What type of cardiologist works in the CCU?

[EgOmaniac]

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Ignorant questin, but what type of cardiologist do you have to be to work in the CCU? Do you have to be an interventionalist to cath?

 

[Shah_Patel_PT]

Ignorant questin, but what type of cardiologist do you have to be to work in the CCU? Do you have to be an interventionalist to cath?

..the ones who complete fellowship training....

 

[VCMM414]

Despite Shah_Patel_PT's somewhat flippant reply, he is actually right. As it currently stands, a general cardiologist without additional sub-speciality training can staff the CCU, and can diagnostically cath as well (but not therapeutically, ie. stenting). This may be changing, however. A recent article in the Journal of the American College of Cardiology (Katz JN, Turer AT, Becker RC. Cardiology and the critical care crisis: a perspective. J Am Coll Cardiol. 2007;49(12):1279-82.) called for the creation of combined Cardiology/Critical Care fellowships, similar to the current Pulm/CC setup. Given how Critical Care as a field has really taken off of late, it is not inconceivable that one day CCUs may be staffed solely by cardiologists who have also undergone critical care training (ie. intensivists).

 

[gutonc]

A recent article in the Journal of the American College of Cardiology (Katz JN, Turer AT, Becker RC. Cardiology and the critical care crisis: a perspective. J Am Coll Cardiol. 2007;49(12):1279-82.) called for the creation of combined Cardiology/Critical Care fellowships, similar to the current Pulm/CC setup. Given how Critical Care as a field has really taken off of late, it is not inconceivable that one day CCUs may be staffed solely by cardiologists who have also undergone critical care training (ie. intensivists).

Interesting. I wonder how well/if this will work. Cardiology is already a long fellowship, would this add another year for the CCM part or would something else have to give way? Another thing that I've seen at least in our program is that more people are going the single CC board route and foregoing Pulm which speeds up the training. Would Cards/CC even be able to attract people to the training? Not saying the training isn't a good idea, just that the trend toward increasing training time is going to start scaring people away from certain fields.

 

[viostorm]

Interesting. I wonder how well/if this will work. Cardiology is already a long fellowship, would this add another year for the CCM part or would something else have to give way?

I am skeptical, it is CRAZY for them to expect people to do 7 years of postgraduate training to work in a CCU. If they continue like JACC article suggests, the only people I can see doing it are FMG's on J-1 Visas to fill it because its the only way they can stay in the country.

Unless cardiology starts being a direct match, I see it starting to become less competitive. Cards is really shooting themselves in the foot with their training program. In the future I think insurance will stop paying for most caths (COURAGE trial). The non-invasive tests will improve and diagnostic caths will no longer be useful.

It was also interesting in the JACC article they wanted the CCU fellows to be able to put in gastric balloons for variceal bleeding ... an obvious attempt to try and bill for the common alcoholic resident of the ICU although it is about as related to cardiology as putting a bandaid on a bleeding wound.

The JACC article really made me think that cardiology people are really focused on making money ... as they are worried about their patients "being taken from them" ... and that was really annoying from an academic journal.

 

[NDESTRUKT]

I think any CCM certified person should be able to put in gastric balloons or something like a Minnesota tube down the esophagus if there's hematemesis. Same with bronching something who has hemoptysis. Just quick temporary things may be necessary for a CCM boarded person.