Addressing Competency Requirements in Heart Failure and Transplant Training Programs

The Advanced Training Statement for advanced heart failure and transplant cardiology consists of 6 general competencies.

The American College of Cardiology (ACC) issued an Advanced Training Statement outlining the clinical competencies that trainees are expected to achieve during a training program in advanced heart failure and transplant cardiology (AHFTC), an American Board of Internal Medicine (ABIM)-certified subspecialty. The Advanced Training Statement was published in the Journal of the American College of Cardiology.

Because AHFTC programs are multifaceted — incorporating participation by general and specialty cardiology faculty, training in community and major hospital settings, and skills in numerous aspects of cardiopulmonary care — the Advanced Training Statement was written in tandem with the American Heart Association (AHA), Heart Failure Society of America (HFSA), the International Society for Heart & Lung Transplantation (ISHLT), and the American College of Physicians (ACP).

According to Mariell Jessup, MD, from the University of Pennsylvania in Philadelphia, who served as chair of the writing committee, the AHFTC Advanced Training Statement is the second jointly developed statement addressing the milestones that should be met during subspecialty cardiology training. “The first such document was done in electrophysiology,” she said.

“The AHFTC Advanced Training Statement is based on the 6 general competencies that are now the framework for all graduate medical education,” Dr Jessup continued.

The training requirements for AHFTC programs include the competency domains of Medical Knowledge, Patient Care and Procedural Skills, Practice-Based Learning and Improvement, Systems-Based Practice, Interpersonal and Communication Skills, and Professionalism.

During the course of the AHFTC program, trainees are expected to acquire detailed knowledge in the areas of heart failure, pulmonary hypertension, mechanical circulatory support, and cardiac transplantation.

Trainees must also demonstrate proficiency in performing procedures commonly employed in the care of patients with heart failure and cardiac transplant by completing a minimum number of procedures, such as right heart catheterization, ventricular assist device interrogation, and endomyocardial biopsy.

According to Dr Jessup, the AHFTC Advanced Training Statement enables physicians and patients to be confident that “a cardiologist with an ABIM certificate in AHFTC has expertise in a wide variety of skills and knowledge as outlined by the milestones in the document.”

“Likewise, if young cardiologists are contemplating additional training in this area, they will have an excellent understanding of the training that might be undertaken during the year that is now required,” she added.

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Jessup M, Drazner MH, Book Wet al. 2017 ACC/AHA/HFSA/ISHLT/ACP advanced training statement on advanced heart failure and transplant cardiology (revision of the ACCF/AHA/ACP/HFSA/ISHLT 2010 clinical competence statement on management of patients with advanced heart failure and cardiac transplant). A report of the ACC Competency Management Committee [published online March 3, 2017]. J Am Coll Cardiol. doi:10.1016/j.jacc.2017.03.001