ACC releases updated training recommendations for cardiology fellows


The American College of Cardiology has released the newest iteration of the Core Cardiovascular Training Statement, or COCATS 4, updating training recommendations for cardiovascular fellows. The statement defines for the first time the full core competencies expected of a clinical cardiologist.

The competency-based education focuses on outcomes assessment, rather than time and volume of experience, with defined evaluation tools. As a result, COCATS 4 extends beyond knowledge and skills to also include communication, professionalism, practice-based learning, and systems-based practice. The six competency domains were developed by the Accreditation Council for Graduate Medical Education and endorsed by the American Board of Internal Medicine and the American Board of Medical Specialties.

“The recommendations in the statement are aimed at training programme directors, faculty, and trainees in our cardiovascular disease fellowship programs,” said Eric S Williams, co-chair of the document as well as a member of the COCATS 4 steering committee along with Jonathan L Halperin, and Valentin Fuster. “But as the competencies defined in COCATS 4 are also aligned with those of Lifelong Learning for practicing cardiologists, the impact extends across the spectrum of our profession and is part of the foundational structure of the educational activities of the ACC.”

The goal of COCATS 4 is to facilitate development of the knowledge and skills all cardiologists should possess and align additional competencies with each fellow’s career focus. The processes formalised in COCATS 4 define the programme characteristics and requisite competencies that will better prepare cardiovascular specialists to meet the future needs of patients and society.

The steering committee also highlights the impact these updates may have on patients. The competencies form the basis for the Entrustable Professional Activities for Subspecialists in Cardiovascular Disease, which are the activities patients and the public expect cardiologists to perform. They include: cardiovascular consultation, acute cardiac care, chronic cardiovascular disease management, cardiovascular testing, disease prevention and risk factor control, team-based care, and lifelong learning.

“Optimal performance in patient care requires a combination of behaviour, attitude, and action,” said Halperin, who is also a co-chair on the statement. “By laying the foundation in fellowship to not only learn the skills needed to perform the actions our patients expect but also learn to communicate and work more effectively with patients, their families and all the members of the cardiovascular care team, we are helping fellows develop into highly skilled and more compassionate cardiologists.”

“In specific terms the COCATS 4 document emphasises training in ambulatory, consultative, and longitudinal cardiovascular care,” says Fuster, a member of the COCATS 4 steering committee. “Furthermore, it more generically emphasises comprehensively training our cardiology fellows to be the best, most well-rounded doctors, which is critical to the future of their careers, clinical cardiac care, the health of our patients, and the advancement of our field of cardiovascular medicine.”