The Society of Pediatric Cardiology Training Program Directors

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Society of Pediatric Cardiology Training Program Directors

Program Director Meeting

February 2, 2021

Virtual Meeting Format

Agenda:

1.       2021 NRMP trends
2.       Pediatric Milestones 2.0
3.       4^th year application timeline
4.       New SPCTPD Fellow Liaison
5.

Coaching for PDs

Click here for the slides used

1.       2021 NRMP trends
Lowell presented data regarding trends in pediatric cardiology fellowship training positions. The Match fill rate for 2020 was 95%. There were 157 applicants and 157 open positions. This equality of applicants:positions is new for our field. Until this year pediatric cardiology fellowships were more competitive, with many more applicants than open positions.
Lowell looked closely at the data and showed that there has been a recent trend in declining numbers of applicants (not open positions). For example, in 2016 there were 56 programs and 162 applicants. In 2020 there were 59 programs and 160 applicants. The trend has demonstrated fewer applicants and relatively steady programs/positions. In comparison, PICU and Emergency Medicine fellowships have become more competitive. In these specialties there are more applicants AND more positions.
Discussion:
-          Many PDs on the call agreed that we would benefit from another workforce survey. However, due to issues raised by the covid pandemic now may not be the best time to survey the workforce.
-          We also wondered how non-shift work based specialties are doing? In general, the current generation of residents include considerations of work-life balance and may be finding shift work based specialties more appealing.
-          The emergence of cardiac critical care as an increasingly popular sub-specialty field, with excellent job prospects, may be drawing residents toward PICU training, with eventual positions in CVICU
-          Should we survey pediatric resident programs? What is the effect of limiting exposure to cardiology wards/CVICUs during residency? What other factors are limiting pediatric residents’ interest in cardiology?
-          Are people drawn toward higher paid positions? Data has shown that PICU, NICU and cardiology are the only three subspecialties that will, over a career, earn higher salaries than a general pediatrician.

2.       Pediatric Milestones 2.0
The Pediatric Milestone evaluations have been in place for the past 8 years. They are currently undergoing a revision and are open for public comment this winter. CoPS is soliciting feedback from each of the sub-specialties, however it is not clear who from pediatric cardiology is involved in the milestone 2.0 revisions, or how we can provide input. As of now no changes specific to pediatric cardiology are anticipated. A report in 2018 on milestone use demonstrated a variance in how specialties are using the milestones. It was generally agreed that non-patient care related milestones are difficult to use, repetitive and ambiguous. Efforts are being made to make them more user friendly and to reduce complexity.
Discussion:
-          Several people raised the issue that milestones have not added benefit at all to the process of evaluating fellows.
-          Many PDs were in favor of presenting feedback to the ACGME calling out the lack of benefit of this exercise. It was pointed out that this input was unlikely to be effective, however there was considerable support in doing so.
-          Several PDs in support of the milestones called out their utility in identifying fellows falling off track, and as a tool to show sub-standard fellows where their performance is falling behind compared to expectations.
-          There was discussion about other ways to provide evaluation to fellows, including an idea from Julie Glickstein about fellows submitting their best echo and having specific feedback provided on this study.

3.       4^th year application timeline
The application process for 4^th year advanced training positions is recognized as a major problem. Currently there is a large and time-consuming burden on fellows to identify open positions, and the timelines for applications and decisions vary widely among programs. A recent survey of the SPCTPD identified this as the number one issue PDs would like to see improved. The idea of creating a single process, similar to the ERAS fellowship application process, is extremely appealing. However, the logistics are difficult to overcome.
Discussion:
-          The problem is that everyone loves this idea however efforts in the past were not sustained.
-          Heart failure/transplant programs have organized among themselves and the process so far is working well.
-          EP, Cath and CVICU are all in discussions about creating more standardized systems.
-          How do we create the system, develop buy-in?
-          We discussed creating a platform like ERAS. But who would pay for it, or manage it, since it’s not a board certified training program?
-          The lack of an enforcement arm makes adherence to this a challenge.
-          Also, many programs use the advanced fellowship positions as somewhat of a faculty position segue and heart center leadership may not be as interested.
-          Adult cardiology advanced training fellowships are ACGME certified so they go thru a match process.
-          Our post-Covid SPCTPD survey of offered 4^th year positions received a 98% response rate. This data was uploaded onto the SPCTPD website for fellows to refer to. This could be repeated each year at a minimum.
-          No resolution was reached.

