Author + information
- Ankur Kalra, MD∗ (, )
- Neal S. Kleiman, MD and
- Deepak L. Bhatt, MD, MPH
- ↵∗Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, 6565 Fannin Street, Houston, Texas 77030
We read with immense interest the article by Rajagopalan et al. (1). We applaud the efforts of the fellows-in-training section leadership council of the American College of Cardiology in this regard. The ACC.org repository is the only reliable source currently available to fellows-in-training for learning about advanced training opportunities in structural and congenital heart interventions in North America (2). We are in complete agreement with the authors for their call to action by professional societies for better alignment of processes among the 36 (and growing) structural heart programs in the United States. However, a major deterrent in moving forward with this crucial step is the current lack of accreditation by the Accreditation Council for Graduate Medical Education for the advanced year of training in interventional cardiology (3). Issues that can be traced to the lack of accreditation include lack of standardized curricula across programs, establishment of minimum case volume per procedure type for procedures that fall under the rubric of structural heart interventions (akin to 250 coronary interventions that are required for fourth-year interventional cardiology fellowship programs), and lack of institutional funding for the advanced interventional year. Graduate Medical Education traditionally derives its funding from Medicare for post-graduate training (4). Therefore, as much as it is essential for current structural heart programs to align their training curricula, it is also crucial for professional societies such as the American College of Cardiology and Society for Cardiovascular Angiography and Interventions to approach this area of growing interest among advanced fellows with the following multipronged approach. The steps may include: 1) forming an early career structural heart disease task force to discuss basic framework for the advanced year of training (5); 2) discussing minimum case volume for transcatheter aortic valve replacement, transcatheter mitral therapy, and left atrial appendage occlusion, for example, required to establish a structural heart program; 3) accreditation and funding of the advanced year of training; and 4) establishing some form of certification or credentialing that provides recognition of the additional year of training, thereby distinguishing prospective structural interventionalist candidates during their job searches. In summary, setting up a repository by the fellows-in-training council is a very laudable first step in what will need to be a multitiered approach.
Please note: Dr. Bhatt has served on the advisory board for Cardax, Elsevier Practice Update Cardiology, Medscape Cardiology, and Regado Biosciences; has served on the board of directors for Boston VA Research Institute and the Society of Cardiovascular Patient Care; has served as the chair of the American Heart Association Quality Oversight Committee; has served on the data monitoring committees of the Duke Clinical Research Institute, Harvard Clinical Research Institute, Mayo Clinic, Population Health Research Institute; has received honoraria from American College of Cardiology (Senior Associate Editor, Clinical Trials and News, ACC.org), Belvoir Publications (Editor in Chief, Harvard Heart Letter), Duke Clinical Research Institute (clinical trial steering committees), Harvard Clinical Research Institute (clinical trial steering committee), HMP Communications (Editor in Chief, Journal of Invasive Cardiology), Journal of the American College of Cardiology (Guest Editor; Associate Editor), Population Health Research Institute (clinical trial steering committee), Slack Publications (Chief Medical Editor, Cardiology Today’s Intervention), Society of Cardiovascular Patient Care (Secretary/Treasurer), WebMD (CME steering committees); has performed roles for Clinical Cardiology (Deputy Editor), NCDR-ACTION Registry Steering Committee (Chair), VA CART Research and Publications Committee (Chair); has received research support from Amarin, Amgen, AstraZeneca, Bristol-Myers Squibb, Eisai, Ethicon, Forest Laboratories, Ischemix, Medtronic, Pfizer, Roche, Sanofi, The Medicines Company; has received royalties from Elsevier (Editor, Cardiovascular Intervention: A Companion to Braunwald’s Heart Disease); has served as a site co-investigator for Biotronik, Boston Scientific, and St. Jude Medical; has been a trustee of the American College of Cardiology; and has conducted unfunded research for FlowCo, PLx Pharma, and Takeda. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- American College of Cardiology Foundation
- Rajagopalan B.,
- Buber J.,
- Yadav P.K.,
- Cullen M.W.
- ↵American College of Cardiology Structural Heart Disease Fellowship Programs Database. Available at: http://www.acc.org/membership/sections-and-councils/fellows-in-training-section/training-resources/structural-heart-disease-and-congenital-interventional-fellowship-programs. Accessed October 4, 2016.
- Kalra A.,
- Bhatt D.L.,
- Pinto D.S.,
- et al.
- ↵Kalra A. Fellowships in advanced interventional and structural cardiology need structure, planning, and collaboration—stat! tctmd. July 5, 2016. Available at: https://www.tctmd.com/news/fellowships-advanced-interventional-and-structural-cardiology-need-structure-planning-and. Accessed October 4, 2016.
- ↵Kalra A. Forming an early career structural heart disease task force. Professional Online Network. September 22, 2016. Available at: http://networking.americanheart.org/blogs/100/1197. Accessed October 4, 2016.