Elsevier

Heart Failure Clinics

Volume 13, Issue 2, April 2017, Pages 361-366
Heart Failure Clinics

How to Develop a Cardio-oncology Fellowship

https://doi.org/10.1016/j.hfc.2016.12.012Get rights and content

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Key points

  • The areas of knowledge required to manage cardiovascular disease in patients with cancer and cancer survivors include specific cardiovascular complications directly related to oncologic therapies and the impact of cancer and its therapies on existing or potential cardiovascular comorbidities, including atherosclerosis, valvular disease, and myocardial disease.

  • The cardio-oncology training milieu, the selection process for cardio-oncology trainees, and the cardio-oncology training curriculum must

Curriculum

The curriculum for cardio-oncology should be structured with core competency-based goals in a manner that is in keeping with the Accreditation Council for Graduate Medical Education and American College of Cardiology’s Core Cardiovascular Training Statements directives.14 These milestones/goals can best be accomplished through a 1-year immersion fellowship with a combination of inpatient and outpatient exposure. As a guide for the recommended number of patient-fellow interactions, a proposal of

Faculty

The presence of faculty dedicated to the mission of cardio-oncology and academic training is essential for a successful cardio-oncology fellowship program. Faculty with expertise in consultative medicine as well as the various cardiac subspecialties, such as echocardiography, nuclear cardiology, and advance cardiac imaging (including cardiac MRI and computed tomography angiography), is desired. The current practice of cardio-oncology is reliant on cardiac imaging, and, as such, fellowship

Multidisciplinary management

The practice of cardio-oncology is a primary example of the multidisciplinary management of patients. Fellows in cardio-oncology must have the opportunity to attend and participate in clinical conferences focusing on patient management decisions in which oncologists, radiologists, radiation oncologists, and oncologic surgeons collectively determine the best course of action for particular patients with cancer. Through this team approach, the goals of safest oncologic care and minimizing

Institutional support

Institutional support must come in the form of both financial and philosophic support. Fellowship programs that are most effective operate in environments in which there is an institutional commitment to high-quality care. How this translates may vary on an institution to institution basis but should include a commitment to personnel, marketing, and providing state-of-the-art cardiac imaging to keep current with the emerging role of advanced imaging techniques such as strain imaging and cardiac

Challenges

There are concerted efforts being made by the International Cardioncology Society and the Canadian Cardiac Oncology Network to advocate for further development of this subspecialty.13 In response to knowledge gaps and needs identified by the practicing cardio-oncology community, the American College of Cardiology has created a Cardio-Oncology Council with task-oriented working groups to address the major components such as practice requirements, and the curriculum in research.

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References (23)

  • C.E. DeSantis et al.

    Cancer treatment and survivorship statistics, 2014

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  • Cited by (10)

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      Training in cardiovascular medicine is often defined by the development of competencies, with achievement of curricular milestones leading to the acquisition of specific skills (42). In cardio-oncology, there has been a concerted effort of many in the field to define a complete set of competencies (27,43–47). Incorporating required competencies, for example, questions related to cardio-oncology on American Board of Internal Medicine certification and recertification examinations, may incentivize general training programs to support dedicated educational efforts within cardio-oncology.

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