Cardiovascular Journal of Africa: Vol 27 No 3 (May/June 2016)

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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 27, No 3, May/June 2016 188 AFRICA
Cardiology–cardiothoracic subspeciality training in South
Africa: a position paper of the South Africa Heart Association
Karen Sliwa, Liesl Zühlke, Robert Kleinloog, Anton Doubell, Iftikhar Ebrahim, Mohammed Essop, Dave
Kettles, David Jankelow, Sajidah Khan, Eric Klug, Sandrine Lecour, David Marais, Martin Mpe, Mpiko
Ntsekhe, Les Osrin, Francis Smit, Adriaan Snyders, Jean Paul Theron, Andrew Thornton, Ashley Chin,
Nico van der Merwe, Erika Dau, Andrew Sarkin
Abstract
Over the past decades, South Africa has undergone rapid
demographic changes, which have led to marked increases in
specific cardiac disease categories, such as rheumatic heart
disease (now predominantly presenting in young adults with
advanced and symptomatic disease) and coronary artery
disease (with rapidly increasing prevalence in middle age).
The lack of screening facilities, delayed diagnosis and inad-
equate care at primary, secondary and tertiary levels have led
to a large burden of patients with heart failure. This leads to
suffering of the patients and substantial costs to society and
the healthcare system.
In this position paper, the South African Heart Associa-
tion (SA Heart) National Council members have summarised
the current state of cardiology, cardiothoracic surgery and
paediatric cardiology reigning in South Africa. Our report
demonstrates that there has been minimal change in the
number of successfully qualified specialists over the last
decade and, therefore, a de facto decline per capita. We
summarise the major gaps in training and possible interven-
tions to transform the healthcare system, dealing with the
colliding epidemic of communicable disease and the rapidly
expanding epidemic of non-communicable disease, including
cardiac disease.
Hatter Institute for Cardiovascular Research in Africa, MRC
Inter-University Cape Heart Group, Department of Medicine,
Faculty of Health Sciences, University of Cape Town; Soweto
Cardiovascular Research Unit, University of the Witwatersrand,
Johannesburg, South Africa
Karen Sliwa, MD, PhD, FESC, FACC,
Departments of Paediatric Cardiology and Medicine, Faculty of
Health Sciences, University of Cape Town, South Africa
Liesl Zühlke MB ChB, DCH, FCPaeds, Cert Cardiology (SA), MPH,
FESC, PhD
Cardiothoracic Surgery, Ethekwini Hospital and Heart Centre,
Durban, South Africa
Robert Kleinloog, BSc Hons, BSc Pharm, MB ChB, FCS (SA)
Division of Cardiology, Faculty of Medicine and Health
Sciences, Stellenbosch University and Tygerberg Hospital,
Tygerberg, South Africa
Anton Doubell, MB ChB, MMed, FCP (SA), BSc Hons, PhD
Netcare Unitas Hospital, Lyttleton Manor, Pretoria, South Africa
Iftikhar Ebrahim, MB BCh, MMed (Int Med), Cert Cardiology (SA)
Division of Cardiology, Baragwanath Hospital and Faculty
of Health Sciences, University of the Witwatersrand,
Johannesburg, South Africa
Mohammed Essop, MB BCh, MRCP, FCP, FRCP, FACC
St Dominic’s Hospital, and Frere Hospital, East London, South
Africa
David Kettles, MB ChB, FCP (SA), MMed
Netcare Linksfield Hospital, Linksfield West, Johannesburg,
South Africa
David Jankelow, MB BCH, FCP(SA), FACC
Department of Cardiology, Faculty of Health Sciences,
University of KwaZulu Natal, Durban, South Africa
Sajidah Khan, MB ChB, PhD
Netcare Sunninghill Hospital, Sunninghill, Johannesburg,
South Africa
Eric Klug, MB BCh, FCP (SA), MMed
Andrew Thornton, MB BCh, PhD, FCA (SA)
Hatter Institute for Cardiovascular Research in Africa,
Department of Medicine, Faculty of Health Sciences, University
of Cape Town, South Africa
Sandrine Lecour, DPharm, PhD
Division of Chemical Pathology, Faculty of Health Sciences,
University of Cape Town, South Africa
David Marais, MB ChB, FCP (SA)
Mediclinic Heart Hospital, Arcadia, Pretoria, South Africa
Martin Mpe, MB ChB, FCP (SA), MMed
Department of Cardiology, Faculty of Health Sciences,
University of Cape Town, South Africa
Mpiko Ntsekhe, MD, PhD, FACC
Ashley Chin, MB ChB, FCP (SA), MPhil, FHRS
Zuid-Afrikaans Hospital, Muckleneuk and Department of
Cardiology, Steve Biko Academic Hospital, University of
Pretoria, Pretoria, South Africa
Les Osrin, MMed, MB ChB, BSc
Department of Cardiothoracic Surgery, Faculty of Health
Sciences, University of the Free State, Bloemfontein, South
Africa
Francis Smit, MB ChB, FC Cardio (SA), PhD, FACC
Wilgers Medical Consortium, Die Wilgers, Pretoria, South
Africa
Adriaan Snyders, MB ChB, MMed (Int Med), FACC, FESC
Interventional Cardiology Unit, Netcare Union Hospital,
Alberton, South Africa
Jean Paul Theron, MB ChB, MMed, Cert Cardiology (SA)
Mediclinic Bloemfontein, Bloemfontein, South Africa
Nico van der Merwe, MB ChB, MMed (Int Med), FCP (SA)
South African Heart Association, Tygerberg, South Africa
Erika Dau
Department of Cardiology, Faculty of Health Sciences, Steve
Biko Academic Hospital and University of Pretoria, South
Africa
Andrew Sarkin, MB ChB, FCP (SA)