CARDIOVASCULAR JOURNAL OF AFRICA • Volume 35, No 3, September – October 2024 AFRICA 157 All respondents reported a significant reduction in the number of cardiac patients across the hospital and in the number of cardiac procedures during the COVID-19 pandemic. All respondents observed a negative impact on the fellowship training, attributed to a significant reduction in contact with patients because of a reduction in patient visits and cardiac procedures. A quarter of respondents felt that this impact was severe. Fellows had not adjusted their training expectations for cardiac procedures, namely TTE, coronary angiography as well as in- and out-patient cardiac care; all reported to not being sure that their training volume expectations in performing percutaneous coronary interventions (PCI), device implantations and transoesophageal echocardiography would be achieved. Nonetheless, all expressed confidence that they would achieve the minimum required technical competence by the end of their general cardiology training. Interestingly, all year three fellows had already achieved the minimum requirement in numbers in certain procedures, such as TTE, all of them having performed and interpreted at least 350 TTE studies at the time of the study. Fellows did not feel a time extension to their fellowship programme was needed to catch up but agreed that a dedicated period of mentorship after the fellowship would increase their knowledge base and skills set. By and large, three of the four respondents planned to pursue advanced fellowship training, whereas one was undecided at the time of the survey. Discussion In a relatively new fellowship training programme tasked to Procdures March April 2019 2020 70 60 50 40 30 20 10 0 May Fig. 2. Comparison of coronary angiography procedures by month in 2019 and 2020. March April 2019 2020 300 250 200 150 100 50 0 May Studies performed Fig. 3. Comparison of transthoracic echo studies performed by month in 2019 and 2020. TEE Device implant Coronary angio + PCI Coronary angiogram 2020 2019 0 10 20 30 40 50 60 70 Fig. 4. A comparative fellows’ logbook evaluation of performed cathlab procedures. TEE: transoesophageal echocardiography, PCI: percutaneous coronary intervention. 2020 0 50 100 150 200 250 300 2019 Transthoracic echo studies Fig. 5. A comparative fellows’ logbook evaluation of performed transthoracic echo studies. Table 2. Fellows’ responses on meeting their end-of-training targets and expectations Variable Fellow 1 Fellow 2 Fellow 3 Fellow 4 Do you feel you will meet your expectations with regard to: Pre-COVID During COVID Pre-COVID During COVID Pre-COVID During COVID Pre-COVID During COVID Out-patient cardiac care In-patient cardiac care Transthoracic echo Coronary angiography Percutaneous coronary intervention Device implantations Transoesophageal echo Definitely yes Possible No
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