Task Force 6: Pediatric Cardiology Fellowship Training in Adult Congenital Heart Disease. SPCTPD/ACC/AAP/AHA.

1.1. Document Development Process The Society of Pediatric Cardiology Training Program Directors (SPCTPD) board assembled a Steering Committee that nominated 2 chairs, 1 SPCTPD Steering Committee member, and 4 additional experts from a wide range of program sizes, geographic regions, and subspecialty focuses. Representatives from the American College of Cardiology (ACC), American Academy of Pediatrics (AAP), and American Heart Association (AHA) participated. The Steering Committee member was added to provide perspective to each Task Force as a “nonexpert” in that field. Relationships with industry and other entities were not deemed relevant to the creation of a general cardiology training statement; however, employment and affiliation information for authors and peer reviewers are provided in Appendixes 1 and 2, respectively, along with disclosure reporting categories. Comprehensive disclosure information for all authors, including relationships with industry and other entities, is available as an online supplement to this document. The writing committee developed the document, approved it for review by individuals selected by the participating organizations (Appendix 2), and addressed their comments. The final document was approved by the SPCTPD, AAP, and AHA in February 2015 and approved by the ACC in March 2015. This document is considered current until the SPCTPD revises or withdraws it. 1.2. Background and Scope It is estimated that there are currently more adults than children with congenital heart disease (CHD). Despite this, most adult cardiologists are not familiar with CHD, and to date, pediatric cardiology training has not focused on typical adult diseases or on the social issues that impact adults. Pediatric cardiology training will provide a sound basis for the diagnosis and management of CHD that spans all ages; however, the manifestations, diagnosis, treatments, and outcomes of CHD in adults have important differences from those diseases in children. The goal of Adult Congenital Heart Disease (ACHD) training for pediatric cardiology fellows is to expose them to the common sequelae of both repaired and unrepaired CHD in the adult. This presupposes that the trainee has a solid foundation in the principles of CHD diagnosis and management gained through his or her pediatric cardiology training. Additional subjects for trainees to learn should include the common medical conditions encountered in adults such as coronary disease, pregnancy, and depression. The impact of issues such as employment and insurability should also be a part of the curriculum as they strongly impact patient well-being. A smooth transition of patients from pediatric to adult care is the first step in ACHD care, and in most medical systems, that responsibility lies with the pediatric providers. Therefore, education on the transition process, awareness of the needs of ACHD patients, systems available for care of ACHD patients, and resources to ensure adequate cardiac care are all important parts of the pediatric cardiology curriculum in ACHD. There are a variety of ways to fulfill the training goals in ACHD. The ideal experience combines didactic lectures and