Timeline.

We will describe what we believe is mandatory certification for a CCST in Cardiology.

Finally, we will define the role of training and experience in foreign centres of excellence.


Definition of Roles

Cardiology Post Graduate Training Committee: Consists of the Training Director, National Training

Co-ordinator, and MCS representative as a minimum. In the future, other members from the

Cardiology Consultant body may be recruited.

Training Director: Responsible for overseeing trainers and trainees. Together with the National

Training Co-ordinator, is responsible for selecting candidates for the STPC, and the nomination of

trainees who have successfully completed the STPC for specialist accreditation by the SAC.

National Training Coordinator (NTC), also known as Training Co-ordinator: assists in the process of

selecting trainees and nominating candidates for CCST. Liaises with the ESC in all trans-national

educational activities. Responsible for enrolling candidates and local trainers on the ESCel platform,

and reporting to the ESC in case of technical problems. Enrols candidates for the EEGC in their 3rd

year of training, and submits all necessary paperwork to the ESC. Also works with the Training

Director in trainees’ job rotas to allow equal and fair exposure to all subspecialties, and in guiding

trainees in their choice of subspecialty in their final year of training. Initiates and co-ordinates the

Annual Review of Competence and Progress (ARCP) meetings.

Local Trainer (LT), also known as Educational Supervisor: a mentor, chosen by trainee. However,

the Training Director and NTC must endorse the selected LT-trainee relationship. The LT may not

have the same subspecialty as that chosen by the trainee. The LT assigned to a trainee is likely to

remain the same throughout the STPC since there is currently only one teaching cardiology

department in Malta, but the LT may be changed under special circumstances.

Clinical Supervisor (CS): The consultant heading the team to which the trainee is assigned. Liaises

with LT on any training issues that might arise during the period the trainee spends with the team.

The CS changes every time the trainee rotates to a new team.

Trainee: the candidate selected to enter the STPC by the Cardiology Post-Graduate Training

Committee, having completed core medical training and passed a competitive interview. The trainee

is responsible for becoming a trainee member of the ESC, enrolling on the ESCel platform and

alerting the NTC in his/her 3rd year of training for enrolment in the EEGC. The trainee is responsible

for organising all meetings with his LT every 3 months for assessment of progress on the ESCel

platform and to discuss other issues that come up during the STPC.


Entry Criteria

To enter the STPC, the candidate must be selected after a competitive interview, and satisfy the

following criteria:

(a) Be in possession of a Certificate of Completion of Basic Specialist Training (CCBST) (or

equivalent) in General Internal Medicine

(b) Be in possession of an MRCP certificate or equivalent

(c) Have an online ESC account

Duration of the STPC

The duration of the STPC in Malta is 4 years. This period can be extended (for valid exceptional

reasons) after notification in writing to the NTC in Cardiology, copied to the Training Director, the LT

on the ESCel platform, and the CS.


The Components of the STPC

Theoretical Knowledge of Core curriculum topics

The theoretical knowledge required to complete the STPC can be divided into 28 topics: (We will not

go into detail of the objectives, and the required knowledge, skills, behaviours and attitudes for each

curriculum topic, as these are covered in the relevant ESC publications):

1. History taking and Examination

2. The Electrocardiogram

3. Non-invasive Imaging

4. Invasive imaging

5. Genetics

6. Clinical Pharmacology

7. Cardiovascular Prevention

8. Acute Coronary Syndromes

9. Chronic Ischaemic Heart Disease

10. Myocardial Diseases

11. Pericardial Diseases

12. Oncology and the Heart

13. Congenital Heart Disease in Adult Patients

14. Pregnancy and Heart Disease

15. Valvular Heart Disease

16. Infective Endocarditis

17. Heart Failure

18. Pulmonary Arterial Hypertension

19. Physical activity and Sport in Primary and Secondary Prevention

20. Arrhythmias

21. Atrial Fibrillation and Flutter

22. Syncope

23. Sudden Cardiac Death and Resuscitation

24. Disease of the Aorta and Trauma to Heart and Aorta

25. Peripheral Artery Disease

26. Thromboembolic Venous Disease

27. Acute Cardiovascular Care

28. The Cardiac Consult

Targets:

(a) Complete and successfully pass 100% of modules on the ESCel platform (in the Knowledge

Module) by the end of 4th year of training

(b) The trainee is expected to regularly view the ESC webinar series, ESC Clinical Case Gallery

and ESC Congress Resources on the ESC website.


