Consensus Statement by the Congenital Cardiac Anesthesia Society: Milestones for the Pediatric Cardiac Anesthesia Fellowship

Nasr, Viviane G.; Guzzetta, Nina A.; Miller‐Hance, Wanda C.; Twite, Mark; Latham, Gregory J.; Zabala, Luis; Nicolson, Susan C.; Mossad, Emad B.; DiNardo, James A.

doi:10.1213/ane.0000000000002482

Cited by 22 publications

(7 citation statements)

References 3 publications

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“…To achieve more homogeneity across training programs, consensus guidelines and milestones were developed, and in 2022 the Pediatric Cardiac Anesthesiology Fellowship Program underwent Accreditation Certification of Graduate Medical Education (ACGME) accreditation. 23,24 Accredited fellowships must provide 12 months of fellowship training, nine of which are dedicated to clinical anesthesia practice. This includes at least 100 cardiopulmonary bypass (CPB) cases, 50 of which the fellow is the primary anesthesia provider, 25 interventional catheterization procedures, and 10 electrophysiology procedures requiring general anesthesia.…”

Section: The State Of Pediatric Cardiac Anesthesiology In the United ...mentioning

confidence: 99%

The Year in Review: Anesthesia for Congenital Heart Disease 2022

Goodmanson

Latham

Landsem

et al. 2023

Semin Cardiothorac Vasc Anesth

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This review focuses on the literature published during the calendar year 2022 that is of interest to anesthesiologists taking care of children and adults with congenital heart disease (CHD). Four major themes are discussed: enhanced recovery after surgery(ERAS); diversity, equity, and inclusion; the state of pediatric cardiac anesthesiology as a subspecialty in the United States; and neuromonitoring for pediatric cardiac surgery.

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Section: The State Of Pediatric Cardiac Anesthesiology In the United ...mentioning

confidence: 99%

The Year in Review: Anesthesia for Congenital Heart Disease 2022

Goodmanson

Latham

Landsem

et al. 2023

Semin Cardiothorac Vasc Anesth

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“…To determine the content, the Working Group reviewed the program requirements and Milestones from similar specialties (eg, pediatric anesthesia, adult cardiothoracic anesthesia) and the consensus statement on Milestones by the CCAS. 4 The members identified subcompetencies that are both important to be assessed and developmental in nature. Through a process of large and small working groups, 7 PC and 5 MK sub-competencies were developed.…”

Section: Milestones-developmental Competenciesmentioning

confidence: 99%

“…3 Specifically, it was recommended that pediatric cardiac anesthesiology be a second, 12-month advanced fellowship following pediatric anesthesia to acquire skills unique from those acquired during a pediatric anesthesia fellowship. This was reiterated in 2018, when specific pediatric cardiac anesthesia training milestones were developed through consensus by the CCAS leadership 4 (Supplemental Digital Content 1, Supplemental Table 1, http://links.lww.com/AA/E133). However, these milestones were not enforced and training programs were not audited by the CCAS for compliance.…”

mentioning

confidence: 99%

Evolution of Accredited Pediatric Cardiac Anesthesiology Fellowship Training in the United States: A Step in the Right Direction

Nasr

Ambardekar

Grant

et al. 2022

Anesthesia &Amp; Analgesia

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Pediatric cardiac anesthesiology has developed as a subsubspecialty of anesthesiology over the past 70 years. The evolution of this specialty has led to the establishment in 2005 of a dedicated professional society, the Congenital Cardiac Anesthesia Society (CCAS). By 2010, multiple training pathways for pediatric cardiac anesthesia emerged. Eight programs in the United States offered advanced pediatric cardiac anesthesia with variable duration, ranging from 3 to 12 months. Other programs offered a combined fellow/staff position for 1 year. The need for a standardized training pathway was recognized by the Pediatric Anesthesia Leadership Council (PALC) and CCAS in 2014. Specifically, it was recommended that pediatric cardiac anesthesiology be a second, 12-month advanced fellowship following pediatric anesthesia to acquire skills unique from those acquired during a pediatric anesthesia fellowship. This was reiterated in 2018, when specific pediatric cardiac anesthesia training milestones were developed through consensus by the CCAS leadership. However, given the continuous increasing demand for well-trained pediatric cardiac anesthesiologists, it is essential that a supply of comprehensively trained physicians exists. High-quality training programs are therefore necessary to ensure excellent clinical care and enhanced patient safety. Currently, there are 23 programs offering one or more positions for 1-year pediatric cardiac anesthesia fellowship. Due to the diverse curriculum and evaluation process, formalization of the training with accreditation through the Accreditation Council for Graduate Medical Education (ACGME) was the obvious next step. Initial inquiry started in April 2020. The ACGME recognized pediatric cardiac anesthesia as a subsubspecialty in February 2021. The program requirements and milestones for the 1-year fellowship training were developed in 2021 and 2022. This special article reviews the history of pediatric cardiac anesthesia training, the ACGME application process, the development of program requirements and milestones, and implementation.

