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PCI 100 - A basic PCI course for Interventional Fellows.

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  • PCI 100 - A basic PCI course for Interventional Fellows.

    Having graduated 10years ago, I’m reasonably aware of the gaps in fellowship training when it comes to transitioning to real life. Very often, interventional fellows have good exposure to the advanced stuff, without as much exposure to basic stuff. This includes the engineering of products we often use i.e. interventional equipment, cath labs and devices themselves. There is also a paucity of how to get the basics right. As part of a large interventional cardiology practice, I often am in a position of mentoring new graduates and am amazed to see lacunae in basics despite their robust exposure to advanced technologies. For instance, having TAVR exposure doesn’t guarantee a great operator at basic PCI.

    I’m proposing creating a small group format course on a quarterly basis at our facility where we design a very basic curriculum. The attendees will include the fellows from 8-10 interventional cardiology programs WITH a faculty member (preferrably program director). (If a program can’t send the faculty, we will not want the fellows of that program to attend.) This will be a single day event on a Saturday. The focus will be on a group discussion format.

    The curriculum will include
    1. Basics of PCI
    a. Patient selection
    b. Appropriateness in real life
    c. Interventional gear
    i. Guides - engineering, designs (from industry engineers) as well as guide selection (from faculty)
    ii. Guidewires - engineering, designs (from industry engineers) as well as guidewire selection, use as well as tips and tricks (from faculty)
    iii. Balloons - engineering, designs (from industry engineers) as well as balloon use, tips and tricks(from faculty)
    iv. Stents - engineering, designs (from industry engineers) as well as stent use, tips and tricks (from faculty)
    d. Hemodynamics of PCI - more than just FFR.
    e. IVUS and OCT imaging
    2. Common PCI complications and pitfalls.
    1. Access complications
    2. PCI complications
    1. Hemodynamic issues
    2. Managing the pericardium
    3. Managing coronary disruption
    3. Hands on with devices with the engineers to help understand how they work.
    4. Brief section on things I never learnt in fellowship
    1. Billing
    2. Dealing with partners and colleagues (particularly difficult ones)
    3. Dealing with cath lab staff (real world discussion of how staff in the cath lab (from our facility) deal with physicians, particularly new ones)

    Unlike didactic courses, with fellows being assaulted with information, the idea behind this course is to have the fellow’s own faculty member join a group of program directors and our faculty to provide a more stimulating discussion and learning experience. There will be no mention of results from large randomized control trials, no late breaking trials, no CTOs, no high risk PCI, no TAVR or AAAs.

    We look forward to developing this course further and are in talks with SCAI for sponsorship in the future.