ACC, AHA, SCAI Release New Training Guidance for Interventional Cardiology

The training statement emphasizes competency-based training in a highly specialized field

The American College of Cardiology, the American Heart Association and the Society for Cardiovascular Angiography and Interventions have jointly issued a clinical document outlining competency-based training requirements for interventional cardiology trainees. This is the first document of its kind to define the training requirements for the full breadth of interventional cardiology for adults, which lay the foundation for coronary interventions, peripheral vascular (PVI) and structural heart interventions (SHI).

Advanced Training Statements describe the necessary learning experiences and outcomes needed to achieve competency in a subspecialty area of cardiology through a structured training program.

“With this groundbreaking document, the writing committee provides a roadmap for both program directors and interventional cardiology trainees to help them progress through important training milestones,” said Theodore A. Bass, MD, chair of the Advanced Training Statement writing committee. “The document defines the required competencies for the full scope of interventional cardiology, providing trainees for the first time with the information to support training across all these areas.”

The training pathway for cardiovascular fellows to gain the necessary experience in interventional cardiology includes: 1) A three-year general cardiovascular disease fellowship (successful completion consists of Level I competency in all aspects of cardiovascular medicine and Level II competency in diagnostic cardiac catheterization to pursue interventional cardiology training); 2) A one-year accredited interventional cardiology fellowship, the focus of which is coronary intervention with the opportunity to gain procedural experience in various aspects of PVI or SHI (Level III competency); and 3) An option for additional post-fellowship training based on the trainee’s career goals.

Level III training aims to give interventional cardiology trainees a well-rounded, competency-based education, including didactic instruction, clinical experience in the diagnosis and care of patients, and hands-on procedural experience. Competency requirements are defined using the Accreditation Council for Graduate Medical Education’s six competency domains: Medical Knowledge; Patient Care and Procedural Skills; Practice-Based Learning and Improvement; Systems-Based Practice; Interpersonal and Communication Skills; and Professionalism. These competencies are essential for all interventional cardiology trainees, as well as additional select competencies in PVI and SHI for trainees based on career focus.

To support the attainment of competencies, the writing committee recommends a minimum of 250 interventional cardiology procedures. Of the 250 procedures, 200 should be coronary procedures, with the remaining 50 specialized in coronary, PVI or SHI, which allows the fellows to customize training based on their career goals. Adjunctive procedures related to physiologic assessment and intracoronary imaging are also required (25 of each). These minimum numbers are meant to provide trainees with exposure to a variety and spectrum of complexity of clinical case material and give supervising faculty sufficient opportunity to evaluate trainees’ competency.

Trainees must also acquire experience working as part of a multidisciplinary team to provide a holistic approach to patient care. The document also highlights the importance of cardiovascular health equity, mentorship and lifelong learning beyond initial training.

The “2023 ACC/AHA/SCAI Advanced Training Statement on Interventional Cardiology (Coronary, Peripheral Vascular, and Structural Heart Interventions)” will be published simultaneously in the Journal of the American College of Cardiology, the American Heart Association’s journal Circulation: Cardiovascular Interventions, and the Society for Cardiovascular Angiography and Interventions’ journal the Journal of the Society of Cardiovascular Angiography and Interventions.

The statement was developed in collaboration with and endorsed by the American Association for Thoracic Surgery, the American Society of Echocardiography, the Heart Failure Society of America, the Heart Rhythm Society, the Society of Cardiovascular Anesthesiologists, the Society of Cardiovascular Computed Tomography, the Society for Cardiovascular Magnetic Resonance, the Society of Thoracic Surgeons and the Society for Vascular Medicine.

About the American College of Cardiology
The American College of Cardiology (ACC) is the global leader in transforming cardiovascular care and improving heart health for all. As the preeminent source of professional medical education for the entire cardiovascular care team since 1949, ACC credentials cardiovascular professionals in over 140 countries who meet stringent qualifications and leads in the formation of health policy, standards and guidelines. Through its world-renowned family of JACC Journals, NCDR registries, ACC Accreditation Services, global network of Member Sections, CardioSmart patient resources and more, the College is committed to ensuring a world where science, knowledge and innovation optimize patient care and outcomes. Learn more at www.ACC.org or follow @ACCinTouch.

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public’s health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.

About the Society for Cardiovascular Angiography and Interventions
The Society for Cardiovascular Angiography & Interventions (SCAI) is a nonprofit professional association with over 4,500 members representing interventional cardiologists and cardiac catheterization teams in the United States. SCAI promotes excellence in interventional cardiovascular medicine for both adults and children through education, representation, and the advancement of quality standards to enhance patient care. Follow @SCAI on Twitter for the latest heart health news.