The EEGC

The EEGC is an exam consisting of 200 multiple choice questions (with a common stem and 5

options, only one of which is the correct answer). It is organised by the training subcommittee of the

ESC, and Malta contributes questions and participates in standard setting every year. The exam is

held in a Pearson-Vue centre in Malta.

The trainee must pass the EEGC (or equivalent exam) in the 3rd year of training (usually June). Failure

to pass will result in trainee having to re-sit the exam the following year. The final decision on course

of action following multiple failed re-sits rests on the Cardiology Post-Graduate Training Committee,

depending on individual circumstances.

IMPORTANT: The EEGC is only a test of theoretical knowledge and is NOT an exit exam, and it is NOT

intended as a certificate to practice Cardiology.


Workplace-based assessments

Clinical Case Logbook

The trainee must complete the minimum number of clinical cases for each curriculum topic, as

stipulated in table below. A given clinical encounter may satisfy more than one topic.

Myocardial diseases 4

Pericardial Disease 4

Oncology and the Heart 4

Congenital Heart Disease in Adult Patients 4

Pregnancy and Heart Disease 4

Valvular heart disease 4

Infective endocarditis 4

Heart Failure 4

Pulmonary hypertension 4

Physical activity and sport in primary and secondary prevention 4

Arrhythmias 8

Atrial Fibrillation 4

Syncope 8

Ventricular Tachycardia and Sudden Cardiac Death 4

Diseases of the Aorta and Trauma to the Aorta and Heart 4

Peripheral Artery Diseases 4

Thromboembolic Venous Disease 4

The cardiac consult 20

Genetics 4

Cardiovascular prevention 8

Acute Coronary Syndromes (ACS) 4

Chronic Ischaemic Heart Disease 4

In addition, the trainee must observe the following cardiothoracic surgical procedures, keep a log,

and obtain a certificate (see next page for template) from the supervising surgeon:

5 CABG procedures

5 Valve replacement/repair procedures

2 Thoracic Aorta Surgery procedures

Targets:

(a) Complete all requirements on the Case Logbook section of the ESCel platform by the end of

the 4th year of training

(b) All cases must be logged in the Skills module on ESCel, in the Case Logbook section

(c) All cases must be discussed with, and signed off by, the LT during the 3 monthly informal

encounters.


Training Director & National Training Co-ordinator,

Cardiology Post-Graduate Training Committee

Dear …………………………………………………………………………………….,

RE: Observation of Cardiothoracic Surgical Procedures towards obtaining

Certification of Completion of Training in Cardiology (Malta)

This is to certify that Dr. ……………………………………………………………………………………………………….., has

observed the following procedures, as part of the Specialist Training

Programme in Cardiology (Malta):

□ 5 CABG procedures

□ 5 Valve replacement/repair procedures

□ 2 Thoracic Aorta Surgery procedures

Yours sincerely,

Signature:

Name:…………………………………………………………………………………………………..

Date: ………………………………….

Designation: Consultant Cardiothoracic Surgeon


Practical Cardiology Skills

The following is a list of minimum figures for practical procedures required for a CCST in cardiology.

These figures are only intended as a guide. Whilst most figures should be adhered to unless there

are exceptional circumstances, more flexibility is required in some cases. Please refer to comments

in situations which warrant the latter approach.

