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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.
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The cardio-oncology training milieu, the selection process for cardio-oncology trainees, and the cardio-oncology training curriculum must
How to Develop a Cardio-oncology Fellowship
Section snippets
Key points
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.
The next steps in
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Cited by (10)
Training and Career Development in Cardio-Oncology Translational and Implementation Science
2022, Heart Failure ClinicsCitation Excerpt :A mentored experience is provided for the cardiovascular assessment of oncology patients with attention to the specific cardiotoxicities of chemotherapeutics, targeted therapies, immuno- and cell-based therapies, and radiation therapy as well as the appropriate application and interpretation of cardiac diagnostic tests (eg, ECG, imaging, and biomarkers). Specific topics that the cardio-oncology fellow will be expected to master include precancer treatment cardiovascular risk assessment, management of cancer-treatment associated cardiotoxicities, cardiac implantable device management in radiation oncology, and cardiovascular disease management in the cancer survivor.11,19,31,44 The fellow will be required to have no less than 100 unique patient encounters over the course of the year, as outlined in the ICOS and the CCON training document.19
What Does a Cardio-oncology Service Offer to the Oncologist and the Haematologist?
2021, Clinical OncologyCitation Excerpt :One key aspect relates to the training of future specialist cardio-oncologists. This sub-specialised training is ideally in the form of a cardio-oncology fellowship programme, which should preferably take place at a high-volume centre [30]. At present, formalised cardio-oncology programmes remain limited.
Preparing the Cardiovascular Workforce to Care for Oncology Patients: JACC Review Topic of the Week
2019, Journal of the American College of CardiologyCitation Excerpt :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.
Cardio-oncology Training in the COVID-19 Era
2021, Current Treatment Options in OncologyEstablishing an oncocardiology service
2020, HerzCardio-oncology discipline: focus on the necessities in developing countries
2020, ESC Heart Failure