4.       Common match with adult subspecialties
The conflict between adult and pediatric subspecialty matches is being examined. The current situation is that the adult programs match 9 hours prior to the time the pediatrics match list needs to be submitted. This creates problems for several reasons.
There is an interest in creating a single match list deadline for adult and pediatric programs. The adult programs can either move to the (later) pediatrics timeline, or the pediatrics programs can move to the (earlier) adult timeline.
Discussion:
-          It was agreed that our strong preference would be to move the adult programs to the pediatric timeline.
-          The larger programs in particular would have a great deal of difficulty moving their match timeline any earlier, especially since moving from the Spring to the Fall already shortened the interview process.
-          It was agreed that if the adult programs elect not to move their timeline to meet ours, we would prefer to leave things as they currently are.

5. New SPCTPD fellow liaison
Dr. Kristin Bonello is our new Fellow Liaison for the term 2020-2022. Dr. Bonello is currently a second year fellow at Boston Children’s Hospital. We had 9 fantastic fellow applicants this year. It was difficult to choose among the applicants, but we are excited to welcome Kristin and look forward to working with her.

6.       Coaching for PDs
Julie Glickstein reviewed a recent ACC sponsored webinar focused on the role of the PD in coaching and sponsorship. The webinar was organized by adult Program Directors from CHOP, Pittsburg, Columbia and Texas. Julie was part of the leadership team and participated in the activity. She felt that it was an extremely well executed and valuable exercise, and suggested that we include this for the SPCTPD group in an upcoming national meeting.
-          The slides Julie presented will be made available
-          The activity is meant to define the concepts of coaching and sponsorship, and to develop tangible ways for PDs to provide these services.
-          In the webinar Julie helped run, five questions categories were created. The 70 adult PDs were divided into 5 break-out groups and after 70 minutes of discussion a representative from their group summarized their conclusions. This led to a robust and very helpful discussion.
-          The suggestion was to repeat this at the AAP in the Fall in Boston with the SPCTPD membership.
Discussion:
-          In summary, we all do this now, and working together to build our skillset would be fun and helpful.
-          This is a great opportunity for continued professional development for us as PDs.
-          Julie Glickstein will lead, and has invited others to help.
-          Anyone interested in joining this effort, please contact Laurie Armsby (armsbyl@ohsu.edu).
-          We’ll continue to work on ACC planning at our next meeting.

7. PC-NES planning
The PC-NES was very well received last Spring. There is interest in continuing this. Goals are to have a short curriculum throughout the Spring. We are currently surveying fellows, looking for the most convenient time for the majority of fellows.

8. ACC planning
The ACC will be held in May, in a virtual format.

The next meeting of the SPCTPD will be held via virtual format on March 31, 3pm eastern, 12pm pacific times.
Respectfully submitted by SPCTPD Board
February 2021

SPCTPD Meeting Minutes
September 9, 2020
via Zoom

Welcome - Dr. Lowell Frank reviewed the executive team members with a shout out to David Brown who has remained as past president when Antonio Cabrera moved to division chief and was thus no longer a program director

Lowell presented the SPCTPD 4^th year availability and directed the attendees to the website for information about which programs offer a 4^th year. There are data on the website for 36 of the 61 programs
We reviewed the fellow and faculty COVID survey results and the plans for publications of each of these under the leadership of Sinai Zyblewski and Rupali Gandhi; thanks to Julie Glickstein, Robert Elder, Meryl Cohen, and the rest of the SPCTPD board as well
Lowell reviewed the success of the PC-NES and the plans to continue this under the leadership of Rupali Ghandi
Laurie Armsby spoke about the Board Review Course for fellows and encouraged the members to speak about this to the fellows
Rob Spicer was asked to speak on his role as the pediatric cardiology representative on the ACC Competency Management Committee and solicited a request for a replacement as his term is over Spring 2021. Program directors were asked to submit their name if they were interested
The timeline for the upcoming year including fellowship applications/Match details, upcoming SPCTPD events and elections was presented
Susan Etheridge presented details on the finances
- Invoices have been sent
- 13 (now 15) of the 61 programs have paid dues and there has been no pushback with the dues increase to $250.00
- We have $20,456.31 in the Bank of America account
- The membership was asked to please pay online if possible if not please mail to:

