Specialty specific changes for CESR in Cardiology
The new Cardiology curriculum was published in August 2022. For a transition period you can make your CESR application in either the new curriculum or the previous version.
This option is available until the transition deadline of 30 October 2024.
Specialty specific guidance
We’ve produced guidance documents for each version of the curriculum with the Joint Royal Colleges of Physicians Training Board.
How to apply
You can apply through your GMC Online account. When choosing your application specialty, please make sure you choose the curriculum version that you wish to be assessed against – 2016 or 2022, as the application structure is tailored to the above specialty specific guidance version.
Our standards for postgraduate medical curricula are Excellence by design and the framework for Generic professional capabilities. These help postgraduate medical training programmes focus trainee assessment away from an exhaustive list of individual competencies, towards fewer broad capabilities needed to practise safely from your first day as a consultant.
As a result, the 2022 physicianly curricula are outcomes based. This means trainees will be assessed against the fundamental capabilities required of consultants in the working week. These include the general skills which all doctors need to have as well as those needed to carry out all the specific day to day tasks undertaken by a consultant physician (Capabilities in Practice – CiPs).
The Cardiology curriculum is made up of six Generic CiPs which are common to all physicianly specialties, eight clinical internal medicine CiPs, five specialty CiPs unique to Cardiology, and a further five specialty CiPs in advanced themes of Cardiology, of which one CiP must be demonstrated.
In demonstrating these capabilities a successful applicant will be awarded a dual CESR in Cardiology and General internal medicine.
Completion of three years Internal Medicine Training replaces Core Medical Training as the core training programme.
Content shared between all physicianly specialties
There are six CiPs which are shared between all physicianly specialties:
- CiP 1 - Able to function successfully within NHS organisational and management systems
- CiP 2 - Able to deal with ethical and legal issues related to clinical practice
- CiP 3 - Communicates effectively and is able to share decision making, while maintaining appropriate situational awareness, professional behaviour and professional judgement
- CiP 4 - Is focused on patient safety and delivers effective quality improvement in patient care
- CiP 5 - Carrying out research and managing data appropriately
- CiP 6 - Acting as a clinical teacher and clinical supervisor
Clinical internal medicine content
- CiP 1 - Managing an acute unselected take
- CiP 2 - Managing the acute care of patients within a medical specialty service
- CiP 3 - Providing continuity of care to medical inpatients, including management of comorbidities and cognitive impairment
- CiP 4 - Managing patients in an outpatient clinic, ambulatory or community setting, including management of long-term conditions
- CiP 5 - Managing medical problems in patients in other specialties and special cases
- CiP 6 - Managing multidisciplinary team including effective discharge planning
- CiP 7 - Delivering effective resuscitation and managing the acutely deteriorating patient
- CiP 8 - Managing end of life and applying palliative care skills
Specialty Specific Content
- CiP 1 - Coronary disease and Intervention: Manage coronary artery disease and associated conditions.
- CiP 2 - Imaging: Management of valvular heart disease, aortopathy and cardiac tumours
- CiP 3 - Electrophysiology and Devices: Management of cardiac arrhythmias and cardiac implantable electronic devices
- CiP 4 - Adult Congenital Heart Disease: Management of adult congenital heart disease and heart disease in pregnancy
- CiP 5 - Heart Failure: Managing disorders of the heart muscle, pericardium and pulmonary vasculature
Cardiology Advanced Themes
Applicants must demonstrate one of the following higher-level outcomes themed to service needs. This is to ensure the output of cardiologists with appropriate capabilities to meet growing service need, with some flexibility as that evolves.
- CiP 1 - Lead a Coronary Intervention Service
- CiP 2 - Lead a Cardiac Imaging Service
- CiP 3 - Lead an Arrhythmia Management Service
- CiP 4 - Lead an Adult Congenital Heart Disease service
- CiP 5 - Lead a Heart Failure Service
Changes in assessment tools
There are no changes to the assessment tools.
Changes in knowledge and skills
All JRCPTB specialties identified as group 1 will dual train in internal medicine (IM) and the IM learning outcomes have been embedded in the Cardiology curriculum. This curriculum will train doctors that are specialists with generalist skills to manage the acute unselected take and care of acutely ill patients.
Modular specialist areas have been rationalised into five coherent pathways aligned to service need. Trainees will train in one themed for service area in years three to five alongside continued general cardiology and internal medicine training.
There is a new requirement for all trainees to contribute to pre-pregnancy counselling and pregnancy management as part of themed for service training. This was only required by doctors undertaking Adult Congenital Heart Disease (ACHD) advanced training in the current curriculum and is considered to be an outdated model. Feedback from the consultation was that need all specialists need the skills to manage pregnant patients.
The curriculum will no longer require all trainees to be competent in diagnostic angiography and this will only be required for those undertaking advanced coronary intervention training. All trainees competent to perform diagnostic angiography under direct supervision. This reflects service and patient needs.
In addition to the Echocardiography Curriculum Delivery Tool referenced in the current curriculum, further curriculum tools will be provided to help trainees to demonstrate competency in echocardiography, device interrogation and implantation. They have been listed in the evidence of progress section of the curriculum alongside methods of assessment.