interventional cardiology questions

[mjohn7wy]

Hi all,

I am a didactic year student in the new york city area, i am beginning to plan my electives but we only have one elective. I am really interested in cardiology but am unsure if i should complete an elective in Interventional cardiology, traditional cardiology or cardio-thoracic surgery. I would like to have the opportunity to perform some procedures but also enjoy working with patients. Basically i am asking for some in sight on the scope of practice for each speciality, what type of procedure i would be credentialed to complete or assist with. I know bylaws very almost everywhere but any advice would be greatly appreciated.

 

Thanks

[marilynpac]

If you can get the CT surg, go for it. If you ever get tired(?) of doing the surgery you can always decide on the other two later....just my opinion...

[andersenpa]

I would imagine that if you can find a site with interventionalists then you can spend some time with them and some time with the general cardiologists. Make the rotation what you want it to be. It's your (precious) time in clinicals and your money being spent on your education. If you found a site with all three available, do a bit of each if the preceptors are open to it. It is an elective after all and unless there are rules imposed by your program, get exposure to each discipline. If it's 6 weeks then you could do 2 weeks with each.

[NewtonsApple]

We do two rotations of internal medicine. Many in rotation now did not know until after the fact that they were allowed to have one of the two blocks be a specialty; cardio, neuro, nephrology, etc. Just a thought but maybe your school allows the same. I am thinking about doing my rotation in infectious disease or critical care.

[mjohn7wy]

thanks for the help,

Any interventional caridiologists out there??? I would love to get a little perspective on the scope of practice for PA's in that fields.

Matt

On a side note, anyone know a website that gives brief descriptions on the scope of practice in different fields.

[Houstonian]

PA's in interventional cardiology and in general cardiology typically perform primary care type functions, i.e. H&P's, hospital rounds, consults, discharge summaries, and office evaluations. Many cardiology PA's supervise cardiac stress tests of all kinds--and lots of them. Very few PA's in interventional cardiology actually work in the cath lab, but there are a few. Cardiology PA's oftentimes are very heavy on hospital-based, inpatient work and oftentimes have significant ICU exposure. Some PA's may supervise tilt table tests. Some may have the opportunity to perform or review pacemaker or ICD interrogations.

 

The cardiologists scope of practice includes performing cardiac catheterizations, and depending on their special field of expertise may include coronary interventions, i.e. stents, implantations of temporary pacemakers, cardioversions, interpretation of echocardiograms, stress tests, nuclear studies, performing EP studies, and implantation of pacemakers and implantable cardioverter-defibrillators. The latter three are typically performed by specialists in cardiac electrophysiology (rather than interventional cardiology). Of course they also provide cardiac care for patients in all settings.

 

PA's in cardiothoracic surgery typically have a very large role as a first assistant in surgery, especially with harvesting leg veins for bypass surgery. They also perform H&P's, rounds, discharge summaries, consults, etc. They may be involved with the management of chest tubes, and critical care monitoring devices such as Swan-Ganz catheters, central lines, or arterial lines.

[andersenpa]

some CTS PA data for duties, as reported in the last APACVS survey (% of respondents):

 

ICU Care 76%

Stepdown 87%

H&P, Consult, Discharge 84%

 

Assist 95%

Conduit Harvest up to 100% (vein/arterial)

On-call- highly variable

 

The average CTS PA does first assist, harvest, ICU and stepdown/telemetry care and most basic procedures (lines/tubes)