1
|
German CA, Baum SJ, Ferdinand KC, Gulati M, Polonsky TS, Toth PP, Shapiro MD. Defining Preventive Cardiology: A Clinical Practice Statement from the American Society for Preventive Cardiology. Am J Prev Cardiol 2022; 12:100432. [DOI: 10.1016/j.ajpc.2022.100432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/31/2022] [Accepted: 11/12/2022] [Indexed: 11/17/2022] Open
|
2
|
García-Zamora S, Lépori AJ, Jordán A, Nauhm Y, Roif R, Paredes G, Sigal A, Ferrández-Escarabajal M, Pulido L, Álvarez-García J. [Manejo de la cesación tabáquica entre residentes de cardiología de Iberoamérica]. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2021; 91:431-438. [PMID: 33938903 PMCID: PMC8641460 DOI: 10.24875/acm.20000381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introducción y objetivos: Si bien los cardiólogos asisten cotidianamente a pacientes que sufren daño por el tabaquismo, no se conoce el grado de formación que reciben sobre esta problemática durante su residencia. Debido a ello nos propusimos evaluar las preferencias y prácticas de los residentes de cardiología para la cesación tabáquica de los pacientes que asisten. Materiales y métodos: Encuesta cerrada, prefijada, voluntaria y anónima entre médicos que realizaban la especialidad de cardiología en cinco países de Latinoamérica y España. Resultados: Se encuestaron 716 residentes: un 62.4% de Argentina, un 19% de México, un 6.8% de España, un 6.7% de Chile, un 3.2% de Uruguay y un 1.9% de Paraguay. Con respecto a la importancia que asignaban a esta problemática (empleando una escala de 1-10), el 85.8% le asignó a esta pregunta una puntuación de 8 o mayor. Mientras el 80.5% de los participantes expresó dar consejo breve antitabáquico sistemáticamente, solamente un 27.7% empleaban terapia farmacológica con este fin. Entre quienes no empleaban terapia farmacológica, el 58.3% manifestó que el motivo era no encontrarse familiarizados con los tratamientos. El 62.9% de los encuestados dijo no haber recibido ningún tipo de formación en esta problemática. Aquellos residentes que recibieron algún tipo de formación manifestaron sentirse más preparados (p < 0.0001). Conclusión: Encontramos un bajo conocimiento sobre el tratamiento farmacológico y relativamente poca seguridad por parte de los residentes de cardiología para brindar asistencia en cesación tabáquica. Consideramos esencial incluir este tópico en la formación de los futuros cardiólogos a fin de lograr una prevención cardiovascular más integral.
Collapse
Affiliation(s)
| | - Augusto J Lépori
- Consejo Argentino de Residentes de Cardiología (CONAREC), Buenos Aires, Argentina
| | - Antonio Jordán
- Asociación de Fellows y Residentes Cardiólogos de México (ARCAME), Ciudad de México, México
| | - Yalile Nauhm
- Sociedad Chilena de Cardiología y Cirugía Cardiovascular (SOCHICAR), Santiago de Chile, Chile
| | - Romina Roif
- Comité de Cardiólogos en Formación de Uruguay (CCFUR), Montevideo, Uruguay
| | - Gabriel Paredes
- Instituto Nacional de Cardiología Prof. Dr. Juan A. Cattoni, Asunción, Paraguay
| | - Alan Sigal
- Consejo Argentino de Residentes de Cardiología (CONAREC), Buenos Aires, Argentina
| | | | - Laura Pulido
- Consejo Argentino de Residentes de Cardiología (CONAREC), Buenos Aires, Argentina
| | - Jesús Álvarez-García
- Servicio de Cardiología del Hospital de la Santa Creu i Sant Pau, Instituto de Investigación Biomédica Sant Pau, CIBERCV, Universidad Autónoma de Barcelona, España
| |
Collapse
|
3
|
Permission to prescribe: do cardiologists need permission to prescribe diabetes medications that afford cardiovascular benefit? Curr Opin Cardiol 2021; 36:672-681. [PMID: 34173772 DOI: 10.1097/hco.0000000000000892] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Antihyperglycemic therapies including sodium glucose contransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) have been demonstrated to confer significant cardiovascular benefit and reduce future events in patients with type 2 diabetes mellitus (T2DM). However, despite positive data from cardiovascular outcome trials, these therapies remain underutilized in a large proportion of patients who have clinical indications and meet coverage guidelines for their initiation. One of the causes of the observed gap between scientific evidence and clinical cardiology practice is therapeutic hesitancy (otherwise known as therapeutic inertia). The purpose of this review is to discuss the contributors to therapeutic hesitancy in the implementation of these evidence-based therapies and, more importantly, provide pragmatic solutions to address these barriers. RECENT FINDINGS Recent studies have demonstrated that clinicians may not initiate cardiovascular protective therapies due to a reluctance to overstep perceived interdisciplinary boundaries, concerns about causing harm due to medication side effects, and a sense of unfamiliarity with the optimal choice of therapy amidst a rapidly evolving landscape of T2DM therapies. SUMMARY Herein, we describe a multifaceted approach aimed at creating a 'permission to prescribe' culture, developing integrated multidisciplinary models of care, enhancing trainees' experiences in cardiovascular disease prevention, and utilizing technology to motivate change. Taken together, these interventions should increase the implementation of evidence-based therapies and improve the quality of life and cardiovascular outcomes of individuals with T2DM.
