Attitudes and Perception Surrounding Heart Failure Fellowship Training: A Survey Study

Abstract

Background: Despite the burgeoning burden of heart failure (HF) in South-east Asia, very few opportunities exist to be formally trained in HF within the region. The aim of this study was to assess the knowledge, attitudes and perception surrounding HF training and HF as a potential subspeciality. Methods: A national-level, 28-item online survey study was conducted between 20 October and 20 November 2022. The target group for the survey was cardiology fellows-in-training, cardiologist post-training (non-consultants) and consultant cardiologists. A total of 82 people were asked to complete the survey. The type of data collected included the following areas of interest: respondent demographics; knowledge and perception of current clinical practice locally; knowledge, attitudes and perceptions of training in HF, associated cardiology subspecialities and AHFT; and attitudes and perceptions towards a recommended HF curriculum designed by the authors. Results: Fifty-one responses were obtained (response rate 62.2%). The mean (± SD) age of respondents was 39.4 ± 6.5 years, most of whom were men (84.3%). Most respondents were cardiology fellows-in-training (58.8%) and consultant cardiologists (29.4%). Although most respondents (82.4%) felt that advanced HF and transplantation (AHFT) training should be made available, only 52.9% felt that training was feasible in Malaysia. Nevertheless, training without AHFT exposure may still be feasible, especially when incorporating other subspecialities. When introduced to our proposed HF curriculum, most respondents (82.4%) felt that it was feasible for implementation locally, although many (66.7%) felt that the lack of AHFT exposure would make it less attractive and that a rotation in an AHFT-capable centre would be essential (90.2%). When asked about other ‘adjunctive’ rotations, again most agreed that echocardiography, critical care cardiology and cardiac MRI training were potentially supplementary. Although exposure to clinical research and training was most welcome (78.4%), formal research through a Master’s or PhD degree was not essential. Conclusion: The survey highlights several important issues surrounding knowledge and perception of current cardiology training in South-east Asia. The information obtained will be useful in designing a HF curriculum that is ‘fit for purpose’ in Malaysia.