Susan Etheridge
Cardiology, 4^th Floor
81 North Mario Capecchi Dr
Salt Lake City, UT, 84113

The work force survey was reviewed
Applications for a fellow Liaison to the SPCTPD are being sought - Interested 1^st and 2^nd year fellows should apply with a personal statement of interest and a paragraph of support from their PD
Future Business

SPCTPD Meeting Minutes

April 27, 2020 1:00 - 2:15 Eastern

32 participants via Zoom

COVID update and check in

Lowell Frank opened the meeting with a question about how we and our fellows were doing in these difficult times.

There was an interesting and informative dialogue about how the fellows and the fellowships were doing in NYC. Julie Glickstein from NYU gave us an update. As an aside Julie hosted a fantastic webinar this past Friday AAP SOCCS – COVID and the Impact on Pediatric Cardiology Patients and Practices that is available to review. https://www.youtube.com/watch?v=octqLzM0oBo&t=3270s

The NY programs have been hardest hit thus far and second and third year fellows have been voluntarily redeployed to care for adult COVID patients.

Some of these fellows are dealing with new stressors such as caring for a dying patient who cannot be with family or loved ones. Ideas for additional resiliency and wellness training were discussed.

Some faculty mentioned push back from fellows about returning to increased clinical duties. Some of this might relate to stress but also to child care issues considering schools and day cares are closed.

We will be putting together a PD survey as a follow-up to the initial PD survey about fellow duties in this time of pandemic.

Virtual interview season

It is likely that the upcoming fall fellowship interview season will be a virtual interview. The APPD will be addressing this Wednesday – session information at www.appd.org/home/virtual cafe.cfm

We as a group are concerned about this but all seem to agree that whatever is done should be uniform across all fellowships. Most thought this should even pertain to internal candidates to make it as fair as possible.

This will likely be mandated by the local GME of each institution.

This is likely to be a big concern and Rob Ross brought up the problematic recent interview season in which there were 12 unfilled fellowship positions and concern that this number could increase as a result of this and the difficult pediatric cardiology job market.

Quarantine of new fellows

This is an issue in some locations and it does not appear that there is consensus or uniformity

Job Market and Hiring Freeze

There seems to be as general hiring freeze at least in academic positions with this likely to affect the job market not just this July but also next year. Thus, it could impact our present second year fellows. There also may be some loss of 4^th year positions as the funding for these might be pulled.

The group thought that this is an important project for the SPCTPD to deal with the landscape for jobs and 4^th years for at least the next 2 years. We should reach out to the division directors across the nation for possible jobs and 4^th year positions. Different mechanisms for finding the division chiefs were discussed.

· Using the ACC and SOCCS
· Using the regional organizations for example the Western Society of Pediatric Cardiology as these may also include private practice groups

Dues increase

Susan relayed the executive committees vote to increase the dues to 250 dollars beginning July 2020.

There has not been a dues increase since the inception of the Society.

Administrative costs are increasing. We are planning to continue to support the fellow lectures although these will change to once a week.

We hope to use some of this as grant support for educational and PD collaborative projects from the Society.

This is dues to the program not just the PD.

Cardiology fellowship for CCM-trained fellows

There was a short discussion on the details of cardiology training for CCM-trained fellows. Some programs will not accept them for two years. Mary McBride, a cardiac intensivist from Lurie Children’s, is working on this through PCICS and offered to work with the SPCTPD on this.

