Society of Pediatric Cardiology Training Program Directors

Program Director Meeting

June 9, 2021

Virtual Meeting Format

ABP Verification Process – we are online at last! ABP Program Director Portal website appears to work remarkably well.

4^th year Fellowship Application Process – Live on website is updated 2021 data on potential and actual 4^th year fellowships by subspecialty, including program contacts. Please encourage people looking at 4^th year fellowships. Continued work on standardizing timelines for applicants. Need fellow input on process and Kristin Bonello our SPCTPD Fellow Representative has put together a survey for fellows to gather more data; draft will be sent to PDs for review.

Pediatric Subspecialty and Internal Medicine Match Date Process - Peds subspecialties have been 2 weeks later in match process than IM. Problems with couples matching, those applying in both like infectious disease etc. IM does not want to move due to larger groups, high % of international applicants with Visa issues, tighter timeline for scramble for unmatched applicants, etc. Peds would move up by 2 weeks, new deadline for rank list submission would be before Thanksgiving (not for this coming 2021-22 season). SPCTPD vote is planned although we may not have an alternative; informal straw poll 85% approved.

ACHD milestones are being developed for the first time – this is a good time to have input into creation of these.

Progress in Pediatric Cardiology Journal – our SPCTPD partner journal – PPC board is interested in a yearly special edition dedicated to fellow/trainee research and QI projects. Consideration for possible oral symposium in the future. Timeline for abstract submission early 2022 for published edition 3^rd quarter of 2022. Rob Ross is looking for volunteers to help with editorial oversight board for the special edition: rross@dmc.org

Exercise Medicine Curriculum: pediatric cardiology fellowship exercise training standards have been developed by a group of collaborators. The guidelines are being prepared for eventual publication. Heart University topics are being developed. As we work toward 2025 training guidelines revision this work would be included.

SPCTPD in person meeting: planning underway for our meeting at AAP meeting in Philadelphia PA. Friday October 8^th 2022 late afternoon. Trainee workshop planning for Saturday late afternoon October 9^th 2022. Mark your calendars!

2021-2022 Interview Season – recommendation from APPD, CoPS and others that this coming interview season be virtual. Multiple program directors noted they are bound to respect their hospital’s GME decision to be virtual this coming season. Pros and cons discussed – with general consensus that programs get to know applicants better than applicants get to know programs. Most agree that interaction/time with fellows, chance interactions with other faculty, sense of program culture and overall “fit” is diminished with virtual interviewing. Balanced by finances, equity, timing, scheduling, ease of interviewing. Discussion of need to get data from our new 2021 fellows on the process to inform subsequent years decision.    

Diversity, equity, and inclusion – agenda item for SPCTPD meeting in October in Philadelphia. Carly Fifer (U Michigan, email: cago@med.umich.edu ) has volunteered to chair SPCTPD task force. First step to gather info on where we are to inform how to proceed, some preliminary data reviewed. Key question – how do we attract more URM to Peds Cardiology?

Elections for SPCTPD Board: 2021-2023 Secretary/Treasurer – current board is now accepting peer or self-nominations for the Secretary/Treasurer role. Our SPCTPD board roles move up stepwise every 2 years, so this is an 8-year commitment. Candidate statements (less than 1 page) and photo due by Aug 11. Voting opens Aug 16, closes Sept 3. Results announced Sept 13. New board takes effect AAP meeting 2021. Please send nominations to Lowell Frank at lfrank@childrensnational.org

Society of Pediatric Cardiology Training Program Directors

Program Director Meeting

March 31, 2021

Virtual Meeting Format

Agenda

1. Welcome
2. Educational opportunities - Stanford bootcamp, CHA webinar on mentorship
3. Updates from last meeting - Proposed common match with internal medicine subspecialties, Pediatric Milestones 2.0
4. 4th year fellowship survey/availability
5. Update on 4th year application standardization
6. Progress in Pediatric Cardiology fellow research/QI competition – Rob Ross
7. Program presentation - professionalism lecture series – Julie Glickstein
8. ACC/CHD Community Day - programming for you and your fellows – Susan Etheridge
9. SPCTPD finance update –Susan Etheridge
10. AAP planning

Meeting slides

Diversity in cardiology article

-Lowell Frank called the meeting to order and referred those in attendance to the minutes of the previous meeting on the SPCTPD Website

-Consolidate Match

• There was a discussion about the proposed common or consolidated match with the internal medicine subspecialties and further discussion will happen between the Exec Committee and members of the Internal Medicine group on 4/5/21
• Issues concerning the ability to complete paperwork and Visas exists on the IM side as a great number of their new trainees require VISAs

- Shared New Fellows Bootcamp

• ·         Scott Ceresnak spoke about the Stanford Common New Fellows Bootcamp
• ·         Interested fellows can contact Kara Motonaga if interested at sachie@stanford.edu
• ·         This is now a virtual conference with plans for a “real” conference next year
• ·         Contact Scott if your program has interest in sponsoring this