The level of competence (ranging from I to III) to be achieved by the end of training is defined as

follows:

• Level 1 (Observation): Trainee demonstrates detailed knowledge and understanding and is

aware of common complications/issues related to competence/clinical skill/situation

• Level 2 (Direct Supervision): Trainee is capable of performing the task or managing the

clinical problem but with senior support

• Level 3 (Independent practice): Trainee can manage the majority of cases with no direct

supervision or assistance, while having the insight to recognise that senior support will be

needed in certain complex cases/complications.

In some cases, accreditation based on an exam AND logbook awarded by the ESC or a branch of the

ESC can replace the minimum figure criteria, as noted in the comments.

Abbreviations refer to the required status of the trainee doing the procedure, namely, as first

operator (FO), second operator (SO), or observer (O). In diagnostic tests, (O) also represents cases

where the trainee must be able to interpret the result but is not expected to carry out the procedure

himself/herself; however, he/she MUST be equipped with the necessary skills to do so should the

situation demand.

Procedure Minimum Number

Comments Expected level of Competence

by end of Training

Implantation of temporary pacing wire

10 (FO/SO)

Performance of less procedures than the

stipulated minimum will not result in trainee failing this module,

unless there are other training concerns

III

Arrhythmia ablation 10 (FO/SO/O) I

Electrical cardioversion 10 (FO) III

Implantable loop recorder 5 (FO) III

Ambulatory BP 50 (FO/SO/O) III

CRT programming 20 (FO/SO) II

Stress echo 50 (FO/SO)

Successful relevant ESC exam- and logbook-

based accreditation is an alternative way to satisfy

this criterion

II


Transoesophageal echo 50 (FO)



this criterion

II

Adult Congenital Heart Disease Echo

20 (FO/SO)



this criterion

II

Coronary angiography 300 (FO) III

Treadmill/Bicycle stress ECG 150 (FO) III

Pericardiocentesis 5 (FO/SO)

Performance of less procedures than the

stipulated minimum will not result in trainee failing this module,

unless there are other training concerns

III

Electrophysiological studies 25 (FO/SO/O)



this criterion

II

Adult echocardiography 350 (FO)

Successful completion of Adult Transthoracic Echocardiography

Accreditation obviates this requirement

III

Right heart and PA catheter 20 (FO/SO) III

Ambulatory ECG 100 (FO/SO/O) III

CRT implantation 10 (FO/SO)



this criterion

I

ECG 500 (FO/SO/O) III

ICD implantation 10 (FO/SO)



this criterion

I

Nuclear studies 50 (FO/SO)



this criterion

I

PM/ICD programming 50 (FO/SO) III

PM implantation 20 (FO) II

PCI 20 (FO/SO) I

CMR 50 (FO/SO)

Level I accreditation awarded by an expert

body is acceptable; successful relevant exam- and logbook-

I


based ESC accreditation is an alternative way to

satisfy this criterion

Cardiac CT 50 (FO/SO)

Level I accreditation awarded by an expert

body is acceptable; successful relevant exam- and logbook-

based ESC accreditation is an alternative way to

satisfy this criterion

I

Targets:

(a) Fulfil all requirements on ESCel as stipulated in table above, by end of 4th year of training

(b) All procedures must be logged in the Skills module on ESCel, in the Procedures Logbook

section

(c) All cases must be discussed with, and signed off by, the LT during the 3 monthly informal

encounters.


Patient Safety Logbook

The trainee should record all complications of cardiac procedures or interventions in the Patient

Safety Logbook on ESCel. This list of complications is outlined below. There are no minimum figures,

but the trainee is expected to fill this section when the situation arises. All complications should be

logged in the Skills module on ESCel, in the Patient Safety Logbook section, and signed off by the LT

during one of the informal 3-monthly meetings.

