|Glenn P. Gravlee, MD
Fellowship Accreditation Update
In a President's Message of precisely one year ago, I traced the history of SCA's pursuit of accreditation for cardiothoracic anesthesiology fellowship programs, which began in the late 1990s. At that time this history included two applications sent by SCA to the Accreditation Council on Graduate Medical Education (ACGME), both of which were rejected with constructive suggestions for resubmission. ACGME delegates initial screening of subspecialty fellowship applications to its Residency Review Committee (RRC) for the primary specialty. As promised in that message, a third application was submitted late in 2003, and we were pleased that the anesthesiology RRC responded with specific questions and with a request for SCA to present and answer questions at their semi-annual meeting in March, 2004.
After that RRC meeting, some additional queries were posed to SCA, to which we promptly responded. At present our understanding is that the anesthesiology RRC accepts the concept of cardiothoracic anesthesiology fellowships, and that the program requirements and application need some rewriting for presentation to the RRC's parent organization, ACGME. Once this process is complete, ACGME will announce its interest in this concept and will send a set of proposed fellowship program requirements to US residency program directors with a timeline for response. As appropriate, these suggestions will be incorporated into the program requirements, which will then be considered, hopefully approved by ACGME, announced, and implemented.
As noted in the December, 2003 President's Message and in others before it, American SCA members should understand that fellowship accreditation only involves developing a standardized approach and approval process for fellowship programs. It is not tantamount to subspecialty certification in cardiothoracic anesthesiology, which would involve testing and certifying individual practitioners by an American Board of Medical Specialties (ABMS) member board such as the American Board of Anesthesiology (ABA). Fellowship accreditation does not require future implementation of certification in cardiothoracic anesthesiology, and SCA members should rest assured that SCA is not pushing for certification. The ongoing certification process in Perioperative Transesophageal Echocardiography (PTE) is a separate voluntary process organized and implemented by the National Board of Echocardiography (NBE) that does not involve ABMS or ABA. The proposed fellowship program requirements are designed such that graduating fellows will fulfill the didactic and case requirements to be eligible for the NBE certification process. For more information on NBE certification, see www.echoboards.org and click on PTEeXAM.
If the ACGME should elect to proceed with approval and implementation of fellowship programs in cardiothoracic anesthesiology (as I believe it will), what is the likely time course? My best guess is 2006 or 2007, but 2007 may be the more likely implementation date.
What will the final fellowship program requirements look like? At the request of your SCA Board of Directors, we have just posted SCA's most recent program requirement submission to ACGME on the SCA web site (www.scahq.org, click under Fellowships on "Program Requirements for Residency Education in Cardiothoracic Anesthesiology"). Both the fellowship program approval process and the accompanying program requirements are now in the hands of the anesthesiology RRC of the ACGME, so the final version might look substantially different from the one on our web site. Nevertheless, for those desiring a program template in the interim, this is our best approximation at present.
I wish to thank the Chair of our Task Force on Fellowship Accreditation, SCA Past President Alan Jay Schwartz, for his outstanding and tireless work on this project. Stephen J. (Butch) Thomas was also an invaluable resource in developing and presenting our third submission to ACGME. I also thank other members of the Fellowship Accreditation Task Force (listed in the box), fellowship and residency program directors who responded to our previous draft program requirements, and the anesthesiology RRC members for their roles in this important educational initiative.
Glenn P. Gravlee, MD
Cardiac Anesthesia Fellowship Accreditation Task Force
Alan Jay Schwartz, MD, MSEd, Chair
J. G. Reves, MD, Vice Chair
Frederick Campbell, MD
Michael D'Ambra, MD
Richard F. Davis, MD
Glenn P. Gravlee, MD
Roger A. Moore, MD
Mark Rockoff, MD
Michael F. Roizen, MD
Linda Shore-Lesserson, MD
Stephen J. Thomas, MD
Daniel M. Thys, MD