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Salik JR, Zern EK, McCarthy IR, Theriot P, West K, Thakker P, Weissman G, Rose-Jones LJ. In-Person vs Virtual Interview Format for Fellowships in Cardiovascular Disease: A Nationwide Survey of Fellows-in-Training. J Am Coll Cardiol 2023; 82:465-468. [PMID: 37495283 DOI: 10.1016/j.jacc.2023.05.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 07/28/2023]
Affiliation(s)
- Jonathan R Salik
- Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
| | - Emily K Zern
- Providence Heart Institute, Center for Cardiovascular Analytics, Research, and Data Science (CARDS), Providence St Joseph Health, Portland, Oregon, USA
| | - Inbar R McCarthy
- Cardiology Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Paul Theriot
- American College of Cardiology, Washington, DC, USA
| | - Kristin West
- American College of Cardiology, Washington, DC, USA
| | - Prashanth Thakker
- Cardiovascular Division, Washington University in St Louis School of Medicine, St Louis, Missouri, USA
| | - Gaby Weissman
- MedStar Heart and Vascular Institute, MedStar Health and Georgetown University School of Medicine, Washington, DC, USA
| | - Lisa J Rose-Jones
- Division of Cardiovascular Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
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Alviar CL, Miller PE, Van Diepen S, Jentzer JC, Rampersad P, Hollenberg SM, Metkus TS, Fordyce C, Theriot P, Quien M, Sinha SS, Barnett CF, Roswell R, Morrow DA, Solomon MA. WHAT ARE THE CURRENT PRACTICE PATTERNS AND PERCEPTIONS OF CARDIOLOGISTS AND FELLOWS-IN-TRAINING IN MANAGING POSITIVE PRESSURE VENTILATION IN THE CARDIAC INTENSIVE CARE UNIT? J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)02829-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Luu JM, Wei J, Shufelt CL, Asif A, Tjoe B, Theriot P, Bairey Merz CN. Clinical Practice Variations in the Management of Ischemia With No Obstructive Coronary Artery Disease. J Am Heart Assoc 2022; 11:e022573. [PMID: 36172938 DOI: 10.1161/jaha.121.022573] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Ischemia with no obstructive coronary artery disease is a condition associated with major adverse cardiovascular outcomes. To date, there are no specific American Heart Association or American College of Cardiology guidelines. The objective of this survey is to better understand the clinical practice and knowledge gaps that exist nationally. Methods and Results Participant-specific links for a survey with 11 questions and 3 reminders were sent between September and October 2020 to the American College of Cardiology CardioSurve Panel. The panel consist of randomly selected cardiologists (n=437) who represent the current profile of the American College of Cardiology US membership. The survey received a 30% response rate. Of the 172 respondents, 130 (76%) indicated that they have treated patients with ischemia with no obstructive coronary artery disease. Although the majority (69%) are generally confident in their ability to manage this condition, 1 of 3 report lack of confidence or are neutral. The American College of Cardiology/American Heart Association Chronic Stable Angina Guidelines are the most commonly used reference for treating ischemia with no obstructive coronary artery disease (81%), with most cardiologists wanting additional clinical guidance, such as randomized controlled trials (61%). More than 4 of 5 cardiologists rarely or never order advanced imaging modalities to assess coronary flow reserve. Approximately 2 of 3 of respondents frequently prescribe statins (68%), aspirin (66%), calcium channel blockers (63%), and β blockers or α/β blockers (55%). However, nearly 70% never prescribe angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. Conclusions This survey demonstrates heterogeneity in the management of ischemia with no obstructive coronary artery disease among US cardiologists, identifies support for guideline development, and outlines knowledge gaps for research and education in the therapeutic management of this condition.
