The Cardiology Senior Residency programme aims to groom cardiologists who are dedicated to compassionate and high quality patient-centered care. The senior residents will be trained in independent and collaborative care of patients with a broad range of cardiovascular diseases. The programme will include the following:
- Prevention, Diagnosis and Treatment of Coronary Artery Disease
- Myocardial Disease
- Heart Failure
- Congenital Heart Disease
- Valvular Disease
- Vascular Disease
Senior residents in this programme will be guided by our experienced and committed clinicians who also hold strong interest in academia. Residents can expect our clinicians to mentor and help develop the necessary foundation in achieving proficiency in all aspects of their training.
We are confident that our programme will help prepare our senior residents for a promising vocation in cardiovascular medicine.
During the 3.5 year Cardiology senior residency programme, our residents are also rotated to Ng Teng Fong General Hospital (NTFGH). This rotation provides a holistic exposure to cardiology care in a different hospital setting for our senior residents.
Overall Educational Goals
1. Patient Care
Senior residents in our programme will be taught how to deliver high quality, patient-centered care that is appropriate, effective and compassionate.
Our senior residents are expected to:
- Provide competent medical care for patients with common uncomplicated diagnoses
- Provide care in acute complicated patients and under difficult circumstances
- Provide comprehensive case presentations on new patient consults in the inpatient and ambulatory setting
- Know the indications and expected expertise in ordering cardiac investigations
- Respond appropriately to common cardiac investigations
- Perform basic interventional procedures for diagnosis and improvement of patient condition
2. Medical Knowledge
The cardiology senior residency programme will prepare our senior residents for a career in cardiovascular medicine. The programme offers a 3.5 year advanced specialist training programme leading to the Singapore Accreditation Board (SAB) accreditation. Our senior residents will be equipped with knowledge in clinical, biomedical and epidemiological sciences. The residents will also be expected to translate those knowledge into application for patient care.
3. Practice-Based Learning & Improvement (PBL)
Our senior residents will be guided in identifying their own strengths, deficiencies, knowledge gaps through formative evaluation feedback, with the aim of setting appropriate learning and improvement goals. They will learn to identify, appraise and assimilate scientific evidence relevant to their patient care from the available resources and information technology. Other goals include systematically analyzing practice with quality improvement methods and implementation of changes to improve patient care. The senior residents are also expected to pursue life-long learning and be involved in educating patients, their families, students, residents and other healthcare professionals.
4. Interpersonal & Communication Skills (ICS)
Our senior residents will acquire interpersonal and communication skills that include verbal, nonverbal cues and written communications between the relevant stakeholders (patients, caregivers and the multidisciplinary team). They will also develop interpersonal skills that involve teamwork and rapport.
The senior residents will learn to:
- Communicate effectively and compassionately with the patients and their family members, including informed consent taking and family discussions
- Communicate effectively and conduct proper handover of patients’ care with other doctors
- Act in a consultative role to doctors from other disciplines as well as other healthcare professionals
5. Professionalism (P)
Commitment and accountability are two values that we aim to inculcate in our senior residents – in managing patients to the best of their abilities, adhering to all ethical principles and demonstrating sensitivity to the local cultural and religious diversity. Values such as compassion, integrity and respect for patients, colleagues and other healthcare professionals are also values that will be instilled upon to our senior residents. Through the programme, the senior residents will learn to be committed to patient privacy and autonomy, and to put the patients’ needs above their own.
6. System-Based Practice (SBP)
Our senior residents will learn about the available resources in our healthcare system and how to coordinate patient care so as to optimise it. Our senior residents will also be exposed to the diversity and organisation of clinical services through our clinical rotation that takes place across two hospital systems. They will also be taught on how to incorporate cost awareness and risk-benefit analysis in patient care. The senior residents will also be expected to participate in identifying and improving system inefficiencies.
Weekly conference on the subject of revascularisation strategies that involves the heart-team and the cardiothoracic surgeons. Selected angiography/angioplasty morbidity/mortality cases are also discussed during the conference. Senior residents are instructed on decisions in revascularisation modality as well as complications associated with angiography/angioplasty.
This focuses on the discussion of complex valvular cases in a heart-team setting. The focus is on selecting the patient who may benefit from valve surgery or a minimally invasive valve replacement. Valvular cases with difficult diagnostic and therapeutic issues are also discussed.
Arrhythmia/ EP Round
Led by the electrophysiology team, the bi-weekly conference revolves around the discussion of interesting ECGs. The ECGs will be selected by the senior residents and staff. Correlation with electrophysiology study is performed whenever possible.
Bi-weekly seminar where a senior resident is tasked to appraise and discuss a scientific paper. The paper is selected by the Faculty and the senior resident will be supervised in preparation.
Mortality & Morbidity Round
Conference to discuss significant cardiovascular morbidity and mortality with the aim of addressing systemic issues and improving patient care.
Senior Staff Round
A bedside teaching or case-based discussion that focuses on developing clinical skills, diagnostic reasoning and professionalism. The purpose of these sessions is to prepare the senior residents for their exit. This is an opportunity for them to consolidate knowledge and review areas of deficiencies.
Core Curriculum Lectures
Lecture series with case presentations where relevant by the Faculty. The focus will be on key topics that provide the foundation for continued learning.
Topic Review/ Journal Club
Monthly lectures or research update given by faculty members or a senior resident guided by a faculty.
Monthly conference on interesting echocardiography cases led by a senior staff echocardiologist.
Nuclear/ Heart Failure Round
Monthly conference on interesting cases with these imaging modalities. These sessions are led by a senior faculty.
Research skills training
Research skills are taught through a series of core lectures and research conferences. All senior residents are required to complete the Collaborative Institutional Training Initiative (CITI) online Research Ethics and GCP program (www.citiprogram.org). They will also be encouraged to attend the Asia Pacific Evidence Based Medicine (APEBM) workshop and conference held yearly and organised by the National University Hospital. During this meeting, the following research skills are taught: choice of methodology, sampling issues, bias and confounding issues, data entry, result analysis, discussion and conclusion, as well as critical appraisal.
Senior residents are also required to participate in departmental presentations including journal club, topic review and case presentations. The senior residents will be guided by a faculty in preparation and presentation. Through these presentations, tutorials and mentorship, the senior residents will also be given formal instruction and practical experience to develop and demonstrate skills in locating sources of scientific data pertinent to the care of patients, analysing the appropriateness of research design and statistical methods, obtaining information about diagnostic and therapeutic effectiveness, and applying evidence from pertinent clinical studies to patient care.
Research skills training
Each senior resident will participate in at least one research project and supervision will be provided by a senior faculty with proven record in research. The faculty will mentor the senior resident and aid in the formulation of ideas and commencement of scholarly work. The faculty will also monitor the progress of the work and aid in publication or presentation. The programme director will be informed if a senior resident encounters obstacles during the scholarly work and will work with the senior resident and/or faculty to help identify institutional resources that can be tapped on to address these issues.