The visit was initiated by HMC Ben Stewart (Navy Cardiovascular Technician Enlisted Technical Leader). He had met me at one of our professional meetings in San Diego and since his crew used The Cardiac Catheterization Handbook1, he asked if they could come to Long Beach, meet me, and talk about careers in the cath lab. Of course, I was honored and delighted.
What a surprise to see the class in uniform, impeccably assembled with their specific designations (Figure 2), medals, awards, and attention. I asked them where they were from, their service experience (some on land and some at sea), and what they wanted to know. We talked about interventional cardiology, cath lab techniques from access to TAVR, and teamwork, both in and out of the cath lab. We spent 2 hours talking about closure devices, access technique, and roles of scrub techs/RTs/LVNs. The Navy’s CVTs take on all of these roles, cross training being a key to their program and their future success.
I was very impressed with the dedication and personal stories of this group of young and eager-to-learn service men and women. I was very proud of them and their commitments to the Navy. I was also proud that our VA lab could be part of their education and future.
I’ll let the Navy speak for itself when describing their program:
“Navy Cardiovascular Technician Program - NEC 8408
“The Navy’s Cardiovascular Technician (CVT) program is a 13-month-long advanced school that takes basic ‘General Duty Corpsmen’ (medics) and trains them to work in all facets of cardiology. The Navy CVTs are trained in both invasive and non-invasive cardiovascular procedures. After successful completion of the program, all students challenge the Registered Cardiovascular Invasive Specialist (RCIS) and Registered Cardiac Sonographer (RCS) examinations offered by Cardiovascular Credentialing International (CCI). The Navy offers the school two times per year and admits the 10 most qualified and motivated individuals for each class. Most of the students have already spent time in the ‘Fleet’, meaning they have served as corpsmen alongside the Marines, aboard ships, or in Naval Medical Treatment Facilities.
“The students begin their training in San Antonio, Texas, at the Medical Education and Training Campus (METC). While at METC, the Navy and Army work jointly to complete the rigorous, 5-month advanced cardiac and internal medicine didactic portion of the training. Those students who successfully complete this portion of the training are then transferred, often times with families, to the Navy Enlisted Training Element located near the Naval Medical Center in San Diego, California (NMCSD), to continue on with the next eight months of training. While in San Diego, students are trained on the latest and greatest equipment and procedures in the field of cardiology by an exceptional group of active duty Navy cardiologists and staff CVT mentors. CAPT Keshav Nayak, MD, Director of Cardiac Cath Labs at NMCSD, leads the heart team operating in a state-of-the-art hybrid OR cath lab where students participate in advanced structural heart procedures such as transcatheter aortic valve replacement (TAVR) and ASD/PFO closures, as well as complex coronary procedures such as UPLM interventions and CTO recanalization. CDR Greg Francisco, MD, the Navy Cardiology Specialty Leader and Director of Electrophysiology, leads the EP lab where students get acquainted with atrial fibrillation ablations, pediatric EP, and the implantation of subcutaneous ICDs. CDR Steven Romero, MD, Director of NMCSD’s Echo Lab, has established a lab that performs 5,000 echos per year to include transthoracic echo, stress echo, and transesophageal echo in support of major structural heart interventions. The echo lab utilizes four Philips EPIQ 7s and one iE33 echocardiography machine. Needless to say, Navy CVT students receive a fantastic clinical experience at the best cardiology program in the United States Navy thanks to the Navy cardiologists, nurses, and CVTs at NMCSD.
“Once the students have completed the program, they are asked to fulfill cardiology duties worldwide. They are sent to places like Washington, D.C., Washington State, Okinawa, Japan, or even Guam. CVTs also volunteer for humanitarian missions onboard the Navy hospital ships, USNS Comfort and USNS Mercy (Figures 3-4). On these deployments, they perform non-invasive cardiac procedures in countries like Vietnam, Columbia, Ecuador, Philippines, and the Solomon Islands, just to name a few.
“In summation, Navy CVTs are experts in invasive and non-invasive cardiology, and have and will continue to perform those duties worldwide.”— Courtesy U.S. Navy public relations office through HMC Ben Stewart.
For those of you who read the CLD Clinical Editor’s page from March 2014, “The Cardiac Cath Lab, U.S. Naval Air Training, and Operational Excellence”2 on the similarities between training in both systems, you would be interested to know that the visit from USN San Diego CVT class embodied the essence of Admiral Sizemore’s philosophy and teachings. His description of his profession, its mission, service requirements, and specific skills was truly enlightening, but moreover, these traits are acquired via “sacrifice, commitment and hard work” as aptly demonstrated by my visitors this day.
I’ll conclude with the table published in that editor’s page (Table 1). It’s worth seeing again. My thanks to the U.S. Navy and as I said then (and I believe I can speak for every cath lab team I know on this), thank you for your service.
- Kern M, Sorajja P, Lim MJ. The Cardiac Catheterization Handbook. 6th ed. Philadelphia, PA: Elsevier; 2016.
- Kern M. The cardiac cath lab, U.S. naval air training, and operational excellence. Cath Lab Digest. 2014 Mar; 3(22). Available online at http://www.cathlabdigest.com/articles/Cardiac-Cath-Lab-US-Naval-Air-Training-Operational-Excellence. Accessed February 18, 2016.