Variable exposure to echocardiography core competencies when applying minimum recommended procedural numbers for...

Area of Science:

• Cardiology
• Medical Education
• Diagnostic Imaging

Background:

• The American College of Cardiology (ACC) Core Cardiovascular Training Statement (COCATS) outlines echocardiography competencies.
• Level 2 training requires interpreting 300 and performing 150 echocardiograms.
• Fellows may have limited exposure to rare but critical cardiac pathologies.

Purpose of the Study:

• To determine if cardiology fellows achieve exposure to all core echocardiography pathologies.
• To assess if meeting COCATS minimums ensures comprehensive pathology experience.

Main Methods:

• Retrospective review of 11,250 echocardiogram reports from 25 fellows (2015-2019).
• Analysis focused on the first 300 interpreted and 150 performed echocardiograms per fellow.
• Reports were screened for pathologies related to COCATS core competencies.

Main Results:

• All 25 fellows lacked exposure to at least one core echocardiography pathology.
• Specific deficiencies included pericardial constriction (16/25), aortic dissection (15/25), and pericardial tamponade (4/25).
• Other infrequent pathologies encountered by few or no fellows included valvular/cardiac mass and prosthetic valve dysfunction.

Conclusions:

• Meeting COCATS minimum echocardiogram numbers does not guarantee exposure to all critical cardiac pathologies.
• Fellowship programs should monitor specific pathology case counts alongside total echocardiogram numbers.
• This ensures fellows are adequately prepared for independent echocardiography practice.