2021 Advanced Training Statement on Vascular Medicine: Key Points

Creager MA, Hamburg NM, Calligaro KD, et al.
2021 ACC/AHA/SVM/ACP Advanced Training Statement on Vascular Medicine (Revision of the 2004 ACC/ACP/SCAI/SVMB/SVS Clinical Competence Statement on Vascular Medicine and Catheter-Based Peripheral Vascular Interventions): A Report of the Competency Management Committee. J Am Coll Cardiol 2021;Jan 15:[Epub ahead of print].

The following are key points to remember from the revised advanced training statement on vascular medicine:

  1. The most recent iteration of the Core Cardiovascular Training Statements (COCATS), published in 2015, established three levels of Vascular Medicine expertise. Level I training, covering basic understanding necessary for consultative cardiologists, is required of all cardiovascular medicine trainees.
  2. Level II training enables some cardiologists to perform or interpret specific procedures or render more specialized vascular care. This can be achieved by some trainees during the standard 3-year cardiovascular medicine fellowship by seeking additional training in interpreting noninvasive diagnostic tests as well as evaluating and managing patients with peripheral vascular disease.
  3. Level III training requires training and experience beyond the cardiovascular fellowship time period and established specialized competency in the diagnosis and management of patients with vascular conditions. This includes the ability to direct a vascular laboratory, train others, and conduct advanced research in vascular medicine.
  4. Medical knowledge competency for Level III trainees should cover a wide array of vascular medicine topics, including arterial diseases (including peripheral, renal, mesenteric, cerebrovascular, and aortic), venous disease (including acute and chronic thrombotic disorders and insufficiency), lymphedema, and less common conditions (e.g., fibromuscular dysplasia, vasculitis, congenital malformations, and entrapment).
  5. To achieve Level III competency, trainees should have both didactic and experiential training in the noninvasive vascular laboratory. They should also gain experience related to other vascular diagnostic modalities (e.g., magnetic resonance angiography, computed tomographic angiography, and invasive angiography).
  6. Specific competencies for a Level III trainee span the domains of Medical Knowledge, Patient Care and Procedural Skills, System-based Practice, Practice-based Learning and Improvement, Professionalism, and Interpersonal and Communication Skills.
  7. Evaluation of proficiency should encompass a multi-source approach. These include direct observations, case logs, chart review, simulation training, and assessment of leadership skills.
  8. Following the completion of advanced training in vascular medicine, trainees are expected to take the certification examination offered by the American Board of Vascular Medicine (ABVM) as well as one or more certification for interpreting noninvasive vascular examinations (e.g., Registered Physician in Vascular Interpretation [RPVI]).

Clinical Topics: Anticoagulation Management, Cardiac Surgery, Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Prevention, Vascular Medicine, Atherosclerotic Disease (CAD/PAD), Aortic Surgery, Cardiac Surgery and Arrhythmias, Interventions and Imaging, Interventions and Vascular Medicine, Angiography, Magnetic Resonance Imaging, Nuclear Imaging

Keywords: Angiography, Anticoagulants, Aortic Diseases, Carotid Artery Diseases, Catheters, Cerebrovascular Disorders, Certification, Clinical Competence, Critical Illness, Diagnostic Imaging, Diagnostic Tests, Routine, Drug Therapy, Endovascular Procedures, Fibromuscular Dysplasia, Intermittent Claudication, Ischemia, Lymphedema, Magnetic Resonance Angiography, Patient Care, Peripheral Arterial Disease, Peripheral Vascular Diseases, Pharmacology, Platelet Aggregation Inhibitors, Secondary Prevention, Therapeutics, Thromboembolism, Thrombosis, Vascular Diseases, Vascular Grafting, Vasculitis, Venous Thrombosis

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