Proposed New Cardiology Board Could "Reshape" the System: AHA 2024

The time has for cardiovascular medicine to form its very own certifying board. As the American Board of Medical Specialties (ABMS) weighs over submitting a formal application, the creation of an American Board of Cardiovascular Medicine (ABCVM) has the potential to reshape the current system for patients, clinicians, and health systems alike. Cathie Biga, MSN, FACC, president, American College of Cardiology, spearheaded a session at this year’s American Heart Association (AHA) conference to overview the latest updates on this board’s formation, and what can be expected if it is achieved.

An official decision from the ABMS should be expected come February.

This transcript has been lightly edited for clarity and length.

Transcript

Can you contextualize the need for cardiovascular medicine to have its own board? What current limitations or gaps in certification would a new board aim to address?

So, one of the reasons that the American College of Cardiology, along with our partners, decided to pursue a new board component was because what we've seen in an evolutionary process is the development of cardiovascular services as a separate entity, and in many organizations as a separate department, especially in some of our academic centers. So as the department of medicine gets subspecialized, the evolution of cardiovascular departments was one thing.

The second thing is the complexity of cardiovascular disease and the need to ensure ongoing, continuous competencies and certification. And so, as we were really looking at what is the main thing for the public and our communities to know about our cardiologist is that they are current in their specific field. So, by designing and promoting a new board, we're hoping that ABMS also sees that need for having our own cardiovascular boards.

How do you foresee the formation of the ABCVM affecting ongoing education and skill validation requirements for cardiologists?

I think it's a complex field and a relatively complex question, because there's of course the initial certification. That is actually fairly well situated, and our COCATS [Core Cardiovascular Training Statements] standards and the training and educational process within the United States is one of the best, if not the best, in the world. So, I think that is well understood.

I think the issue is that ongoing certification, that ongoing identification of knowledge gaps. For instance, my EP [electrophysiologist] physicians have a very distinct need for in-depth EP knowledge and understanding where their gaps in knowledge may be. We're hoping that this new process, with ongoing maintenance of certification, as we refer to it, will really evolve and help to help develop the other thing, however, that we're identifying is we have an enormous shortage of cardiologists, as I think you well know.

We know that 47% of our counties within the United States do not have a cardiologist. So, as we're really looking at that pipeline, how will this impact training? We're not sure yet. We've asked the ABCVM board to eventually look into that, but we may see this evolve into a much larger environmental assessment of how we train our cardiologists.

What potential challenges could arise in the efforts to gain acceptance for a new certifying board from the medical community, and how is the ABCVM preparing to address these?

I think it's a great question, and one that when we opened it up for public comments, we really were not sure. You know, you think, because you're in your own little bubble sometimes, as you're designing and developing something. So, when we open for public comment earlier this summer, in the summertime, it was amazing, the outpouring of public support that we saw. So, I think it was verified and validated that, in fact, not only is the medical community supportive of it, but so is our population health, our hospital systems, our communities are embracing the fact that having a cardiology-specific board is something very, very important.

Compared with the current system, how can a dedicated cardiovascular board better enhance patient care/outcomes, and address the needs of high-risk or underserved populations?

Well, as you know, ACC, one of its main strategic pillars is health equity and diversity, inclusion and access to care. So, will boards really provide that? The issue with boards, when we talk about boards, it's a lifelong event. It's not just coming out of fellowship and sitting for your primary boards, and maybe recertifying every so often. It's really a much longer and larger commitment, and that's the goal of the board. It's not just the initial certifying exam, but really, how do we improve that ongoing process? How do we make it beneficial for the practicing physician?

I don't necessarily want them having to leave their practice for 2 or 3 weeks to do a preparation to retake an exam. What I want them to be able to do is to know where their knowledge gaps are and where they can go to address those knowledge gaps—specific, targeted to what they do on a day in and day out basis. So that's the hope of the new boards, is that it really would be very focused per physician, very personalized: “This is an area that maybe you could learn a little bit more about,” helpful, not punitive.