SOCIETY FOR CARDIOVASCULAR PATHOLOGY FORUM ON CARDIOVASCULAR by xiq51311

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									   SOCIETY FOR CARDIOVASCULAR PATHOLOGY
FORUM ON CARDIOVASCULAR PATHOLOGY TRAINING

              Vancouver, BC, Canada
                  March 6, 2004



 Clinical, teaching and research demands:
        the CV pathologist expertise


          Frederick J. Schoen, MD, PhD
             Department of Pathology
          Brigham and Women’s Hospital
              Harvard Medical School
           e-mail: fschoen@partners.org
Cardiac/cardiovascular (C/CV) pathologists
      have a varied mix of activities
• Diagnostic patient care activities (surgical
  pathology, autopsy) emphasizing C/CV disease
• Other clinical activities
• Forensic pathology
• Research pertinent to C/CV disease (basic,
  translational or clinical)
• Teaching C/CV pathology (to medical students,
  residents, clinician colleagues, others)
• Institutional administrative/leadership activities
• Professional/scholarship/regulatory/standards
  activities (local, national, and international)
• Corporate/medicolegal consultation activities
  pertinent to C/CV disease
C/CVP clinical diagnostic roles are varied
•   Surgical C/CVP
    – Vessels
    – Valves
    – Endomyocardial biopsies
    – Hearts
    – Grafts, prosthetic devices
    – Tumors
•   Logical combined practices (e.g., pulmonary)
•   Autopsy
    – General
    – C/CVP consultant
•   Congenital heart disease
•   External clinical consultation practice
•   Forensic pathology
•   Perinatal/hearts
  Research in C/CVP is opportunity rich

• Clinico-pathologic, translational, and basic
• Primary vs collaborative
• Immense collaborative opportunities (clinicians,
  laboratory investigators), especially in animal
  models for human disease
• Key access to human material (pathologist is
  steward)
• Important role in corporate research (drugs,
  devices)
• Diverse funding mechanisms
           C/CVPs play a key role in
         education/training at all levels
• C/CVP in general and systemic pathology
• C/CVP in pathology GME (core curriculum)
• Conferences for clinicians
• Educational leadership/administration
• Fellowships in C/CVP
• CME
• Research training grants
• Other disciplines (clinical, science/engineering)
  biomedical engineering, cardiovascular biology)
• Diverse funding needs to be made available for
  education/training (institutional, federal, private,
  corporate)
    CV/CVPs arrive via diverse routes
• Pathologist who trains with the goal of C/CVP
  career
• Surgical/transplant pathologist who assumes
  C/CVP role owing to institutional needs
• Other pathologist “assigned” C/CVP owing to
  departmental/institutional need
• Cardiologist/surgeon/pediatrician who assumes
  role of C/CVP
• Physician-scientist seeking pathology sub-
  specialty integrated with research area
    Challenges derive largely from atypical
     characteristics of C/CVP and C/CVPs
•   “income challenged”
•   relatively flexible clinical demands
•   eclectic careers
•   rare outside the academic environment (no private
    practice)
•   must manage tension between “dilution” and enrichment
•   frequently arrive via non-conventional pathways
•   frequently have other training, multidisciplinary (clinical
    training, research, engineering, etc.)
•   declining clinico-pathologic investigation in C/CVP

    The need for C/CVP will continue indefinitely; however; just as the
    growth of heart transplantation in 1980’s “crystallized” C/CVP as a
    specialty and raised its profile, the loss in luster/activity level in heart
    transplantation may diminish the perceived added value C/CVP.
    The advocacy role of the SCVP will be
critical to address ongoing issues for C/CVP

• Define role of/secure funding for academic C/CVPs
  (demonstrate institutional value)
• Recognize/reward diverse career development pathways
• Recruit into the subspecialty
• Define training for the practice of C/CVP (?core/?clinical,
  other; tailored to needs/interests/career paths)
• Define core curriculum for C/CVP in AP/CP training
• Define roles for C/CVP external to conventional
  academic practice
• Generate unconventional sources of training support

								
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