Complication Relevant Procedure/s

1. Cardiac death Various

2. Non-cardiac death Various

3. MI Various

4. Heart Failure (KK 3 or 4) Various

5. Ventilation Various

6. Bronchospasm with need for intervention Various

7. Bronchospasm with need for intervention Various

8. Pneumothorax - conservative Pacemaker/ICD implantation

9. Pneumothorax - drainage Pacemaker/ICD implantation

10. Sedation Various

11. Hypotension (BP < 90 mmHg) with need for intervention Various

12. Arrhythmias AF Various

13. Arrhythmias Sustained VT Various

14. Arrhythmias VF Various

15. Arrhythmias Severe bradycardia (< 40 beats/min) Various

16. Arrhythmias AV Block - grade 1 Various

17. Arrhythmias AV Block - grade 2 Various

18. Arrhythmias AV Block - grade 3 - temporary pacemaker

necessary

Various

19. Arrhythmias AV Block - grade 3 - permanent pacemaker

necessary

Various

20. Arrhythmias Iatrogenic bundle branch block Various

21. Asystole Various

22. Allergic reaction Various

23. Headache Various


24. Infection Various

25. Contrast nephropathy Various

26. Local access complication - Hematoma > 5 cm Invasive angiography/arterial

cannulation

27. Local access complication - Aneurysm Invasive angiography/arterial

cannulation

28. Local access complication - Pseudo aneurysm Invasive angiography/arterial

cannulation

29. Local access complication - AV fistula Invasive angiography/arterial

cannulation

30. Local access complication - Infection/ Ablation Various

31. Local access complication - Haemorrhage Various

32. Local access complication - Retroperitoneal haemorrhage Invasive angiography/arterial

cannulation

33. Local access complication - Local access vessel occlusion Invasive angiography/arterial

cannulation

34. Local access complication - Surgery of local access vessel Invasive angiography/arterial

cannulation

35. Haemorrhage - Minor Various

36. Haemorrhage - Major (needing transfusion/ 3pt Hg) Various

37. Intracranial haemorrhage Various

38. Cardiac perforation - Without tamponade Various

39. Cardiac perforation - With tamponade - Pericardiocentesis Various

40. Cardiac perforation - With tamponade - surgical treatment Various

41. Embolism CVA - complete recovery Various

42. Embolism CVA - incomplete recovery Various

43. Embolism TIA Various

44. Embolism - Systemic embolism Various

45. Embolism - Venous embolism Various

46. Embolism - Deep venous thrombosis Various

47. Embolism - Lung embolism Various

48. Perforation/dissection/thrombosis - Coronary - Perforation

submitted to surgery

Invasive coronary angiography, PCI,

structural interventions

49.Perforation/dissection/thrombosis - Coronary - Perforation

without surgery



50. Perforation/dissection/thrombosis - Coronary - Dissection





51. Perforation/dissection/thrombosis - Coronary - Dissection

without surgery



52.Perforation/dissection/thrombosis - Coronary - Thrombosis




53. Perforation/dissection/thrombosis - Coronary - Thrombosis

without surgery



54.Perforation/dissection/thrombosis - Aortic submitted to surgery Invasive angiography/arterial

cannulation

55. Perforation/dissection/thrombosis - Aortic without surgery Invasive angiography/arterial

cannulation

56. Perforation/dissection/thrombosis - Iliac/femoral submitted to

surgery

Invasive angiography/arterial

cannulation

57. Perforation/dissection/thrombosis - Iliac/femoral without surgery Invasive angiography/arterial

cannulation

58. Perforation/dissection/thrombosis - Carotid submitted to surgery Invasive angiography/arterial

cannulation

59. Perforation/dissection/thrombosis - Carotid without surgery Invasive angiography/arterial

cannulation

60. Perforation/dissection/thrombosis - Peripheral submitted to

surgery

Invasive angiography/arterial

cannulation

61. Perforation/dissection/thrombosis - Peripheral without surgery Invasive angiography/arterial

cannulation

62. Compartment syndrome / limb ischaemia Invasive angiography/arterial

cannulation

63. Phrenic nerve damage - Temporary TOE

64. Phrenic nerve damage - Permanent TOE

65. PV stenosis < 50% AF ablation

66. PV stenosis >50%, asymptomatic AF ablation

67. PV stenosis >50%, symptomatic AF ablation

68. Oesophagus perforation AF ablation, TOE

69. Oesophageal-atrial fistula AF ablation

70. Device loss/fracture Structural interventions

71. Tooth fracture TOE

72. Other Complications Various


360° Appraisals

(a) The trainee must complete two 360° appraisals – one at the end of the 2nd year, and one at

the end of the 4th year. The process for doing this is on ESCel (in the Professional Development

module), and trainees are assessed by their peers and colleagues in 7 fields:

