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Interventional Cardiology Policies

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Eligibility for Certification and Board Policies

The information provided on ABIM's website and in ABIM's print publication, Policies and Procedures for Certification, April 2018 (pdf), governs ABIM's decision about eligibility for certification. The April 2018 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 interventional cardiology, physicians must:

  • At the time of application, be previously certified by ABIM in cardiovascular disease;
  • Satisfactorily complete the requisite formal training and procedural requirements as specified in the descriptions of the Clinical Training Pathway;
  • Demonstrate clinical competence, procedural skills, and moral and ethical behavior in the clinical setting;
  • Hold a valid, unrestricted and unchallenged license to practice medicine; and
  • Pass the Interventional Cardiology Certification Examination.

Interventional cardiology fellowship training must be accredited by the Accreditation Council for Graduate Medical Education (ACGME), the Royal College of Physicians and Surgeons of Canada (RCPSC), the Professional Corporation of Physicians of Quebec or recognized as an Area of Focused Competency by the RCPSC.

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 31 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.

Training and Procedural Requirements

The training pathway requires 12 months of satisfactorily completed clinical fellowship training in interventional cardiology, in addition to the required three years of accredited cardiovascular disease training.

Interventional cardiology training taken July 1, 2002, and thereafter must be accredited by the Accreditation Council for Graduate Medical Education (ACGME). Interventional cardiology training undertaken prior to July 1, 2002, must be conducted within an accredited cardiovascular disease fellowship program.

Beginning with the November 2000 examination, candidates who have been out of formal training three or more years as of June 30 of the year of examination or were admitted to the examination under the former Practice Pathways must document post-training performance as primary operator of at least 150 therapeutic interventional cardiac procedures in the two years prior to application for examination.

During training in interventional cardiology, the fellow must have performed at least 250 therapeutic interventional cardiac procedures, documented in a case list and attested to by the training program director. In addition, the training program director must judge the clinical skill, judgment and technical expertise of the fellow as satisfactory.

To receive credit for performance of a therapeutic interventional cardiac procedure in the training pathway, a fellow must meet the following criteria:

  • Participate in procedural planning, including indications for the procedure and the selection of appropriate procedures or instruments;
  • Perform critical technical manipulations of the case (regardless of how many manipulations are performed in any one "case," each case may count as only one procedure);
  • Be substantially involved in postprocedural management of the case; and
  • Be supervised by the faculty member responsible for the procedure. (Only one fellow can receive credit for each case even if others were present.)

Program directors will be asked to attest to the performance of at least 250 therapeutic interventional cardiac procedures for each candidate who received training in their program.

Required Months of Training and Procedures

The total months of training required, including specific clinical months, and requisite procedures are outlined below.

Minimum Months
of Training
Clinical Months
Required
Procedures

* For deficits of less than one month in required training time, ABIM will defer to the judgment of the program director and promotions or competency committee in determining the need for additional training. With program director attestation to ABIM that the trainee has achieved required competence, additional training time will not be required. Trainees cannot make a request to ABIM on their own behalf.

12* 12 A minimum of 250 therapeutic interventional cardiac procedures during accredited interventional cardiology fellowship training. Those out of interventional cardiology training three years or more as of June 30 of the year of exam must document post-training performance as primary operator of 150 therapeutic interventional cardiac procedures in the two years prior to application for exam.

Clinical Competence Requirements

ABIM requires documentation that candidates for certification are competent in: (1) patient care 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 an ABIM certified program director (other ABMS Board and Canadian certification is acceptable, if applicable).

As outlined in the Program Director Ratings of Clinical Competence table below, all fellows must receive satisfactory ratings of overall clinical competence. In addition, fellows must receive satisfactory ratings in each of the six ACGME/ABMS Competencies 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 of the six ACGME/ABMS Competencies and overall clinical competence.

Program Director Ratings of Clinical Competence

Six ACGME/ABMS Competencies:

The resident/fellow is demonstrating satisfactory development of the knowledge, skill and attitudes/behaviors needed to advance in training. S/he is demonstrating a learning trajectory that anticipates the achievement of competency for unsupervised practice that includes the delivery of safe, effective, patient-centered, timely, efficient and equitable care.

Six ACGME/ABMS Competencies*
Components and Ratings Residents/Fellows:
Not Final Year of Training
Residents/Fellows:
Final Year of Training

* The six required competencies are: (1) patient care and procedural skills, (2) medical knowledge, (3) practice-based learning and improvement, (4) interpersonal and communication skills, (5) professionalism and (6) systems-based practice.

At the discretion of the program director, training in the final year may be extended as necessary to achieve satisfactory ratings in overall clinical competence and/or the six ACGME/ABMS competencies.

Yes Full credit Full credit
Conditional on Improvement Full credit No credit; must achieve satisfactory rating before receiving credit
No Full credit No credit; must repeat year

Overall Clinical Competence

This rating represents the assessment of the resident/fellow's development of overall clinical competence during this year of training:

Overall Clinical Competence
Components and Ratings Residents/Fellows:
Not Final Year of Training
Residents/Fellows:
Final Year of Training
* At the discretion of the program director, training in the final year may be extended as necessary to achieve satisfactory ratings in overall clinical competence and/or the six general competencies.
Satisfactory or Superior Full credit Full credit
Conditional on Improvement Full credit No credit; must achieve satisfactory rating before receiving credit*
Unsatisfactory No credit; must repeat year No credit; must repeat year

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.

Guidelines for proposals are available in Proposing Candidates for Special Consideration.

Certification 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.