-4^th Year Fellowship Discussion

• There was a lengthy discussion about increased standardization of the 4^th years cardiology fellowships
• There was a survey sent and completed by 58 of the 63 ACGME active cardiology programs
• 67% (n=39) reported having some 4^th year programs
• Results of the survey will be on the website
• Briefly in 2022- External Fellowships:
• 16 imaging
• 8 cath
• 8 EP
• 9 HF/Tx
• 14 ACHD – different match
• 17 Critical care  

-Standardized 4^th year match and application

There are different types of a uniform match that are possible at this point
1.       Handshake agreement
2.       San Francisco Match

-  this group already runs the match for other programs such as orthopedic surgery

- There is a fee of 100-200 dollars per program for each 4^th year offered

- more flexible and not as robust enforcement as the NRMP

- SPCTPD would determine on dates to submit a quota, a rank list and the match day and then a posting of unfilled positions and unmatched candidates like the NRMP.

- would need 25 programs in total

       
3.       NRMP

– not flexible on time line and would occur at the time of the General peds Cards match

In general:

Society of Pediatric Echocardiography is cautiously on board

Ongoing discussions with PACES and Intervention groups are planned

Most favor the ability to opt out for internal candidates

Overarching goal is for the SPCTPD to partner and be engaged more with the 4^th year training with a strategy that would include

year 1 – Make the 4^th year program stakeholders aware that the SPCTPD exists and how it can work for them

year 2 – some level of standardization for fellows starting in 2023

Issues relating to the Common 4^th year Match

• ·         Can a fellow rank in > 1 subspecialty?
• ·         This takes away some of the internal programmatic flexibility such as a HF and   CICU combination fellowship
• ·         At present we do now know what fellow numbers we are talking about
• ·         Consideration for another survey to address the number of fellows who did and did not match and how many stayed locally
• ·         There was mention of concern about Canadian programs and issues with VISAs and we were reassured the SF Match does match Canadian people and programs
• -          Rob Ross spoke about the journal Progress in Pediatric Cardiology and the official journal of the SPCTPD
• ·         This journal embraces fellows’ submissions in research and QI and would like this to be the home for our fellows’ research
• ·         They are considering an entire edition dedicated to fellows’ research and QI, each year
• ·         They are considering a “Top Abstracts” edition with a commitment to publish the top 5
• ·         They will consider fellows’ medical education type of research
• ·         Please email Rob Ross if you have questions or would like to participate

Julie Glickstein presented her excellent lecture of Professionalism in Cardiology Fellowship’

• Professionalism and Mentoring are really a cornerstone of fellow education yet unlike the clinical and research aspects has not yet been standardized
• Julie gave a detailed presentation on her approach to this discussing a Peer Mentoring House System

A buddy system groups made up of a 1^st,2^nd and 3^rd year fellows

Work and social engagement

Making sure they junior fellows are prepared but also doing a wellness check in

• She discussed a Professionalism Lecture Series

She mentioned a fellow run program with a brief top 10 articles from the year and a short 5-minute review – not to replace Journal Club

Lectures about writing a condolence letter, spirituality, palliative care, child life, dealing with mistakes, racism and health inequity, career night, taxes and finances

Susan Etheridge and Lowell discussed ACC/ACPC Community day on May 7^th the schedule to be posted on the website
Susan Etheridge Reviewed financials

    $24,036.61 in bank

47 programs are up to date on dues

Laurie Armsby discussed AAP meeting scheduled in Fall in Philadelphia
Glenn Wetzel discussed the weekly fellow ECG reading emails - please contact Glenn at gwetzel@uthsc.edu if you/your fellows want to participate
-         

How can we as SPCTPD address underrepresented minorities in pediatric cardiology?  How do we compare to other subspecialties?

• This would make a great topic for the AAP SPCTPD meeting
•  There are likely data at ACGME or ABP but it seems these data are more skewed to gender rather than race inequity

          Action items
·         Collect data on # of fellows
·         Number who applied for a 4^th year
·         Number granted a 4^th year
·         Number with a job related to the 4^th year
·         Number who stayed internal
·         Diversity and gender data
·         Gather data back for 3 years and then yearly moving forward

• 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
• • We are planning a AAP fellow session 10/16/2020 free to all fellows and to the SPCTPD and this will be a virtual meeting on career development, mentoring and PDs are to encourage fellows to attend. 
  • There is hope for a in person fellow mentoring session at the next ACC in May 15^th-17^th  in Atlanta, Georgia.  There is usually (and likely in 2021) a Community Day the day before the opening of the ACC and there are fellow mentoring opportunities at this session.  More information about this to follow.
    
  • We discussed the need and importance of registering as a 501(c)
    
  • We discussed the importance of a 4^th year application/acceptance timeline and uniformity among the programs
    
  • All are encouraged to complete the survey for PD at https:www.surveymonkey.com/r/FY2work
    

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):

        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
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