Atherosclerotic cardiovascular disease (ASCVD) is one of the leading causes of morbidity and mortality in the United States. Prevention of ASCVD at primordial, primary, and secondary levels, is a public health priority.¹ The responsibility of recognizing, and ultimately limiting, the rise in cardiovascular risk factors like diabetes mellitus, obesity, and physical inactivity falls within the realm of practicing clinicians.

It is not an exaggerated belief that cardiology fellows-in-training (FIT) and early career (EC) members of the cardiology community are at the forefront of this battle. A formidable gap exists between scientific discovery and implementation of evidence-based practices in preventive cardiology. Experts believe that insufficient attention to prevention education during cardiology fellowship may be a part of this problem.² Although training in CVD prevention exists in several cardiology programs, many FIT do not meet the basic requirements for Level I training in this field.³ This is possibly related to the lack of centralized resources to enrich the preventive cardiology learning experience for general cardiology fellows.⁴

The involvement of FIT in CVD prevention related activities within and beyond the American College of Cardiology's (ACC) Annual Scientific Sessions is a central mission of the ACC Prevention Section Leadership Council this tenure. We envision that exposure to this niche field will be instrumental in developing FIT interest in preventive cardiology educational activities and facilitating opportunities for networking with peers as well as mentors. Below is an account on such an initiative by the Council leadership to promote FIT involvement at the annual Scientific Sessions and to enable a bidirectional flow of information between the prevention focused FITs and leading faculty members in the field of CVD prevention.

A "FIT-Faculty" Collaboration for Scientific Review

The ACC Prevention Section Highlights Session was a highly anticipated and attended review session that was held at the culmination of the ACC Scientific Sessions 2019. To represent cutting-edge research studies released at the annual scientific sessions, six pairs of FIT-Faculty were identified by the Council leadership several months in advance of the Sessions. In collaboration with a faculty participant, each FIT member identified a key topic of interest pertaining to CVD prevention. These included presentations that were most likely to impact or change clinical practice or were hypothesis generating for future research agenda. Six niche topics (diet and lifestyle, dyslipidemia, hypertension, diabetes, global health) in CVD prevention were selected to be the broad categories of the highlighted content. The ACC online planner was instrumental in selecting relevant abstracts and presented trials. Keeping in line with the embargo policies, this preparation was key in ensuring accurate representation of the content of the presentations. Each FIT-Faculty pair then summarized the top presentations in a powerpoint presentation followed by audience response questions.

The summation of this work was featured during the ACC Prevention Highlights Session on the last day of the Scientific Sessions. Each ten-minute presentation was divided into two sections; first delivery by the Faculty on the subject matter followed by an audience interactive question polling by the FIT allowing both the Faculty and the FIT to highlight the excellent work presented at the Scientific Sessions. The session provided the audience with a high yield review of cutting-edge research as well as clinical findings presented during the annual meeting. This served as an opportunity to understand and critically appraise the studies that may have been overlooked during the fully packed three-day meeting. The presentations also stimulated notable dialogue between audience members to create a dynamic discussion involving leading prevention Faculty as well as the FIT.

"FIT-Faculty" Networking

Networking is vital to advancing a career in cardiology. As participating FIT, we were unanimously content with the opportunity to participate in this event. Through discussing novel research and clinical data with leading Faculty in CVD prevention with diverse backgrounds, this was not only an opportunity to gain knowledge, but to also discuss career paths.

We compiled a list of the importance of FIT involvement in the high profile and widely attended scientific sessions at a national stage:

• Highlighting important and cutting-edge research that may have been missed during the 3-day high impact and fast-paced scientific event
• Extremely valuable opportunity to network with leaders in cardiology and meet faculty from other nationally and internationally reputed institutions in an intimate one-to-one session
• A catalyst opportunity to establish and promote the beginning of potentially long-lasting relationships as well as mentorship opportunities beyond the realms of the conference
• Exchange of ideas within Faculty and FIT in CVD prevention
• High yield educational exchange in CVD prevention
• A bidirectional exchange of educational and multimedia presentation tips by Faculty to FIT
• The use of social media (#SoMe) to promote, potentially collaborate on future research and other academic endeavors in the field of CVD prevention

"Preventive FIT Work Group": A seed planted by CV Prevention Council Leadership

Nationwide networking amongst CVD prevention focused FIT is direct a byproduct of FIT involvement in the ACC sessions. Following the birth of the "Preventive FIT Work Group" at the Scientific Sessions, several fellows have been actively engaged in sharing novel initiatives several months after the conference. The Preventive FIT work group has held periodic conference meetings to exchange ideas in advancing science and community level initiatives in CV prevention.

A potentially essential resource for other trainees created by our FIT work group is the collation of CV prevention fellowships across the United States (not widely available under one central source prior to this initiative) now available online at the ACC.org website.

Future initiatives by the Preventive FIT Work Group are bound to continue the mission to advance the CV prevention agenda amongst trainees and other clinicians alike to curtail CVD morbidity and mortality in our communities.

Conclusions

Ultimately, CVD trainees are at a unique stage to be forefront leaders in reducing the CVD associated morbidity, mortality, and its economic burden. However, being a cardiology FIT does not guarantee comprehensive clinical exposure, cutting-edge research opportunities nor mentorship in the field of CVD prevention. Being centrally involved in prevention focused activities, such as the "ACC Prevention Council Highlight Session", at a national stage is an exceptional opportunity for prevention focused FIT to be learners and teachers. The ACC Prevention Council's initiative to highlight the FIT involvement in the Scientific Sessions serves as an outstanding platform for FIT to not only carve out mentorship from leading investigators, clinicians and educators but also discuss career pathways in this niche field.

This also shows the commitment of the leadership of the Prevention of Cardiovascular Disease Section to have FIT engagement a central pillar driving their membership engagement strategy.

Recruitment of today's FIT into the field is a crucial step in expanding prevention and, thereby, planting the seeds amongst our communities to decrease cardiovascular disease morbidity and mortality.

If you are a FIT and would like to get involved with the Prevention Section, please email Ms. Kim Kooi at kkooi@acc.org

References

1. Nambi V, Bhatt DL. Primary Prevention of atherosclerosis: time to take a selfie? J Am Coll Cardiol 2017;70:2992-94.
2. Mehta A, Dhindsa DS, Sandesara PB. Enhancing preventive cardiovascular medicine training during general cardiology fellowship. J Am Coll Cardiol 2019;74:1637-41.
3. Pack QR, Keteyian SJ, McBride PE. Subspecialty training in preventive cardiology: the current status and discoverable fellowship programs. Clin Cardiol 2012;35:286-90.
4. Saeed A, Dabhadkar K, Virani SS, Jones PH, Ballantyne CM, Nambi V. Cardiovascular disease prevention: training opportunities, the challenges, and future directions. Current atherosclerosis reports 2018;20:35.

Clinical Topics: Diabetes and Cardiometabolic Disease, Dyslipidemia, Prevention, Hypertension

Keywords: Fellowships and Scholarships, Mentors, Cardiovascular Diseases, Health Priorities, Leadership, Risk Factors, Hypertension, Dyslipidemias, Diabetes Mellitus, Evidence-Based Practice, Primary Prevention

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