ACGME Milestone Mapping for Pediatric Cardiology Curriculum¶

Overview¶

This document maps the curriculum learning objectives to ACGME Core Competencies and Pediatric Cardiology Milestones, enabling: - Fellowship program compliance documentation - Trainee progress tracking - Curriculum gap analysis - Rotation planning

ACGME Core Competencies¶

Competency	Abbreviation	Description
Medical Knowledge	MK	Understanding of clinical sciences and their application
Patient Care	PC	Compassionate, appropriate care for treatment of health problems
Systems-Based Practice	SBP	Awareness of healthcare system and resource optimization
Practice-Based Learning	PBLI	Investigation and evaluation of care, appraisal of scientific evidence
Professionalism	PROF	Commitment to professional responsibilities and ethics
Interpersonal Communication	ICS	Effective communication with patients, families, and team

Curriculum Mapping by Competency¶

Medical Knowledge (MK)¶

Topic	Learning Objectives Aligned
01 - Kawasaki Disease	Apply diagnostic criteria, identify high-risk features, interpret coronary Z-scores
02 - Heart Failure/CHD	Differentiate HFrEF/HFpEF, apply GDMT, evaluate for MCS/transplant
03 - HCM	Differentiate phenocopies, apply pediatric risk stratification, interpret CMR
04 - Hypertension	Apply AAP staging, select antihypertensive by etiology, interpret ABPM
05 - Arrhythmias/Devices	Apply risk algorithms, interpret channelopathy genetics, determine ICD indications
06 - Pulmonary Hypertension	Apply diagnostic criteria, interpret hemodynamics, formulate treatment
07 - IE Prophylaxis	Apply 2024 guidelines, identify high-risk populations
09 - Myocarditis	Apply Dallas criteria, interpret CMR, differentiate from MIS-C
10 - Acute Rheumatic Fever	Apply Jones Criteria by population, diagnose Sydenham chorea
11 - Channelopathies	Apply diagnostic criteria by syndrome, interpret genetic testing
12 - Sports Cardiology	Apply screening protocols, evaluate high-risk findings
16 - Cardiomyopathy	Differentiate CM types, identify phenocopies, interpret genetics
17 - Fetal Echo	Identify indications, recognize high-risk features
18 - Syncope	Differentiate cardiac from non-cardiac, identify red flags
21 - CCHD Screening	Apply 2025 algorithm, identify target lesions, recognize limitations
23 - Fontan	Analyze Fontan physiology, apply surveillance protocols
24 - PDA Preterms	Evaluate hemodynamic significance, compare treatment approaches
25 - Neuromuscular Disease	Apply DMD surveillance, differentiate arrhythmia risk by disease
26 - Pericarditis	Apply diagnostic criteria, risk stratify for complications
27 - AAOCA	Differentiate AAOLCA vs AAORCA risk, identify high-risk anatomy

Patient Care (PC)¶

Topic	Learning Objectives Aligned
01 - Kawasaki Disease	Formulate treatment intensification, manage IVIG resistance
02 - Heart Failure/CHD	Prescribe medical therapy, determine MCS timing
03 - HCM	Formulate medical therapy, determine septal reduction timing
04 - Hypertension	Select antihypertensive therapy, manage hypertensive urgency
05 - Arrhythmias/Devices	Manage acute arrhythmias, determine device programming
06 - Pulmonary Hypertension	Select PAH-specific therapy, manage acute decompensation
08 - MIS-C/COVID	Formulate treatment regimen, develop return-to-play protocol
09 - Myocarditis	Manage acute phase, determine immunosuppression
13 - Resuscitation	Apply PALS algorithms, manage post-arrest care
14 - Aortopathy	Prescribe medical therapy, determine surgical timing
24 - PDA Preterms	Select closure method, manage pharmacotherapy
26 - Pericarditis	Select treatment approach, manage colchicine therapy
28 - Transplantation	Formulate immunosuppression, manage rejection
34 - Catheterization	Manage procedural complications

Systems-Based Practice (SBP)¶

Topic	Learning Objectives Aligned
01 - Kawasaki Disease	Coordinate multidisciplinary care, ensure follow-up protocols
02 - Heart Failure/CHD	Coordinate MCS/transplant pathway, ensure transition planning
03 - HCM	Implement family screening, coordinate genetic counseling
07 - IE Prophylaxis	Ensure patient carries prophylaxis card
12 - Sports Cardiology	Develop school/community education programs
14 - Aortopathy	Implement first-degree relative screening
15 - Neurodevelopmental	Coordinate multidisciplinary developmental follow-up
17 - Fetal Echo	Coordinate fetal cardiac program referrals
19 - Lipid Screening	Implement universal screening protocols
20 - Genetic Syndromes	Coordinate syndrome-specific multidisciplinary care
22 - ACHD	Implement structured transition program
23 - Fontan	Coordinate multidisciplinary Fontan care
25 - Neuromuscular	Coordinate multidisciplinary clinic care
30 - RHD	Implement screening programs, prophylaxis tracking
34 - Catheterization	Participate in quality assurance programs