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Affiliation(s)
- Judy M Luu
- Barbra Streisand Women's Heart Center, Smidt Heart Institute Cedars-Sinai Medical Center Los Angeles CA
| | - Janet Wei
- Barbra Streisand Women's Heart Center, Smidt Heart Institute Cedars-Sinai Medical Center Los Angeles CA
| | - Chrisandra L Shufelt
- Barbra Streisand Women's Heart Center, Smidt Heart Institute Cedars-Sinai Medical Center Los Angeles CA
| | - Anum Asif
- Barbra Streisand Women's Heart Center, Smidt Heart Institute Cedars-Sinai Medical Center Los Angeles CA
| | - Benita Tjoe
- Barbra Streisand Women's Heart Center, Smidt Heart Institute Cedars-Sinai Medical Center Los Angeles CA
| | | | - C Noel Bairey Merz
- Barbra Streisand Women's Heart Center, Smidt Heart Institute Cedars-Sinai Medical Center Los Angeles CA
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Waldman CE, Min JH, Wassif H, Freeman AM, Rzeszut AK, Reilly J, Theriot P, Soliman AM, Thamman R, Bhatt A, Bhavnani SP. COVID-19 telehealth preparedness: a cross-sectional assessment of cardiology practices in the USA. Per Med 2022; 19:411-422. [PMID: 35912812 DOI: 10.2217/pme-2021-0179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: The COVID-19 pandemic forced medical practices to augment healthcare delivery to remote and virtual services. We describe the results of a nationwide survey of cardiovascular professionals regarding telehealth perspectives. Materials & methods: A 31-question survey was sent early in the pandemic to assess the impact of COVID-19 on telehealth adoption & reimbursement. Results: A total of 342 clinicians across 42 states participated. 77% were using telehealth, with the majority initiating usage 2 months after the COVID-19 shutdown. A variety of video-based systems were used. Telehealth integration requirements differed, with electronic medical record integration being mandated in more urban than rural practices (70 vs 59%; p < 0.005). Many implementation barriers surfaced, with over 75% of respondents emphasizing reimbursement uncertainty and concerns for telehealth generalizability given the complexity of cardiovascular diseases. Conclusion: Substantial variation exists in telehealth practices. Further studies and legislation are needed to improve access, reimbursement and the quality of telehealth-based cardiovascular care.
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Affiliation(s)
- Carly E Waldman
- Department of Internal Medicine, Scripps Clinic, San Diego, CA, USA.,Division of Cardiology, Healthcare Innovation Laboratory, Prebys Cardiovascular Institute, Scripps Clinic, San Diego, CA 92037,USA
| | - Jean H Min
- Department of Internal Medicine, Scripps Clinic, San Diego, CA, USA.,Division of Cardiology, Healthcare Innovation Laboratory, Prebys Cardiovascular Institute, Scripps Clinic, San Diego, CA 92037,USA
| | - Heba Wassif
- Department of Cardiovascular Medicine, Section of Clinical Cardiology, Heart, Vascular & Thoracic Institute, Cleveland Clinic Foundation, Cleveland, OH 44103, USA
| | - Andrew M Freeman
- Department of Medicine, Division of Cardiology, National Jewish Health, Denver, CO 80206, USA
| | - Anne K Rzeszut
- American College of Cardiology, Heart House, Washington, DC 20037, USA
| | - Jack Reilly
- American College of Cardiology, Heart House, Washington, DC 20037, USA
| | - Paul Theriot
- American College of Cardiology, Heart House, Washington, DC 20037, USA
| | - Ahmed M Soliman
- Division of Cardiology, Houston Methodist DeBakey Cardiology Associates, Houston, TX 77030, USA
| | - Ritu Thamman
- Division of Medicine, University of Pittsburg School of Medicine, Pittsburg, PA 15213, USA
| | - Ami Bhatt
- Division of Cardiology, Adult Congenital Heart Disease Program, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Sanjeev P Bhavnani
- Division of Cardiology, Healthcare Innovation Laboratory, Prebys Cardiovascular Institute, Scripps Clinic, San Diego, CA 92037,USA
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Cullen MW, Damp JB, Soukoulis V, Keating FK, Abudayyeh I, Auseon A, Qasim A, Tam MC, Theriot P, Weissman G. Identification and Management of Learner Burnout in Cardiology Fellowship Programs. J Am Coll Cardiol 2022; 79:2548-2549. [PMID: 35738719 DOI: 10.1016/j.jacc.2022.04.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/21/2022] [Accepted: 04/26/2022] [Indexed: 10/18/2022]