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“…6 The subspecialty has now evolved to the point at which there is an established second-year advanced 12-month pediatric cardiac anesthesia fellowship with dedicated training milestones. 9,10 Furthermore, earlier this year, pediatric cardiac anesthesiology was recognized as a distinct subspecialty by the Accreditation Council of Graduate Medical Education (ACGME). 11 Previous investigations have demonstrated inhomogeneous distribution of general pediatric surgeons and pediatric anesthesiologists in the United States.…”

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confidence: 99%

The Practice of Pediatric Cardiac Anesthesiology in the United States

Nasr

Staffa

Vener

et al. 2022

Anesthesia &Amp; Analgesia

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BACKGROUND: With advances in surgical and catheter-based interventions and technologies in patients with congenital heart disease (CHD), the practice of pediatric cardiac anesthesiology has evolved in parallel with pediatric cardiac surgery and pediatric cardiology as a distinct subspecialty over the past 80 years. To date, there has not been an analysis of the distribution of pediatric cardiac anesthesiologists relative to cardiac and noncardiac procedures in the pediatric population. The primary aim is to report the results of a survey and its subsequent analysis to describe the distribution of pediatric cardiac anesthesiologists relative to pediatric cardiac procedures that include surgical interventions, cardiac catheterization procedures, imaging studies (echocardiography, magnetic resonance, computed tomography, positron emission tomography), and noncardiac procedures. METHODS: A survey developed in Research Electronic Data Capture (REDcap) was sent to the identifiable division chiefs/cardiac directors of 113 pediatric cardiac anesthesia programs in the United States. Data regarding cardiac surgical patients and procedures were collected from the Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHD). RESULTS: This analysis reveals that only 38% (117 of 307) of pediatric cardiac anesthesiologists caring for patients with CHD pursued additional training in pediatric cardiac anesthesiology, while 44% (136 of 307) have gained experience during their clinical practice. Other providers have pursued different training pathways such as adult cardiac anesthesiology or pediatric critical care. Based on this survey, pediatric cardiac anesthesiologists devote 35% (interquartile range [IQR], 20%–50%) of clinical time to the care of patients in the cardiac operating room, 25% (20%–35%) of time to the care of patients in the cardiac catheterization laboratory, 10% (5%–10%) to patient care in imaging locations, and 15% covering general pediatric, adult, or cardiac patients undergoing noncardiac procedures. Attempts to actively recruit pediatric cardiac anesthesiologists were reported by 49.2% (29 of 59) of the institutions surveyed. Impending retirement of staff was anticipated in 17% (10 of 59) of the institutions, while loss of staff to relocation was anticipated in 3.4% (2 of 59) of institutions. Thirty-seven percent of institutions reported that they anticipated no immediate changes in current staffing levels. CONCLUSIONS: The majority of currently practicing pediatric cardiac anesthesiologists have not completed a fellowship training in the subspecialty. There is, and will continue to be, a need for subspecialty training to meet increasing demand for services especially with increase survival of this patient population and to replace retiring members of the workforce.

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Consensus Statement by the Congenital Cardiac Anesthesia Society: Milestones for the Pediatric Cardiac Anesthesia Fellowship

Cited by 22 publications

References 3 publications

The Year in Review: Anesthesia for Congenital Heart Disease 2022

The Year in Review: Anesthesia for Congenital Heart Disease 2022

Evolution of Accredited Pediatric Cardiac Anesthesiology Fellowship Training in the United States: A Step in the Right Direction

The Practice of Pediatric Cardiac Anesthesiology in the United States

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