Advanced Heart Failure and Transplant Cardiology Policies
- Eligibility for Certification and Board Policies
- General Requirements
- Training and Procedural Requirements
- Clinical Competence Requirements
- Candidates for Special Consideration
- Certification Using the Research Pathway
Eligibility for Certification and Board Policies
The information provided on ABIM's website and in ABIM's print publication, Policies and Procedures for Certification, August 2009 (pdf), governs ABIM's decision about eligibility for certification. The August 2009 edition supersedes all previous publications. ABIM reserves the right to make changes in fees, examinations, policies and procedures at any time without advance notice. Admission to ABIM's certification process is determined by policies in force at the time of application. ABIM is a member of the American Board of Medical Specialties (ABMS).
General Requirements
To become certified in the subspecialty of Advanced Heart Failure and Transplant Cardiology, physicians must:
- At the time of application, be previously certified in internal medicine by ABIM
- At the time of application, maintain a valid underlying certificate in cardiovascular disease
- Satisfactorily complete the requisite graduate medical education fellowship training
- Demonstrate clinical competence in the care of patients
- Meet the licensure and procedural requirements
- Pass the Certification Exam in Advanced Heart Failure and Transplant Cardiology
No credit will be granted toward certification in a subspecialty for training completed outside of an accredited U.S. or Canadian program.
Fellowship training taken before completing the requirements for the MD or DO degree, training as a chief medical resident, practice experience, and attendance at postgraduate courses may not be credited toward the requirements for subspecialty certification.
To be admitted to an examination, candidates must have completed the required training in the subspecialty, including vacation time, by October 31st of the year of examination.
Candidates for certification in the subspecialties must meet ABIM's requirements for duration of training as well as minimum duration of full-time clinical training. Clinical training requirements may be met by aggregating full-time clinical training that occurs throughout the entire fellowship training period; clinical training need not be completed in successive months. Time spent in continuity outpatient clinic, during non-clinical training, is in addition to the requirement for full-time clinical training. Educational rotations completed during training may not be double counted to satisfy both internal medicine and subspecialty training requirements. Likewise, training which qualifies a diplomate for admission to one subspecialty exam cannot be double-counted toward certification in another subspecialty, with the exception of formally approved pathways for dual certification.
Practice Experience and Training Requirements
For the first three Certification Examinations in Advanced Heart Failure and Transplant Cardiology (2010, 2012, and 2014), ABIM will offer two pathways for admission, a practice pathway and a training pathway.
Practice Pathway
The practice pathway is available only to candidates who complete the training required for certification in Cardiovascular Disease prior to July 1, 2011.
For the first five years and three examinations (2010, 2012, and 2014), cardiologists certified by ABIM who have not completed formal training in advanced heart failure and transplant cardiology will be eligible to apply for the Certification Examination in Advanced Heart Failure and Transplant Cardiology if they can:
- Demonstrate that for at least three out of the past five years including the year prior to application for the examination, they spent either 40% of their post-training clinical practice time or 25% of their total post-training professional time in the discipline of advanced heart failure and transplant cardiology; and
- Substantiate practice experience on a “Form Attesting Advanced Heart Failure and Transplant Cardiology Practice,” signed by the Program Director of an accredited training program in cardiovascular disease affiliated with the hospital where the candidate spends the majority of clinical time or by the Chief of Cardiology (or equivalent) in the hospital where the candidate spends the majority of clinical time.
Training Pathway
The training pathway involves satisfactory completion of four years of training – 36 months of accredited cardiovascular disease fellowship, including 24 months of full-time clinical training, plus 12 months of advanced heart failure and transplant cardiology fellowship training* that meets the following criteria:
- Advanced heart failure and transplant cardiology fellowship training must be undertaken in programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) when accreditation has been established (currently estimated to be July 1, 2012). Until that time, advanced heart failure and transplant cardiology fellowship training must be conducted within an institution that has an accredited cardiovascular disease fellowship program.
- For those institutions without a cardiac transplant center, program directors will need to establish a documented relationship with a transplant center at an affiliated institution in order to provide trainees with the required experience in the evaluation and management of pre-and post-operative cardiac transplant patients.
* NOTE: Advanced heart failure and transplant cardiology fellowship training cannot be used to fulfill the requirements for admission to the Certification Examination through the Training Pathway if that training has been credited toward the required 36 months of cardiovascular disease training. Total training must be four years.
TopTraining and Procedural Requirements
The total months of training required, including specific clinical months, and requisite procedures are outlined below.
| Minimum Months of Training |
Clinical Months Required |
Procedures |
|---|---|---|
| 12 | 12 | To be determined |
Clinical Competence Requirements
ABIM requires documentation that candidates for certification are competent in (1) patient care (which includes medical interviewing, physical examination and procedural skills), (2) medical knowledge, (3) practice-based learning and improvement, (4) interpersonal and communication skills, (5) professionalism, and (6) systems-based practice.
Through its tracking process, FasTrack, ABIM requires verification of fellows' clinical competence from the training program director.
As outlined in the Program Director Ratings of Clinical Competence table below, all fellows must receive satisfactory ratings of overall clinical competence and moral and ethical behavior in each of the required years of training. In addition, fellows must receive satisfactory ratings in each of the components of clinical competence and the requisite procedures during the final year of required training. It is the fellow's responsibility to arrange for any additional training needed to achieve a satisfactory rating in each component of clinical competence.
Program Director Ratings of Clinical Competence
| Ratings | Fellows (any year) |
|---|---|
| Satisfactory or Superior | Full credit |
| Unsatisfactory | No credit, must repeat year |
| Ratings | Fellows (any year) |
|---|---|
| Satisfactory | Full credit |
| Unsatisfactory | No credit, must repeat year or, at the request of the program director and at ABIM’s discretion, a successful period of observation can be arranged in lieu of repeating the year to be granted credit |
| Ratings | Fellows (any year) |
|---|---|
| * The six required competencies are: (1) patient care (which includes medical interviewing, physical examination and procedural skills), (2) medical knowledge, (3) practice-based learning and improvement, (4) interpersonal and communication skills, (5) professionalism, and (6) systems-based practice. | |
| Satisfactory or Superior | Full credit |
| Unsatisfactory | Must repeat year if during final year of required training |
Candidates for Special Consideration
ABIM diplomates in internal medicine may be proposed for special consideration for admission to a subspecialty examination by the program director of an accredited fellowship program if they:
- Have completed the full training required by ABIM in the subspecialty in another country and have met all current applicable ABIM procedural requirements.
- Are a full-time Associate Professor or higher in the specified subspecialty division of the Department of Medicine in an LCME-accredited medical school or an accredited Canadian medical school at the time of proposal.
- Have served eight years, after formal training, as a clinician-educator or clinical investigator with a full-time appointment on a medical school faculty.
- Possess a valid, unrestricted license to practice medicine in a state, territory, commonwealth, province or possession of the United States or Canada.
Guidelines for proposals are available in Proposing Candidates for Special Consideration.
TopCertification Using the Research Pathway
The ABIM Research Pathway is designed to integrate training in research and clinical internal medicine for those physicians who are seriously pursuing careers in basic science or clinical research. The value of the ABIM Research Pathway is that while it requires core clinical training, it concentrates on fostering a research experience that is comprehensive in terms of time, formal curriculum, and structured evaluation and feedback. These components are essential for professional growth and development and to promote continuous quality improvement.
Guidelines for certification using the research pathway are available in Research Pathway.
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