- Medical expert

- Communicator

- Collaborator

- Manager

- Health advocate

- Scholar

- Professional.

(b) A minimum of 9 colleagues, 2 of whom must be consultant cardiologists, should respond to

each appraisal request for the process to be declared valid. Each 360° appraisal must be signed

off by the LT during one of the 3-monthly informal meetings.


Requirements for developing the clinical leader

(b) The trainee should attend and successfully complete a management course for clinicians.

The MCS is currently trying to organise a local course, but any course offered by a reputable

(as judged by the Cardiology Post-Graduate Training Committee) organisation (including

foreign) will be accepted for the time being

(c) The trainee should complete and present 3 audits of local Cardiology service provision by

the end of the 4th year of training. Closing-the-loop re-audits are encouraged. The audits

may be presented or published in national or international meetings and/or peer-reviewed

journals. In case of publication, this will also count towards the “Requirements for

developing the clinical scientist” (see below)

(d) The trainee is expected to undertake at least three activities which demonstrates managerial

and leadership skills by the end of the 4th year of training. Such activities include, but are not

limited to, the following examples:

(i) Contributing significantly to the organisation and running of a local annual scientific

meeting eg. Maltese Cardiac Society Conference

(ii) Contributing significantly to the organisation and running of a weekly

multidisciplinary meetings eg. Endocarditis Team Meeting, Journal Club

(iii) Setting up and running a new service eg. syncope clinic, endocarditis team, electrical

cardioversion list

(iv) Representing the MCS on a European initiative eg. registries, Cardiologists of

Tomorrow

(v) Writing a national guideline or patient information leaflet

(vi) Initiatives that improve professional relationships, communication and clinical care

across other specialties eg. primary care

(vii) Writing a business case for a new drug or technology

(e) The trainee should attend at least 75% of the weekly “Morbidity and Mortality” meetings

held in the department.


Requirements for developing the clinical teacher

(a) Although a teaching course is not obligatory, we highly recommend that the trainee attend

and complete a “Teaching the teachers Course” by the end of the 4th year of training. Any

course offered by a reputable (as judged by the Cardiology Post-Graduate Training

Committee) organisation (including foreign) will be accepted for the time being

(b) The trainee is expected to show evidence of teaching contribution including, but not limited

to, the following opportunities:

(i) Informal (e.g. bedside) teaching

(ii) Lectures

(iii) Workshops

(iv) Simulation

(v) Teaching presentations – may be local, regional, or national

Other opportunities relevant to teaching include:

(i) Course development and management (ii) Creation of e-learning packages (iii) As an examiner for examinations (iv) Contributing to exam-related resources

The target audience can include, but not be limited to, the following:

(i) Undergraduates (ii) Postgraduate doctors (iii) Nursing staff (iv) Allied health professionals (v) Teaching outside the medical profession

(c) All above activities should be recorded in the Teaching section of the Professional

Development module of ESCel.