Society of Pediatric Cardiology Training Program Directors Fall 2019 Meeting at the American Academy of Pediatrics Conference

October 25, 2019, 12:00 – 1:30 PM

New Orleans, LA

Highlights/action items (details below):

·         Please submit nominations of your interested fellows for the SPCTPD fellow liaison (first or second year fellow only) to Lowell Frank by January 31^st
·         The Workforce Survey may move to being a primary SPCTPD project due to logistical challenges with partner organizations
·         Note that the ACGME Program Requirements as of July 1, 2019 state: “Fellows must have a minimum of 12 months dedicated to research and scholarly activity…”
·         Make plans to attend our next in-person meeting on Saturday, March 28, in Chicago at the ACC
·         Consider attending the ACC CV Training Program Directors session on Friday, March 27, in Chicago
·         Contact Lowell if you would like to speak at our next meeting on a training area you are passionate about, or if you would like to speak at the fellow mentoring session

I. SPCTPD Board Update

The SPCTPC welcomes Dr. Susan Etheridge (Primary Children’s Hospital, UT) as the newly elected Secretary/Treasurer. Dr. Laurie Armsby (Oregon Health Sciences University, OR) is the incoming Vice President and Dr. Lowell Frank (Children’s National, DC) leads the board as President.

Typically the past president remains an active member of the board and serves as the SPCTPD representative to the Council of Pediatric Subspecialities (CoPS). However our past president, Dr. Antonio Cabrera, has recently resigned as the fellowship program director at Texas Children’s Hospital to become the director of the Children’s Heart Center at Primary Children’s Hospital. Dr. David Brown (Boston Children’s Hospital), the outgoing past present of the SPCTPD will continue as past president and CoPs represtentative. Appreciation was extended to Dr. Cabrera for his service and dedication to the SPCTPD over the past 6 years.

Dr. Josh Kurtz, outgoing SPCTPD fellow liaison, is graduating fellowship. Appreciation was extended to Dr. Kurtz for his engagement in the society over the past two years. Nominations for the SPCTPD Fellow Liaison 2019-2021 may be submitted to Dr. Lowell Frank. This is a great opportunity for fellows to engage in national work and develop relationships with leaders in education across the field.

II. AAP Membership: Tina Morton

Ms. Morton presented information about the value of AAP membership for pediatric cardiology fellows. This includes opportunities for fellows in mentorship, advocacy, PREP cardiology, Peds in Review. The cost of membership for trainees is $140/member. This is less than the cost of PREP cardiology alone. Membership pays for itself. Some programs sponsor membership for their trainees. If a program would like to do this, or for more information about AAP membership, call 630-626-6061.

III. AAP Early Career Physician Workgroup: S. Menon

The co-chairs of the SOCCS Early Career Workgroup presented information about their work. The mission of this workgroup is to facility integration of early career physicians and fellows into activities of the AAP and SOCCS. They are creating a clinical guidelines repository, a current list of grant opportunities, developing a mentor-mentee program and collecting information about P&T processes at different institutions. They are also working on an Early Career Workforce Survey, which will collect information about salary, wRVU issues, work satisfaction, outcome of job searches and aspects of their positions that facilitate their happiness and success within their program. They are looking into opportunities to work together with the SPCTPD.

IV. AAP Specialty Review Course 2020 Update: L Armsby

The 2020 AAP Specialty Review Course in Pediatric Cardiology will be held August 17-21, in Chicago, IL.

The curriculum is outstanding this year, with a number of new faculty and a re-organization of topics. A Practice Q&A and Study Guide booklet will be provided to the registrants this year. Please encourage your fellows to attend!

Co-directors and Planning Committee: Maria Serratto, Laurie Armsby, David Brown, Antonio Cabrera, Shaji Menon, Amy McCammond, John Colquitt. Admin: Jane Whitener, Vivian Thorne.

V. ACGME Program Requirements GME in Pediatric Cardiology specific to Research: L Frank

We discussed the ACGME requirements which state “Fellows must have a minimum of 12 months dedicated to research and scholarly activity…” It isn’t clear to many PDs how this 12 month period is defined, specifically whether research could be combined with call or clinical elective activities. Some PDs expressed that their fellows felt that 12 months was excessive as it drew them away from clinical educational activities. We learned that at CoPS some specialities are pushing to move from 3 years to 2 years as they are struggling to attract enough new physicians into their subspecialty. The ABP is pushing back to require a full year of research. We also discussed that research requirements are somewhat specific to the individual fellow and to specific types of projects. Some fellows can integrate research into their clinical work, while others require blocks of time for productive research. While many PDs were aware of this requirement others learned about it for the first time at the APPD conference. We discussed appointing a liaison to the ACGME so that we are able to contribute to the discussion about directives early in the process. It was also suggested that the PDs share information about site reviews with regard to how this research requirement is being assessed during the re-accreditation process.

