CardioExchange Archive

Several Cardiology Fellows who are attending ESC.13 in Amsterdam this week are blogging for CardioExchange. The Fellows include Paddy Barrett, Louis Handoko, and  Amanda Vest. For more of our ESC.13 coverage of late-breaking clinical trials, interviews with the authors of the most important research, and blogs from our fellows on the most interesting presentations at the meeting, check out our Coverage Headquarters.

An Internal Medicine Attending I had the opportunity to work with during my residency training would routinely regale the team with tales of when he first took up his position and was only one of two physicians covering the entire hospital. Ward rounds were not on your patients alone but were on all of those under the medical service, both adult and pediatric. He did, indeed, wear many hats and, more importantly, had to be comfortable doing so. As the field of medicine evolved, so did the volume and complexity of its content, and thus the subspecialist was born.

From the range of niche topics being presented here at the Congress it is clear that no one physician can be entirely au fait with the all details of all specialties or pathologies. And that’s okay; being all things to all people will surely leave a knowledge gap somewhere; subspecialization, whether you like it or not, is here to stay.

However, it is becoming more apparent that to achieve greater degrees of specialization, one must learn to appreciate not just the minute details of one’s own specialty but also the inner workings of others also.

At the EACVI Club 35 presentation this morning, Dr Emer Joyce of Leiden University Medical Center gave a tour de force overview of the role of multimodality imaging in complex interventional procedures such as TAVI and LAA closure. What was most striking was the illustration of the necessity for both imaging and interventional specialists to have an incredibly robust understanding of the inner workings of each others’ speciality. Our degree of subspecialization has reached a point where we can no longer act in isolation — indeed, we cannot function without expanding our knowledge base outside of our subspeciality field of interest.

Subspecialties are here to stay, but we who work within them will have to broaden our view to achieve even sharper focus.