The In and the Out
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Interventional cardiology is a unique medical discipline with a knowledge base of internal medicine and cardiology coupled with physical skill and analytic thinking common to surgical subspecialties. Not surprising, the training required to become an interventional cardiologist is substantial and ending one’s career as an interventionalist presents special challenges. Given the focus and physical demands required to excel at this discipline, retirement may come early in one’s professional career. Unfortunately, there are no guidelines of when to stop being an interventionalist or what pursuits should follow. In the article, we will discuss the issues most pertinent to the initiation and completion of a career as an interventional cardiologist.
The first challenge in the pursuit of a career as an interventional cardiologist comes during training. In its earliest days, interventions performed in cardiac catheterization laboratory were limited to percutaneous transluminal coronary angioplasty and there was no formal curriculum for trainees.1 Now 40 years later, the coronary interventional cardiologist’s toolbox is vast and includes multiple complex and specialized therapies including stenting, atherectomy, hemodynamic support devices, filters, and thrombectomy. Furthermore, the techniques and strategies for advanced and high-risk interventions have increased in complexity and require more dedicated educational time to master.
The scope of practice of interventional cardiology is no longer limited to coronary interventions, but rather has expanded to include peripheral vascular and structural interventions. Moreover, the magnitude and complexity of this menu of tasks is so substantial that many say that no single individual interventionalist can master all of them.
To effectively educate trainees in all facets of coronary interventions, while also incorporating training in peripheral vascular and structural interventions, many training programs have expanded from 1 to 2 or 3 years in duration.2 The average trainee will already have spent …