As the global burden of cardiovascular disease continues to increase worldwide, nurturing the development of early career cardiologists interested in global health is essential to create a cadre of providers with the skill set to prevent and treat cardiovascular diseases in international settings, according to a review topic by ACC’s Early Career International Working Group, published Jan. 4 in the Journal of the American College of Cardiology.

Although interest in global health has grown among cardiology trainees and early-career cardiologists over the past decade, opportunities for international clinical and research experiences abroad have not increased at the same rate. In the review, Marwah Abdalla, MD, MPH, et al., describe the ACC International Cardiovascular Exchange Database, a new resource for cardiologists interested in pursuing short-term clinical exchange opportunities abroad, and report some of the benefits and challenges of global health cardiovascular training.

The ACC International Cardiovascular Exchange Database was created to support growth of trainees and early career cardiologists and promote the exchange of cardiovascular medical skills, expertise and knowledge. In addition to providing a list of institutions around the world that are interested in hosting visiting cardiologists, the database collects feedback from participants of international clinical and research experiences.

From this feedback, the review describes six lessons learned from global health experiences. One is that mastering the bedside physical examination and use of mobile technology in resource-limited settings is critical. When it is difficult or impossible to obtain x-rays, basic metabolic panels, and other diagnostic tools, taking a thorough history and performing a comprehensive bedside exam become more important than ever. The use of advanced portable technologies, like clinical smartphone apps, also has proved beneficial in hospitals with resource constraints. Experience in these environments also helps sharpen the participants’ triage and resource allocation skills.

A striking advantage of participating in global health experiences is the opportunity to learn new skills and use new technologies not yet available or approved in the U.S. Differences in approval processes mean that health care professionals in European countries often begin using novel and advanced methods and devices before their U.S. counterparts. Access to these methods and technologies can help broaden the knowledge and experience of early career cardiologists.

Another lesson learned is that forming new global cardiovascular disease research collaborations “can lead to collaborative problem solving and development for both groups. Forming these global cardiovascular research and mentorship relationships as a trainee provides one with a broader network of collaborators at a critical time in the transition to an academic early-career cardiologist.”

The review concludes that international exposure helps to shape and refine the cardiology trainee, and can influence his or her decision to pursue a research career that focuses on global health and cardiology. In order to fully realize the benefits captured in the ACC International Cardiovascular Exchange Database, as well as contribute to the ACC-endorsed global effort to reduce premature deaths from noncommunicable diseases by “25 percent by 2025,” the authors encourage the ACC and other organizations to work to ensure that trainees and early career cardiologists have access to a wide range of global health experiences. 

Keywords: Cardiovascular Diseases, Cooperative Behavior, Europe, Global Health, Mentors, Mortality, Premature, Physical Examination, Physicians, Problem Solving, Research, Resource Allocation, X-Rays

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