Current status of cardiology fellow training based on COCATS-4 framework: A cross-sectional study from three tertiary care institutes across India

Abstract

Background: The Core Cardiology Training Symposium (COCATS) guidelines, endorsed by the American College of Cardiology (ACC) emphasize competency-based training and establish milestones to be met during cardiology training. However, India lacks such guidelines for training cardiology fellows.

Objectives: The study aimed to evaluate the self-declared competencies of cardiology fellows across multiple preselected domains as per the COCATS-4 recommendations.

Methods: The study was conducted at three premier institutions across India between June 2022 and December 2024. A total of 52 cardiology fellows who had recently completed their 3-year core cardiology training course were included in the study. These candidates completed a questionnaire that included a checklist assessing different levels of competency in various preselected aspects of cardiovascular medicine. Candidates were also asked about their awareness of COCATS-4 standards and cardiology training in India.

Results: While all trainees reported Level 1 competency in cardiac catheterization, heart failure, and adult congenital heart disease, a significantly lower percentage of trainees achieved Level 1 competency in nuclear medicine (1.9 %), cardiac MRI (3.8 %), and cardiac CT (17.3 %). At Level 2, cardiac catheterization (73.1 %) and echocardiography (63.5 %) had the highest self-declared competencies, whereas nuclear medicine (3.8 %), cardiac MRI (0 %), and cardiac CT (0 %) had the lowest. Only 23.1 % of trainees were aware of COCATS-4, and 82.7 % believed that standardized guidelines would improve cardiology training in India.

Conclusions: The results emphasize the wide variability in self-reported competencies of cardiology trainees across India and highlight the deficiencies in certain core areas like cardiovascular imaging.

Keywords: COCATS; Cardiology in India; Cardiology training; Competency; Curriculum.

Fig. 1

Horizontal bar chart showing the number of candidates who self-declared their competence levels across various domains of cardiology training. Blue bars indicate the number of candidates who declared themselves to have complete competence. Grey bars indicate the number of candidates who self-declared to be not completely competent.