Veterans Affairs Health Care System as Cardiology Training Site: A Fellow's Perspective.

A majority of cardiology fellows receive at least part of their training at the Veterans Affairs Health Administration (VHA) hospitals and clinics. In this paper, we discuss the unique role and challenges of advanced cardiology training at the VHA from the fellow’s perspective. Finally, we explore the potential improvements and future directions of cardiology training at the VHA, which will have a significant effect on future generation of cardiologists. VHA is the largest integrated health care system in the United States, with 150 medical centers and nearly 1,400 community-based outpatient clinics (1). On January 30, 1946, a historic document, Memorandum Number 2, was signed permitting the establishment of VHA’s affiliations to medical schools. Title 38 U.S.C. mandates the VHA’s assistance with training of health care professionals for its own and the national health care professional demand (2). Through VHA’s partnership with academic institutes, it is the largest provider of education and training for health care professionals in the United States. In 2014, >41,000 medical residents, 23,000 medical students, and approximately 300 advanced fellows received at least some of their clinical training in the VHA (2). The accredited Veterans Affairs (VA) residency and advanced subspecialty training programs are also partly funded by the VHA (2). Hence, the VHA contributes significantly to U.S. medical education and has been offering training to medical students, residents, and fellows in various subspecialties for a long time. Training in the VHA is an important component of a majority of cardiology fellowships in