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Cullen MW, Damp JB, Soukoulis V, Keating FK, Abudayyeh I, Auseon A, Bhakta D, Qasim A, Seryak A, Smith SA, Tam MC, Theriot P, Weissman G. Burnout and Well-Being Among Cardiology Fellowship Program Directors. J Am Coll Cardiol 2021; 78:1717-1726. [PMID: 34674817 DOI: 10.1016/j.jacc.2021.08.034] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/11/2021] [Accepted: 08/12/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The third annual Cardiovascular Diseases (CV) Fellowship Program Directors (PDs) Survey sought to understand burnout and well-being among CV fellowship PDs. BACKGROUND Physician burnout is a common phenomenon. Data on burnout among cardiologists, specifically CV PDs, remain limited. METHODS The survey contained 8 questions examining satisfaction, stress, and burnout among CV fellowship PDs. Burnout was defined based on the self-reported presence of ≥1 symptom of burnout, constant feelings of burnout, or complete burnout. RESULTS Survey response rate was 57%. Most respondents were men (78%) and 54% represented university-based programs. Eighty percent reported satisfaction with their current job as PD, and 96% identified interactions with fellows as a driver of their satisfaction. Forty-five percent reported feeling a great deal of stress from their job. Stress was higher among women PDs, early-career PDs, and PDs of larger and university-based programs. Twenty-one percent reported some symptoms of burnout, and only 36% reported enjoyment without stress or burnout. Rates of enjoyment without stress or burnout were higher among men and late-career PDs, PDs of smaller programs, and PDs of community-based programs. Seventeen percent of PDs reported a high likelihood of resigning in the next year, of which the most common reason was the tasks of PDs were becoming overwhelming. CONCLUSIONS Most CV fellowship PDs are satisfied with their position, but stress and burnout remain common. Women PDs, early-career PDs, and PDs of larger, university-based programs demonstrate more adverse markers of well-being. Opportunities exist to support CV fellowship PDs in their critical role.
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Affiliation(s)
- Michael W Cullen
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
| | - Julie B Damp
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Victor Soukoulis
- Division of Cardiovascular Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Friederike K Keating
- Division of Cardiology, University of Vermont Larner College of Medicine, Burlington, Vermont, USA
| | - Islam Abudayyeh
- Division of Cardiology, Loma Linda University, Loma Linda, California, USA
| | - Alex Auseon
- Division of Cardiology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Deepak Bhakta
- Division of Cardiology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Atif Qasim
- Division of Cardiology, University of California, San Francisco, San Francisco, California, USA
| | - Audrey Seryak
- Division of Cardiology, Christiana Care Health System, Newark, Delaware, USA
| | - Sakima A Smith
- Cardiovascular Medicine, Ohio State University, Columbus, Ohio, USA
| | - Marty C Tam
- Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Paul Theriot
- American College of Cardiology, Washington, DC, USA
| | - Gaby Weissman
- Department of Cardiology, Medstar Heart and Vascular Institute and Georgetown University, Washington, DC, USA
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Damp JB, Cullen MW, Soukoulis V, Tam MC, Keating FK, Smith SA, Bhakta D, Abudayyeh I, Qasim A, Sernyak A, Auseon A, Theriot P, Weissman G. Program Directors Survey on Diversity in Cardiovascular Training Programs. J Am Coll Cardiol 2021; 76:1215-1222. [PMID: 32883415 DOI: 10.1016/j.jacc.2020.07.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Women and minorities are under-represented in cardiovascular disease (CVD) specialties. It remains unknown how characteristics of the CVD learning environment affect diversity and how program directors (PDs) approach these critical issues. OBJECTIVES The second annual Cardiovascular PD Survey aimed to investigate characteristics of the CVD learning environment that may affect diversity and strategies PDs use to approach these issues. METHODS The survey contained 20 questions examining U.S.-based CVD PD perceptions of diversity in CVD and related characteristics of the CVD fellowship learning environment. RESULTS In total, 58% of PDs completed the survey. Responding programs demonstrated geographic diversity. The majority were university-based or -affiliated. A total of 86% of PDs felt diversity in CVD as a field needs to increase, and 70% agreed that training programs could play a significant role in this. In total, 89% of PDs have attempted to increase diversity in fellowship recruitment. The specific strategies used were associated with PD sex and the presence of under-represented minority trainees in the program. PDs identified lack of qualified candidates and overall culture of cardiology as the 2 most significant barriers to augmenting diversity. A majority of programs have support systems in place for minority fellows or specific gender groups, including procedures to report issues of harassment or an unsafe learning environment. PDs identified shared best practices for recruitment and implicit bias training, among others, as important resources in their efforts to support diversity in CVD training. CONCLUSIONS Diversity is important to CVD PDs. They are striving to increase it in their programs through recruitment and strategies directed toward the fellowship learning environment. The CVD community has opportunities to standardize strategies and provide national resources to support PDs in these critical efforts.