Requirements for developing the clinical scientist

(a) The trainee must demonstrate a sound grasp of scientific principles and research

methodology. Towards this aim, the trainee must obtain a minimum score of 3 by satisfying

combinations of criteria according to the following scheme, by the end of the 4th year of

training:

Type of Scientific Activity Score Original scientific investigation or meta-

analysis1,2 3 PhD 3

Cochrane Review1 3 MSc 2

Book Chapter1 2 Narrative literature review1,2 2

Systematic review1,2 2 Successful application for a Research Grant1 1

Case report1,2 1 Letter to Editor/Commentary1,2 1

Audit1,2 1 Abstract/poster presented in an international

conference1 1 Programming and implementing a

computerised algorithm/software tool for research use

0.5

Abstract/poster presented in a national conference1 0.5

Any of the above publications NOT as first author 0.5

1 The trainee must be a first author

2 All these papers should be published in peer-reviewed journals; submissions which are rejected or still under review are

not considered valid

(b) Publications and conference attendance should be logged in the Professional Development

module on ESCel, in the Professional Profile section

(c) The trainee must complete a Good Clinical Practice course and submit a valid certificate by the

end of the 4th year of training


Requirements for developing the Heart Team member

(a) The trainee must attend, and offer significant contribution in, at least 75% of Heart Team

meetings by the end of the 4th year of training

(b) The Trainee must attend at least 75% of all other departmental educational activities (eg.

cardiac imaging meeting, journal club, ECG meeting)


Mandatory Certificates

(a) The trainee should have a valid and up-to-date Advanced Life Support certificate by the

end of the 4th year of training

(b) The trainee should successfully complete the ESC accreditation in Adult Transthoracic

Echocardiography by the end of the 4th year of training

(c) The trainee must complete a Good Clinical Practice course and submit a valid certificate by

the end of the 4th year of training (as described in Requirements for Developing the Clinical

Scientist)

Role of experience in foreign centres

We strongly recommend that the trainee spends up to 2 years in a foreign centre of excellence.

He/she may choose to train in a foreign centre even if the skills can be acquired locally, especially if

there are insufficient number of procedures carried out locally to offer quality training or if there

little local expertise. The benefit of clinical experience in different working environments is

recognised by the Cardiology Post-Graduate Training Committee.

To count towards time in the STPC, the work placement must be at least 80% clinical, including ward

rounds, outpatient clinics, and on-calls in cardiology. A placement which consists only of research

commitments will NOT count towards the STPC, although the academic performance will be taken

into consideration. A placement which focuses only, or in the majority, on learning a specific

procedure or set of procedures will also NOT count towards time in the STPC, although the acquired

practical skills will be taken into consideration.

The Cardiology Post-Graduate Training Committee is willing to consider each situation individually

and decide accordingly regarding the extent by which foreign experience constitutes valid time in

the STPC.

Frequency of trainer/trainee encounter and ARCPs

(a) The trainee and LT should meet informally every 3 months (flexibility is allowed) to assess

progress and validate entries on ESCel

(b) The trainee will be assessed at the end of each year by a board chosen by the Cardiology

Post-Graduate Training Committee (Annual Review of Competence and Progress – ARCP).

The yearly requirements assessed during this interview are summarised in the STPC timeline

below

(c) Further meetings can be organised and initiated by the trainee and/or the LT as the situation

demands.


Pattern of clinical assignments during the STPC

Although the assignment of clinical rotations depends heavily on local service demands, the

Cardiology Post-Graduate Training Committee, in conjunction with the rota co-ordinator, will strive

to provide equal and just exposure for all trainees to the different Cardiology subspecialties. The

recommended pattern of assignments is as follows:

- First two years: 6 monthly rotations in all major subspecialties, namely,

electrophysiology, interventional and structural cardiology, cardiac imaging, grown-up

congenital heart disease, heart failure/cardiomyopathies/inherited cardiac conditions

- Third year: 3 monthly rotations in different subspecialties, especially if trainee has

specific training demands or interests

- 4th and final year: trainee to spend whole year in his/her subspecialty of choice


The STPC Timeline

Below are year-by-year flowcharts, summarising the main time-points:

YEAR 1


YEAR 2


YEAR 3


YEAR 4

Documents

Specialist training programme in cardiology - malta · S p e c i a l i s t T r a i n i n g P r o g r a m m e C a r d i o l o g y – M a l t a P a g e | 5 Definition of Roles Cardiology