A Graduating Fellows Guide to Pediatric Cardiology Resources

July is an important month for medical education— whether it’s graduating from med school and starting intern year, finally becoming a senior or starting fellowship.  With fellowship ending for me, and starting for many, I started to compile a list of resources for pediatric cardiology to share.

Many of these resources were passed down to me by seniors or mentors, but also many were found on twitter (read more about how you can use this to your advantage in my previous blog). Some emerged recently during COVID-19 in an effort to bring pediatric cardiology together virtually and bridge education gaps for webinars, lectures and more.

For online resources, I recommend creating a folder on your browser and saving sources for easy access later. Another helpful thing for me was saving the links to Moss & Adams, Mayo Clinic Board Review, & Lai echo e-books in this folder so that you can access them anytime and not have to carry the books around(you can find the codes in the front cover of the book).

Below are websites for great lectures, webinars and reading, clinical resources, apps, podcasts, important organizations and ways to find job postings. Enjoy and please share!

Websites for Lectures, Reading and Resources:
Heart UniversityEducational video on pediatric and adult congenital heart disease (ACHD) includes pathology lectures by Dr. Robert Anderson. They also host great webinars on various topics with leaders in the field.
SPCTPD PC-NES (Pediatric Cardiology National Education Series), a lecture series that was started to provide education to fellows during the pandemic— you can access all the previous lectures that were given on various topics with lecturers from around the country, this is planned to continue in the fall.
SCMR– Cardiac MRI case based webinars.
ACHA– ACHD association with webinars on various topics.
Dr. Robert Pass EP lectures; Excellent weekly EP conferences(Mondays 7am EST) with the Mount Sinai pediatric cardiology fellows, past conferences are on this YouTube page and the link to join live is sent via pediheartnet(see below), you can also find Dr. Pass on his podcast(below) and on twitter!
Multimedia Manual of Cardio-thoracic Surgery Surgical videos and descriptions geared towards surgeons but helpful to explain and see common CHD procedures).
Cardiology Notes– Summaries of various chapters from Moss & Adams, Lai Echo, as well as other pediatric cardiology tests and resources.
Parameterz website for Z scores to use for echo, easy to use on desktop or phone
Virtual TEE (Toronto) – TEE simulator.

Pediheart– Peds Cardiology Podcast hosted by Dr. Robert Pass (above) – review of recent literature and topics usually with a great guest, tune in each week (released Friday) and learn to appreciate Opera too.
CardionerdsMostly geared toward adult cardiology with some overlap to Peds.
PCICS– Cardiac ICU topics and discussion with various leaders in the field.

Apps: (links are to the apple store, but they should be available through google play too!)
EP tools lite– Various EP calculators including WPW pathway localization tool.
Heartpedia Great resource for education for patients, medical students and residents with easy to use interactive diagrams of common CHD and repairs.
Pacemaker Using the patient’s chest XR, snap a picture of the pacemaker and this will tell you who the maker is (Medtronic, St. Jude, etc.)
Practice Update– Follow topics (i.e. Cardiology) and receive virtual “stacks” of the latest literature on that topic with quick reviews and links to full text.
Dimity– Use this app to make patient phone calls from your phone so your number shows up as the hospital line and not your number or unknown. Very helpful for home call!

Conferences/Organizations: all conferences through 2020 are now virtual allowing you to access more content. Remember as a fellow your membership and registration is usually discounted or free, take advantage while you can!
ACC Annually in March.
ASE Annually in the summer (virtual August 8-10) and only $75 for fellows).
PICS-AICS Cath focused conference annually in September.
AHAAnnually in November.
PCICS Annually in December for those interested in cardiac ICU. Bonus fact- they are also hosting virtual meetings on experience and research related to COVID-19 and pediatric cardiac care.
PAC3, PC4 & NPC-QICCollaborative organizations to improve outcomes in congenital heart disease, along with these are great organizations for quality improvement and outcomes research and hold an annual conference along with webinars.
CHOP pediatric cardiology update  Annual dedicated pediatric cardiology conference in February.

