COMPETENCE IN CARDIOLOGY

Abstract

"This is the first cardiovascular competency statement to fully utilize the six
domains structure promulgated by the Accreditation Council of Graduate Medical
Education and adopted and endorsed by the American Board of Internal
Medicine," claimed noted John Gordon Harold, MD, MACC, president of the ACC
and chair of the writing committee. "It goes beyond medical knowledge and
procedure performance, to include the important issues of leading an
interdisciplinary team, working in a complex system, communicating effectively,
engaging in continuous quality improvement at the individual and system levels,
adhering to evidence-based medicine, and demonstrating the highest levels of
1 professionalism."

In Cardiology, like all other fields the quality of the patient-doctor relationship affects health and recovery from illness, medical costs and outcomes. This treasurable relationship depends on responding to patients' emotions and involving them in decision 13,14 making. Competence has a relational function-communicating effectively with patients and colleagues. This helps avoiding
15 and handling conflict and facilitates teaching patients, students and colleagues.

The assessment of competence is, now, not confined merely to evaluate performance of a skill rather it is assessed under all defined heads equally and rigorously. Core competency components for Percutaneous Coronary Interventions defined by ACCF includes medical knowledge of coronary anatomy, pathophysiology of myocardial ischemia, sound knowledge of radiation safety, procedure related complications and catheter related hardware. More importantly it includes all the following fields: professionalism, interpersonal skills and communication, systems-based practice practice-based learning and improvement
2,3 and patient care and procedures. Tools have been suggested to carry out assessment in all these domains and further 22 refinement is required. Similar core competency, spanned over all domains, must be defined in all fields of cardiology and training may be modulated to achieve these competencies. Evaluation tools must be robust and reliable to assess what is being assessed and help to enhance the competence of the doctors being evaluated.