Can you please give us a bit of background about yourself as well as explain your involvment within the ESC and EAPCI?
I joined the ESC Working Group of Coronary Circulation in 1987 and was a Nucleus member of this organisation, subsequently renamed Working Group for Coronary Interventions in 1996.
I coordinated a document as first author on “Image Acquisition and Interpretation in Intravascular Ultrasound” which was published in the European Heart Journal in 1997 whilst being appointed a member responsible for Coronary Imaging. Moreover I organised three courses at the European Heart House, on Intravascular Ultrasound, Intracoronary Diagnostic Techniques and Brachytherapy with Prof. Patrick Serruys. I also took part in many extramural courses. These activities and my participation in the excellent Fellows courses organised in the United States after the official approval of the ABIM Accreditation exam in Interventional Cardiology brought to my attention the issue on the lack of training homogeinity in the field of Interventional Cardiology in Europe. It was time to organise things differently.
As soon as I got elected Secretary of the Working Group in Interventional Cardiology in 2002 and then President-Elect in 2004 I spent an increasing amount of my time and activities promoting the need of an official subspecialty training in Interventional Cardiology and I am happy to see PCI recognised as such nowadays.
Can you please describe the role of your committee within the EAPCI?
The Committee on Accreditation, chaired by Prof Vahanian and myself, looks after the training of young interventionalists and re-accreditation of more senior interventionalists. The Committee benefits from the 2005 achievement of an official document published in EuroIntervention which contains the European Curriculum and Syllabus in Interventional Cardiology. (PDF Document)
Incidentally this Committee has not yet been formally appointed and it was felt that its members should be officially nominated by the main European Interventional Societies and Working Groups rather than solely appointed by the Board of the EAPCI. After discussing the matter extensively with the Presidents of the European Interventional Societies and Working Groups, a letter will be sent before Christmas asking them to identify suitable individuals with experience in the field of education and training.
How do you perceive the accreditation process in the future?
The European Board for the Specialty in Cardiology (EBSC), a joint organisation linking the European Society of cardiology (ESC) and the European Union of the Medical Specialists (UEMS)- the only medical group officially accredited to the European Commission- has identified a common process the subspecialty should follow. The process starts from the approval of an official Curriculum to the identification of qualified training centres.
It includes the documentation highlighting the knowledge acquired by the candidate, confirmed by a multiple choice questionnaire, and the candidate's practical experience, documented from the detailed description of the procedures performed. These procedures should meet the minimum requirements that are identified in the Curriculum in terms of number, quality, and variety.
Once the Committee on Accreditation is formally appointed, we expect to rapidly move towards the preparation of a sophisticated database listing the acquired experience . There will be a function allowing us to display a sample of the cases performed as running angiographic images. In addition, the Accreditation Committee will be devising a European exam in Interventional Cardiology.
Would you participate in the future accreditation examination for interventional cardiology and if so, for which reasons?
Unfortunately the situation in Europe is likely to remain very different from the United States for many years. The participation in the European exam and the documentation of the experience obtained will not be enforced by law since there is and cannot be, according to the principle of self-determination in the individual countries of the educational programme, a law regulating access to the profession of Interventional Cardiologist.
Regularisation of the “Grandfather” position in interventional cardiology is not the most urgent problem and will be addressed once the issue of the initial training is solved . Re-accreditation will become the key point in the agenda of the Accreditation Committee.
If I could I would certainly take this accreditation examination. Successful completion of the Interventional Cardiology accreditation process provides formal acknowledgment to individuals and European Recognition, governed by a scientific society. I very much encourage future applicants to make the most of this offer.
What will be the involvement of the national societies within the proposed accreditation process?
They are the gatekeepers, I was pleased they agreed EAPCI should play a key role in promoting European courses for Fellows. They also accepted to nominate members to join the Accreditation Committee to foster the development of a European website and develop an accreditation process in Interventional Cardiology.
What is your vision of interventional cardiology in Europe?
Interventional Cardiology is facing increasing pressures to limit indications, cut budgets, reduce the use of devices with the greatest clinically recognised efficacy to prevent restenosis and drug eluting stents. We must break this down by showing that interventional cardiologists have excellent clinical and operative skills. With a common large congress (EuroPCR), dedicated journal (EuroIntervention) and invited lectures, I believe that EAPCI is in the position to face these challenges.