Job Postings: below are links to sites that may be helpful as you are looking for jobs, don’t hesitate to reach out to people, have your mentors reach out or cast a wide net, you may find opportunities that aren’t posted.
Pediheartnet- A list server with job postings; this also facilitates discussion between cardiologists around the world, this is the server that the weekly EP conferences (above) will be sent out on and other great opportunities- a must join!
Other sites for job postings-
Congenital Cardiology Today
CareerMD Pediatric Cardiology Job Bulletin
NEJM Career Center ACC Career & AHA Career Centerrefine your search by specialty and receive emails with new postings.

Happy July, and don’t forget to be kind and welcoming to someone new in the hospital, you were there once too!

“The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.”


What Exactly Does A Pediatric Cardiac Intensivist Do?

When someone asks me what I do, my answer is usually pretty short and vague.  “I’m a physician.” “I’m a pediatric cardiologist.” “I work in an ICU.”  This is frequently enough detail to move the conversation along to other topics and I rarely dwell on the nitty gritty of what I actually do at work. 

However, recently, I’ve noticed that when physicians, nurses, or other healthcare providers ask what I do, my vague response is seldom enough.  Many are very curious, but have no clue what the scope or responsibilities of my subspecialty actually are.  Someone even recently asked, “So, do you just follow the surgeons around all day and help them take care of their patients?” 

This lack of awareness is partially because it’s such a relatively young subspecialty, though it continues to grow rapidly.  It doesn’t fit what people think of when they envision other realms of perioperative care.  Many people are used to systems where patients are primarily cared for by their surgeons in the perioperative period.  There are also vast differences in the way that congenital heart centers are structured, which affects how adult cardiology care and pediatric cardiology care are delivered differently.  The complexity and varied physiologies of congenital heart surgery patients is also quite different from the adult cardiac surgical population.

Another reason is because there are so many different ways to become a pediatric cardiac intensivist.  Based on the history and development of our subspecialty, we have sprouted from the convergences of multiple different fields; cardiac intensivists can bloom from various taxonomies including pediatric cardiologists, pediatric intensivists, neonatologists, anesthesiologists, and surgeons.  The training pathways are varied, but our ultimate job description remains the same: to care for critically ill pediatric and adult congenital patients with heart disease. 

Of course, this is an oversimplification.  Because of the heterogeneity and newness of pediatric cardiac critical care, the scope of practice and care delivery models can be different from center to center.  In some centers, there isn’t a dedicated cardiac ICU and pediatric intensivists care for cardiac patients at the same time as they manage traumatic brain injury and liver transplant patients.  In others, cardiologists primarily manage these patients with occasional consultation from critical care.  In such a diverse specialty, it’s actually quite difficult to say definitively what exactly a pediatric cardiac intensivist does.

However, our field is currently in the stage of development where we are striving for more standardized and formalized training curricula and well-defined competencies.  With more regionalization of care and new dedicated cardiac intensive care units opening up with the expectation in many centers for 24/7 in-house attending coverage, we will need more young physicians to commit to undergoing the training required to become pediatric cardiac intensivists.  And it may be difficult to convince people to train for 7-8 years after medical school without firm agreement on the legitimacy and scope of the field.

Accordingly, I am currently working with a team on a mixed-methods study to define entrustable professional activities for our field (essentially, the core responsibilities expected of those who practice independently).  Hopefully, soon we will have a well-established and broadly accepted answer to the question, “what does a pediatric cardiac intensivist do?

David Werho Headshot

David K. Werho, MD is an Assistant Clinical Professor at the University of California San Diego and a Pediatric Cardiac Intensivist at Rady Children’s Hospital – San Diego.  His research focuses on pediatric cardiac ICU outcomes as well as interventions and curriculum development in medical education.  He tweets @DWerho and contributes to the Pediatric Cardiac Intensive Care Society Newsletter as editor and contributor.