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VIEWPOINT

A Proposal for an Advanced Cardiovascular Imaging Training Track

Cardiovascular Division, University of Virginia Health System, Charlottesville, Virginia.

Manuscript received March 1, 2006; revised manuscript received April 21, 2006, accepted April 24, 2006.

^_* Reprint requests and correspondence: Dr. George A. Beller, Cardiovascular Division, University of Virginia Health System, P.O. Box 800158, Charlottesville, Virginia 22908-0158. (Email: gbeller{at}virginia.edu).

Cardiovascular (CV) imaging has experienced major growth and technological advances with respect to the long-standing traditional cardiac imaging procedures of echocardiography and nuclear cardiology, the emergence of cardiac computed tomography and magnetic resonance imaging in clinical practice, and multimodality and molecular imaging as new technologies. Therefore, it is perhaps timely to change the training paradigm for fellows interested in emphasizing CV imaging as a subspecialty in their professional careers and desiring extensive training in all CV imaging modalities. Proposed is the establishment of a formal fourth year of training leading to board certification in advanced CV imaging. Areas of training would include the acquisition of knowledge of physics and instrumentation related to the various imaging modalities, interpretation and quantitation of imaging variables, multimodality imaging technology, molecular and vascular imaging, and clinical guidelines with appropriateness criteria for all technologies. The training track would lead to an American Board of Internal Medicine examination for a Certificate of Added Qualification, similar to that for subspecialization in electrophysiology and interventional cardiology, with noninvasive cardiologists who have already completed fellowship training given the opportunity to sit for an examination on the basis of predetermined eligibility criteria. One benefit of this CV imaging subspecialty track that provides cardiologists with expertise in all imaging modalities is the capability to select the best modality for the clinical indication and to independently interpret multimodality imaging studies. Its rigorous didactic and procedural requirements would enhance quality of CV imaging, enhance research, and increase the speed with which new discoveries are translated into practice. This ultimately would yield better patient outcomes.

Abbreviations and Acronyms   ABIM = American Board of Internal Medicine   ABMS = American Board of Medical Subspecialties   ACCF = American College of Cardiology Foundation   ACGME = Accreditation Council for Graduate Medical Education   CAQ = Certificate of Added Qualification   CMR = cardiac magnetic resonance   CMS = Centers for Medicare and Medicaid Services   COCATS = Core Cardiology Training Symposium   CT = computed tomography   FDG = fluorodeoxyglucose   MRI = magnetic resonance imaging   PET = positron emission tomography   SPECT = single-photon emission computed tomography

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