19 4 year results of the cardiology trainee feedback project

Background The Higher Specialist Training (HST) Scheme is run by the Royal College of Physicians (RCPI) overseen by the Irish Board for Training in Cardiovascular Medicine (IBTCM). The stated aim of the scheme is to provide doctors upon completion, with the necessary skills and knowledge to practice competently, professionally and independently as cardiology specialists. In order to inform dialogue surrounding improvements to the training scheme, those enrolled have been surveyed annually over the past 4 years to gage their views regarding the following domains - trainer/trainee interaction, access to training, procedural training, service commitments and training, research and audit, training program structure, gender balance, future career planning and location, quality of life and in the past year the impact of the Covid- 19 pandemic on training. Methods For the past 4 years, the second author surveyed trainees in training years 1-4 through the medium of an online questionnaire. Trainees were asked to respond to a range of questions pertaining to the domains of interest listed above, predominantly indicating their level of agreement with a statement in the format of a 5 point Likert scale. Results The response rate to the survey was excellent and averaged at 65% over the four years. Individual years ranged from 52% to a high of 82%. Even in the year with the lowest response (52%) a significant proportion of the trainees were represented. Overall trainees are happy with the training scheme with 88% saying they would recommend the training scheme. When asked if a trainee encountered significant challenges in accessing training - CT/MRI, followed by Adult Congenital Heart Disease and Electrophysiology were most frequently identified. Interest in dual accreditation was low, with 77% of respondents saying they did not intend to purse dual accreditation. Approximately half (47%) of respondents felt that their year spent doing General Internal Medicine (GIM) enhanced their training experience. 46% of respondents felt they have a poor or very poor work-life-balance, but 72% indicated that they had a very good or good quality of life. Future career planning: 83% of trainees indicated definitely or probably when asked if planning to work in Ireland after completion of training. However, when in 2018, a small number of trainees on overseas out of program experience were asked the same question a smaller proportion of respondents indicated that they wished to work in Ireland. In relation to gender - 28% of respondents were female, in keeping with prior work published by the authors in 2017 showing a 7:3 gender ratio overall for trainees between 1998 and 2017. To address the gender balance respondents felt that changes to the training scheme(63%) and work practices (72%) would be needed. Covid-19 had a marked affect on training, with 94% of trainees responding that it adversely affected their training. Conclusion This 4 year study of the Irish cardiology trainees gives important insights into the strengths and weaknesses of the training scheme. It highlights the impact due to the current Covid-19 pandemic on training. It also gives valuable information regarding the future career goals of current trainees. All of the above, should be useful in the framing and shaping of any discussion regarding the future of cardiology training and service delivery in Ireland in the decades to come.