Proficiency in Coronary Angiography: Local Experience and College Requirements

Background

Proficiency in coronary angiography is a necessary skill for all cardiology trainees and is a requirement of training for the Royal Australasian College of Physicians.

Aims

The purpose of this study was to compare the local experience of advanced trainees with the College guidelines.

Methods

A retrospective analysis of fluoroscopy time and radiation exposure of the first 150 cases of three trainees between 1997 and 2001. These data were also compared to those from three experienced cardiologists.

Results

Advanced trainees are significantly slower than senior colleagues when starting (p<0.01) and improvements are made after 150 cases. Not all trainees improved by the same degree over the study period and most remained slower than consultants after 150 cases. Radiation doses were higher in general although there was significant individual variation between the trainee and the effect of time was diverse.

Conclusions

The performance of 150 coronary angiograms as a primary operator should be considered an arbitrary number. While improvements are seen in any task when performed repeatedly, the question of when an individual is proficient is less clear. Some individualization of assessment and monitoring would seem appropriate to ensure that trainees gain proficiency in performing coronary angiography during their advanced training period.

Keywords: Coronary angiography, Radiation monitoring, Education, Medical, Graduate