Collapse
|
4
|
Saeed A, Agarwala A, Mehta A, Afari ME. Cardiovascular disease prevention career pathways: The status quo and future directions. Am J Prev Cardiol 2020; 4:100134. [PMID: 34327483 PMCID: PMC8315632 DOI: 10.1016/j.ajpc.2020.100134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/11/2020] [Accepted: 11/27/2020] [Indexed: 11/19/2022] Open
Abstract
Cardiovascular disease prevention is a complicated field requiring similar resource allocation and training as any other subspecialty in cardiology. To highlight the increasing need for primordial, primary and secondary cardiovascular disease prevention at a population level, it is necessary to have a clear vision for not only adequate training in the field but also sample career trajectories that today’s fellows-intraining (FIT) and early career (EC) physicians can use as a reference. However due to less centralized training, reduced exposure to the discipline and no clear institutional champions, direct access to “role model” careers in cardiovascular disease prevention may be lacking for today’s generation of trainees. These trends may change with more formalized recognition and more visibility of career trajectories in the field. In the current short report, we propose career pathways in cardiovascular disease prevention that can serve as a board resource roadmap for today’s FIT/EC physicians to design their careers in cardiovascular disease prevention. We explore three types of preventive cardiologists prototypes including; “the researcher”, “the clinician” and “the academic” preventive cardiologist models. These models are based on experiences gained in separate preventive cardiology training fellowships in addition to general cardiology training. Further, with advances in the scientific technologies, we highlight the future trajectory in the field. Preventive cardiology, although currently not the most desired path for FIT/EC physicians to pursue today, has the potential to be seen as the lucrative and essential training field in the future.
Collapse
Affiliation(s)
- Anum Saeed
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Anandita Agarwala
- Baylor Scott and White Health Heart Hospital Baylor Plano, Plano, TX, USA
| | - Anurag Mehta
- Emory University School of Medicine, Atlanta, GA, USA
| | - Maxwell E Afari
- Divison of Cardiology, Maine Medical Center, Portland, ME, USA
| |
Collapse
|
5
|
Shapiro MD, Fazio S. Preventive cardiology as a dedicated clinical service: The past, the present, and the (Magnificent) future. Am J Prev Cardiol 2020; 1:100011. [PMID: 32835348 PMCID: PMC7217102 DOI: 10.1016/j.ajpc.2020.100011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/19/2020] [Accepted: 04/19/2020] [Indexed: 12/30/2022] Open
Abstract
Ischemic cardiovascular disease continues to be most common cause of death after age 55 everywhere in the world. As the average person is exposed over life to a variety of artery-damaging insults it is easy to predict that this trend will continue for decades. We face an unprecedented opportunity to consolidate, strengthen, and broaden the effort to prevent cardiovascular events, both ischemic and non ischemic. This effort requires professional lifestyle counseling, dietary interventions, use of natural supplements, pharmacotherapy, and efficient cross-referral strategies. The nascent subspecialty of preventive cardiology must reach uniformity in protocols of care, and must develop a system of training and certification for the next generation of expert providers.
Collapse
Affiliation(s)
- Michael D Shapiro
- Center for Prevention of Cardiovascular Disease, Section on Cardiovascular Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Sergio Fazio
- Center for Preventive Cardiology, Knight Cardiovascular Institute, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| |
Collapse
|
6
|
|
7
|
Riley H, Ainani N, Turk A, Headley S, Szalai H, Stefan M, Lindenauer PK, Pack QR. Smoking cessation after hospitalization for myocardial infarction or cardiac surgery: Assessing patient interest, confidence, and physician prescribing practices. Clin Cardiol 2019; 42:1189-1194. [PMID: 31647127 PMCID: PMC6906990 DOI: 10.1002/clc.23272] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 08/30/2019] [Accepted: 09/10/2019] [Indexed: 01/08/2023] Open
Abstract
Background Prioritizing and managing multiple behavior changes following a cardiac hospitalization can be difficult, particularly among smokers who must also overcome a serious addiction. Hypothesis Hospitalized smokers will report a strong interest in smoking cessation (SC) but will receive little assistance from their physicians. Methods We asked current smokers hospitalized for an acute cardiac event to prioritize their health behavior priorities, and inquired about their attitude toward SC therapies. We also assessed SC cessation prescriptions provided by their physicians. Results Of the 105 patients approached, 81 (77%) completed the survey. Of these, 72.5% ranked SC as their greatest health change priority, surpassing all other behavior changes, including: taking medications, attending cardiac rehabilitation (CR), dieting, losing weight, and attending doctor appointments. Patients felt that SCM (44%), CR (41%), and starting exercise (35%) would increase their likelihood for SC. While most patients agreed that smoking was harmful, 16% strongly disagreed that smoking was related to their hospitalization. At discharge, medication was prescribed to ~32% of patients, with equal frequency among patients who reported interest and those who reported no interest in using medications. Conclusion The majority of hospitalized smokers with cardiac disease want to quit smoking, desire help in doing so, and overwhelmingly rate cessation as their highest health behavior priority, although some believe smoking is unrelated to their disease. The period following an acute cardiac event appears to be a time of great receptivity to SC interventions; however, rates of providing tailored, evidence‐based interventions are disappointingly low.