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Affiliation(s)
- Julie B Damp
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
| | - Michael W Cullen
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Victor Soukoulis
- Division of Cardiovascular Medicine, University of Virginia, Charlottesville, Virginia
| | - Marty C Tam
- Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan
| | - Friederike K Keating
- University of Vermont Larner College of Medicine, Division of Cardiology, Burlington, Vermont
| | - Sakima A Smith
- Cardiovascular Medicine, Ohio State University, Columbus, Ohio
| | - Deepak Bhakta
- Cardiovascular Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Islam Abudayyeh
- Division of Cardiology, Loma Linda University, Loma Linda, California
| | - Atif Qasim
- Division of Cardiology, University of California, San Francisco, San Francisco, California
| | - Audrey Sernyak
- Division of Cardiology, Christiana Care Health System, Newark, Delaware
| | - Alex Auseon
- Division of Cardiology, University of Illinois at Chicago, Chicago, Illinois
| | | | - Gaby Weissman
- Department of Cardiology, Medstar Heart and Vascular Institute and Georgetown University, Washington, DC
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Damp JB, Cullen MW, Soukoulis V, Tam MC, Keating FK, Abudayyeh I, Qasim A, Theriot P, Weissman G. Parental Leave in Cardiovascular Disease Training Programs. J Am Coll Cardiol 2020; 76:348-349. [PMID: 32674798 DOI: 10.1016/j.jacc.2020.05.044] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/08/2020] [Accepted: 05/11/2020] [Indexed: 11/26/2022]
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Weissman G, Lee J, Sivaram CA, Theriot P, Ferrari VA, Damp JB, Villines TC. The Current State of Cardiovascular Imaging Training. JACC Cardiovasc Imaging 2020; 13:1638-1639. [DOI: 10.1016/j.jcmg.2020.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 02/04/2020] [Accepted: 02/14/2020] [Indexed: 11/28/2022]
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Weissman G, Damp JB, Ferrari V, Sivaram CA, Lee JC, Theriot P, Villines T. THE STATE OF CARDIOVASCULAR IMAGING TRAINING: RESULTS OF THE IMAGING PROGRAM DIRECTORS SURVEY. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)34198-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Auseon AJ, Weissman G, Theriot P, Tam M, Damp J. CHARACTERISTICS OF CARDIOVASCULAR TRAINING PROGRAMS AND PROGRAM DIRECTORS: INITIAL RESULTS OF THE CARDIOVASCULAR PROGRAM DIRECTORS’ SURVEY. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)33626-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Flaker GC, Theriot P, Binder LG, Dobesh PP, Cuker A, Doherty JU. Management of Periprocedural Anticoagulation. J Am Coll Cardiol 2016; 68:217-26. [DOI: 10.1016/j.jacc.2016.04.042] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 04/05/2016] [Accepted: 04/12/2016] [Indexed: 10/21/2022]
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