VI. CoPS Update: R Ross, D Brown

Work Force: Rob and David discussed the pediatric cardiology workforce survey which was completed one year ago. The reason the survey has not been released is because other pediatric subspecialties are also creating similar surveys, and the AAP is creating common language to be included in all. This process has been protracted. Concern was raised over the delays in this process. Even if the survey data was available today, and programs changed their quotas in response, the impact of these quota changes would not be realized for 3-4 years. The SPCTPD membership voted to move ahead to send out the survey.

ABP Roadmap project: Dr. Carole Lannon spoke about the ABP roadmap project “to increase the resilience, emotional and mental health of pediatric patients with chronic conditions and their families.” The premise is that subspecialists can do more to identify children with these challenges and “provide empathy, intervention and resources for those identified at risk or struggling.” A Toolkit for PDs will be available to guide the education of our fellows and faculty in this area. The ACC community day in March 2020 will also have a session on the resiliency roadmap.

Other CoPS updates: There was agreement regarding the importance of supporting women in leadership positions and through academic promotions. Also, data was presented on pay discrepancies. Pediatric Cardiology is one of the top 3 subspecialties. It was remarked that some subspecialties are relatively poorly reimbursed. Again, some subspecialties are suggesting shortening training in part to help attract more trainees into their specialty.

VII. Treasurer’s Report: L Armsby

The SPCTPD funds are healthy and have increased slightly. Our balance has risen to $ 20,119.41. To date we have only collected 55% of 2019-2020 dues collections. We collected 75% of the dues for 2018-2019.

Organizational updates for 2019: Lindsay Attaway has joined the SPCTPD as an administrative assistant. She has been extremely helpful this year. Lindsay maintains the SPCTPD website, manages the collection of dues, handles posts and assists with data collection for the National Fellow Registry and manages the Wild Apricot and Survey Monkey accounts.

VIII. Discussion: Didactic Curricula

Two PDs shared the structure, philosophy and challenges related to their Didactic Curricula.

Drs. Sonal Owens (Mott, MI) and Thomas Chin (Penn State, PA) presented. Dr. Lowell Frank suggested that the SPCTPD develop an anonymized survey of pediatric cardiology programs to better understand the didactic curriculum across a wide array of ped cardiology training programs. This would not only identify current practices but could provide information to PDs to help guide curricular development.

X. ACC CHD Community Day Preparations: L Frank

The ACC is scheduled for March 27-30, 2020 in Chicago, IL. CHD Community Day is on Friday, 3/27. There is currently a conflict between SPCTPD, CHD Community Day and Adult CVTPD sessions. The SPCTPD meeting will take place mid-day on Saturday, March 28. We realize this may impact ease of calling in; however, Friday attendance has been poor in recent years because of the extra day of travel as well as scheduling conflicts. The fellow mentoring session will be on Sunday, March 29. Please share this date with your fellows. We also recommend attending the CV Training Program Director’s Section Meeting all day on Friday, March 27. Much of the information is relevant to our programs, and Julie Glickstein, PD for Morgan Stanley Children’s Hospital/Columbia is an invited speaker.

XI. President’s Message: L Frank

There are many opportunities for engagement with the SPCTPD:
Volunteer to speak at the SPCTPD meetings during the AAP or ACC
Volunteer to speak at a fellow mentoring session (at the AAP or ACC)
Create your own study (funding may be available through the SPCTPD)
Become a SPIN representative
FPQM
Develop an educational curriculum project

Respectfully submitted by SPCTPD Board
December 2019
PDF version

Spring ACC Meeting Minutes
Friday, March 15, 2019
New Orleans, LA

Introduction
Lowell presented the agenda for the weekend, including the SPCTPD meeting, CHD Community Day, the SPCTPD mentoring session, and the ACC ACPC meeting.

Election time!
Antonio presented that we will be having elections! The new Secretary/Treasurer will begin their terms at the fall AAP/SCPTPD meeting. We will also be seeking a new fellow liaison, who should be a current first-fellow. More information will follow over email this summer.

