Contemporary cardiovascular computed tomography (CCT) training: Serial surveys of the international CCT community by the Fellow and Resident Leaders of the Society of Cardiovascular Computed Tomography (SCCT) Committee (FiRST) and SCCT Future Leaders Program (FLP)


Nidhi Madan, Division of Cardiology, Nebraska Methodist Health System, Omaha, NE, USA.
David J. Hur, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA; Division of Cardiology, VA Connecticut Healthcare System, West Haven, CT, USA. Electronic address:
Michael P. Gannon, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.
Sumit Gupta, Department of Radiology, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA.
Jonathan R. Weir-McCall, School of Clinical Medicine, University of Cambridge, Cambridge, UK; Department of Radiology, Royal Papworth Hospital, Cambridge, UK.
Claire Johns, Marketing and Communications, Society of Cardiovascular Computed Tomography, Arlington, VA, USA.
Arnav Kumar, Brigham and Women's Hospital, Boston, MA, USA.
Prashant Nagpal, Cardiovascular Imaging, Department of Radiology, University of Wisconsin-Madison, Madison, WI, USA.
Emilio Fentanes, San Antonio Military Medical Center, San Antonio, TX, USA.
James Lee, Henry Ford Heart and Vascular Institute, Detroit, MI, USA.
Andrew D. Choi, The George Washington University School of Medicine, Washington, DC, USA.
Maros Ferencik, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA.
Christopher D. Maroules, Naval Medical Center Portsmouth, Portsmouth, VA, USA.
Todd C. Villines, Division of Cardiovascular Medicine, University of Virginia Medical Center, Charlottesville, VA, USA.
Edward D. Nicol, Departments of Cardiology and Radiology, Royal Brompton Hospital, London, UK; School of Biomedical Engineering and Imaging Sciences, King's College, London, UK.

Document Type

Journal Article

Publication Date



Journal of cardiovascular computed tomography








CCT; CCT curriculum; CCT education; CCT practice; CCT training; CCTA; Cardiac CT angiography; Cardiac CT training; Cardiovascular computed tomography


BACKGROUND: As cardiovascular computed tomography (CCT) practice evolves, the demand for specialists continues to increase. However, CCT training remains variable globally with limited contemporaneous data to understand this heterogeneity. We sought to understand the role of CCT globally and the training available to underpin its use. METHODS: We performed two consecutive surveys of cardiology and radiology physicians, two years apart, utilizing the Society of Cardiovascular Computed Tomography (SCCT) website, weblinks, social media platforms, and meeting handouts to maximize our response rate. We compared United States (US)-based vs. international responses to understand global similarities and differences in practice and training in the surveys. RESULTS: 235 respondents (37% trainees and 63% educators/non-trainees) initiated the first survey with 174 (74%) completing the core survey, with 205 providing their work location (114 US and 91 international). Eighty-four percent (92/110) of educator respondents stated a need for increased training opportunities to meet growing demand. Dedicated training fellowships are heterogenous, with limited access to structural heart imaging training, despite structural scanning being performed within institutions. The lack of a standardized curriculum was identified as the main obstacle to effective CCT learning, particularly in the US, with web-based learning platforms being the most popular option for improving access to CCT training. 148 trainees initiated the second survey with 107 (72%) completing the core components (51% North America, 49% international). Only 68% said they would be able to meet their required CCT education needs via their training program. Obstacles in obtaining CCT training again included a lack of a developed curriculum (51%), a lack of dedicated training time (35%), and a lack of local faculty expertise (31%). There was regional variability in access to CCT training, and, in contrast to the first survey, most (89%) felt 1:1 live review of cases with trained/expert reader was most useful for improving CCT training alongside formal curriculum/live lectures (72%). CONCLUSIONS: There is a need to expand dedicated CCT training globally to meet the demand for complex CCT practice. Access to CCT education (didactic and 1:1 case-based teaching from expert faculty), implementation of recently published global training curricula, and increased teaching resources (web-based) as an adjunct to existing experiential learning opportunities, are all deemed necessary to address current educational shortfalls.