Interpersonal Communication Skills (ICS)¶

Topic	Learning Objectives Aligned
01 - Kawasaki Disease	Counsel on treatment plan, long-term follow-up
02 - Heart Failure/CHD	Discuss prognosis, advanced care planning
03 - HCM	Counsel on SCD risk, activity restrictions, genetic implications
05 - Arrhythmias/Devices	Counsel on device implications, emergency management
06 - Pulmonary Hypertension	Discuss prognosis, pregnancy contraindication
09 - Myocarditis	Address family anxiety during acute illness
10 - Acute Rheumatic Fever	Counsel on prophylaxis adherence
11 - Channelopathies	Counsel on lifestyle modifications, family screening
12 - Sports Cardiology	Counsel athletes on shared decision-making
13 - Resuscitation	Lead team communication, counsel families
15 - Neurodevelopmental	Counsel families on developmental trajectory
16 - Cardiomyopathy	Discuss genetic testing implications
17 - Fetal Echo	Counsel families on fetal diagnosis
18 - Syncope	Address family anxiety, reassure for benign causes
21 - CCHD Screening	Explain positive screen (most are false positives)
22 - ACHD	Counsel on reproductive options, lifelong follow-up
26 - Pericarditis	Counsel on expected course and recurrence risk
27 - AAOCA	Counsel on SCD risk, surgical rationale
28 - Transplantation	Counsel on transplant process, outcomes
29 - Aortic Disease	Counsel on dissection risk, pregnancy options
31 - Turner Syndrome	Counsel on pregnancy risks, lifelong surveillance
17 - Fetal Echo Indications	Counsel families on fetal echo indications
33 - Pediatric TTE	Explain echo findings to families

Milestone Level Mapping¶

Level 1: Foundation (Intern/Early Fellow)¶

Topics: Basic knowledge of all 35 topics
Objectives: "Recognize," "Identify," "Know" objectives
Assessment: Written examinations, direct observation

Level 2: Developing (Mid-Fellowship)¶

Topics: All topics with deeper understanding
Objectives: "Apply," "Interpret," "Differentiate" objectives
Assessment: Case discussions, procedure logs, 360 evaluations

Level 3: Competent (Senior Fellow)¶

Topics: Complex management scenarios
Objectives: "Formulate," "Evaluate," "Determine" objectives
Assessment: Independent patient management, teaching observation

Level 4: Proficient (Graduating Fellow)¶

Topics: All topics with independent practice capability
Objectives: "Create," "Lead," "Coordinate" objectives
Assessment: Independent practice observation, board performance

Level 5: Expert (Faculty/Subspecialist)¶

Topics: Advanced/subspecialty areas
Objectives: Teaching, research, program development
Assessment: Scholarly output, teaching evaluations

High-Yield Board Topics by Milestone Level¶

Level 2-3 Focus (Core Board Content)¶

Priority	Topics
Essential	Kawasaki, HCM, Channelopathies, Syncope, Sports, CCHD Screening
High Yield	Heart Failure, Arrhythmias, Pulmonary Hypertension, Myocarditis
Important	Pericarditis, ARF/RHD, Hypertension, Fontan, Neuromuscular

Level 3-4 Focus (Advanced Board Content)¶

Priority	Topics
Essential	ACHD Transition, Transplantation, Fetal Cardiology
High Yield	Aortopathy, Catheterization, Genetic Syndromes
Important	Neurodevelopmental Outcomes, Advanced Imaging

Competency-Based Assessment Tools¶

Medical Knowledge Assessment¶

[ ] In-training examination (ITE) scores
[ ] Topic-specific written assessments
[ ] Board-style question performance

Patient Care Assessment¶

[ ] Direct observation during procedures
[ ] Case log review
[ ] Simulation performance

Systems-Based Practice Assessment¶

[ ] Quality improvement project participation
[ ] Transition care planning documentation
[ ] Multidisciplinary conference participation

Communication Assessment¶

[ ] Family conference observation
[ ] Bad news delivery evaluation
[ ] Teaching evaluation by students

Rotation Mapping¶

Rotation	Primary Topics Covered
Inpatient Consults	Heart Failure, Myocarditis, Pericarditis, Arrhythmias, Kawasaki
Echo Laboratory	Pediatric TTE, Fetal Echo, Z-scores, Cardiomyopathy
Catheterization	Catheterization, Pulmonary Hypertension, Interventions
Electrophysiology	Arrhythmias, Channelopathies, Devices, Sports Clearance
Outpatient Clinic	All topics - longitudinal care, Genetic Syndromes, ACHD Transition
Cardiac ICU	Heart Failure, Resuscitation, MCS, Post-operative Care
Adult CHD	ACHD, Fontan, Pregnancy/CHD, Transition

Documentation Template¶

Fellow Milestone Progress Note¶

Fellow Name: _______________
Review Period: _______________

MEDICAL KNOWLEDGE
- Topics mastered: _______________
- ITE percentile: _______________
- Areas for improvement: _______________

PATIENT CARE
- Procedures logged: _______________
- Cases managed independently: _______________
- Feedback from attending observation: _______________

SYSTEMS-BASED PRACTICE
- QI project status: _______________
- Transition plans completed: _______________
- Multidisciplinary care coordination: _______________

COMMUNICATION
- Family conferences observed: _______________
- Teaching sessions delivered: _______________
- Feedback from families/team: _______________

OVERALL MILESTONE LEVEL: _______________
AREAS FOR FOCUSED DEVELOPMENT: _______________
NEXT REVIEW DATE: _______________

References¶

ACGME Pediatric Cardiology Milestones 2.0
ABP Content Specifications for Pediatric Cardiology
SPCTPD Curriculum Guidelines

Last Updated: 2025-12-30