Projects
Antonio discussed the burnout project. Susan asked if there will be an action plan? The idea is to first collect the data, and addressing trainee burnout is a great target for the SPCTPD. Antonio commented that PD burnout is another potential target. The survey uses the Maslach inventory. Ivan offered that at Cincinnati, the GME office is issuing that survey already. He cautioned that comparison amongst different pediatric subspecialties may not be easy. Julie added that comparison to ACGME wellness data might be interesting. That data, however, is not granular. The SPCTPD survey is far more granular. We will send a blast to the PDs to encourage them to have their fellows participate.

New Administrative support for SPCTPD
Lowell introduced Lindsay Attaway, our new SPCTPD program coordinator. We discussed condensing communications to once/month, and offered SPCTPD as a resource for PDs to communicate. We reinforced that in general, SPCTPD emails go to program directors only and we rely on PDs to send this information to their fellows if they see fit. Susan asked about program coordinators; we moved to include PCs in emails that go out. We could investigate ways for PCs to collaborate/share info.

Finances
Antonio presented the financial update on behalf of Laurie. We have a positive balance of $ 17, 811.62.

Slide summary of the above available here.

How other programs do QI and Research
Ivan Wilmot presented the Cincinnati approach to QI and research. Fellows pursue either a personal, class, or institute-wide QI project. They started a QI curriculum this year - 6 classes to discuss the basics. In their first year, they identify a QI target, followed by a course over their second year and a work product in their third year. He also highlighted their “research blitz” - held in August to facilitate fellows identifying mentors; list of faculty research projects. HIRC - Heart Institute Research Core - fellows present in formal fashion. Like a "mini-grant" application. The SOC is separate, although there is overlap. They host a Heart Institute Research Day, including basic and clinical presentations. The program also offers fellows Masters degree program support. Travel for conference is offered at a graded level – 30% for posters, 50% for a talk – on top of regular funds.

Julie Glickstein spoke about the QI experience at Morgan Stanley Children's Hospital. They have had multiple projects, but one of the most successful projects (nearing publication) focused on improving the fellow clinic experience, including continuity of care.

Susan Etheridge spoke about fellow research at the University of Utah, including a number of research forums and mentoring opportunities. “Research on a napkin” is a novel concept discussed. New this year - "Formal" off-site Pediatric Cardiology Fellowship Research Night, with 10-minute formal PPT presentations. They also offer a “Spirited Research Meeting” - established by fellows, with a relaxed atmosphere. There are also grant writing workshops sponsored by the Department of Pediatrics, taking place in Deer Valley in spring and fall (off season for skiing). They have many opportunities, including Intermountain Health, population science, basic, clinical, translational, genetics, and personalized medicine. A MSCI offered to one fellow per year - fellows apply to the program. They offer full financial support for any type of fellow presentation at meetings.

Rob Ross updated the group on CoPS. Our past-president is our CoPS Representative. Rob has been on the CoPs for a number of years and is now sponsored by the AAP. Rob is also chair of the CoPS workforce survey, the next edition of which is coming soon. CoPs is also interested in advocacy, and will be attending congressional sessions in May advocating for medical education and training. He reminded PDs that Progress in Pediatric Cardiology https://www.journals.elsevier.com/progress-in-pediatric-cardiology (PPC) is the official journal of the SPCTPD, and is a great target for QI projects. PPC offers a quick turnaround - fellows should mention that they are in training and it will be quick.

Archives:

2018 CoPS Annual Meeting - presented at SPCTPD/AAP meeting 2018

2018 CoPS Annu al Meeting Report.pptx

SPCTPD Spring 2018 Newsletter

The minutes from the 2018 American College of Cardiology Meeting in Orlando can be found here.

SPCTPD Fall 2017 Newsletter

The minutes from the 2017 American Academy of Pediatrics meeting in Chicago can be found here.

Progress in Pediatric Cardiology is the official journal of SPCTPD and welcomes fellow manuscript submissions with a rapid review time!
The special issue of Progress in Pediatric Cardiology on "Pediatric Graduate Medical Education: Approaches in the Current Era of Duty Hours, Milestones and Entrustable Professional Activities" is now in print: Volume 44 March 2017

SPCTPD Spring 2017 Newsletter

Click here to view...

AAP Offering PREP Course for Free to Fellowship Trainee Members

American Academy of Pediatrics will be offering the PREP course for free to Fellowship Trainee Members!

Click Here for more details...

Fall Newsletter 2016