Collapse
Affiliation(s)
- Hayden Riley
- Division of Cardiovascular Medicine, Baystate Medical Center, Springfield, Massachusetts.,Department of Exercise Science and Sports Studies, Springfield College, Springfield, Massachusetts.,Cardiac and Pulmonary Rehabilitation, The Miriam Hospital, Providence, Rhode Island
| | - Nitesh Ainani
- Division of Cardiology, Baystate Medical Center, Springfield, Massachusetts
| | - Ahmad Turk
- Division of Cardiology, Baystate Medical Center, Springfield, Massachusetts
| | - Samuel Headley
- Department of Exercise Science and Sports Studies, Springfield College, Springfield, Massachusetts
| | - Heidi Szalai
- Division of Cardiology, Baystate Medical Center, Springfield, Massachusetts
| | - Mihaela Stefan
- Institute for Health Care Delivery and Population Science, Baystate Medical Center, Springfield, Massachusetts.,Department of Internal Medicine, Baystate Medical Center, Springfield, Massachusetts.,University of Massachusetts Medical School at Baystate, Springfield, Massachusetts
| | - Peter K Lindenauer
- Institute for Health Care Delivery and Population Science, Baystate Medical Center, Springfield, Massachusetts.,Department of Internal Medicine, Baystate Medical Center, Springfield, Massachusetts.,University of Massachusetts Medical School at Baystate, Springfield, Massachusetts
| | - Quinn R Pack
- Division of Cardiovascular Medicine, Baystate Medical Center, Springfield, Massachusetts.,Division of Cardiology, Baystate Medical Center, Springfield, Massachusetts.,Institute for Health Care Delivery and Population Science, Baystate Medical Center, Springfield, Massachusetts
| |
Collapse
|
8
|
Enhancing Preventive Cardiovascular Medicine Training During General Cardiology Fellowship. J Am Coll Cardiol 2019; 74:1637-1641. [DOI: 10.1016/j.jacc.2019.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
9
|
Aspry KE, Van Horn L, Carson JAS, Wylie-Rosett J, Kushner RF, Lichtenstein AH, Devries S, Freeman AM, Crawford A, Kris-Etherton P. Medical Nutrition Education, Training, and Competencies to Advance Guideline-Based Diet Counseling by Physicians: A Science Advisory From the American Heart Association. Circulation 2018; 137:e821-e841. [DOI: 10.1161/cir.0000000000000563] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Growing scientific evidence of the benefits of heart-healthy dietary patterns and of the massive public health and economic burdens attributed to obesity and poor diet quality have triggered national calls to increase diet counseling in outpatients with atherosclerotic cardiovascular disease or risk factors. However, despite evidence that physicians are willing to undertake this task and are viewed as credible sources of diet information, they engage patients in diet counseling at less than desirable rates and cite insufficient knowledge and training as barriers. These data align with evidence of large and persistent gaps in medical nutrition education and training in the United States. Now, major reforms in undergraduate and graduate medical education designed to incorporate advances in the science of learning and to better prepare physicians for 21st century healthcare delivery are providing a new impetus and novel ways to expand medical nutrition education and training. This science advisory reviews gaps in undergraduate and graduate medical education in nutrition in the United States, summarizes reforms that support and facilitate more robust nutrition education and training, and outlines new opportunities for accomplishing this goal via multidimensional curricula, pedagogies, technologies, and competency-based assessments. Real-world examples of efforts to improve undergraduate and graduate medical education in nutrition by integrating formal learning with practical, experiential, inquiry-driven, interprofessional, and population health management activities are provided. The authors conclude that enhancing physician education and training in nutrition, as well as increasing collaborative nutrition care delivery by 21st century health systems, will reduce the health and economic burdens from atherosclerotic cardiovascular disease to a degree not previously realized.
Collapse
|
10
|
Saeed A, Dabhadkar K, Virani SS, Jones PH, Ballantyne CM, Nambi V. Cardiovascular Disease Prevention: Training Opportunities, the Challenges, and Future Directions. Curr Atheroscler Rep 2018; 20:35. [PMID: 29781057 DOI: 10.1007/s11883-018-0735-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE Cardiovascular diseases (CVDs) are a leading cause of morbidity and mortality worldwide, necessitating major efforts in prevention. This review summarizes the currently available training opportunities in CVD prevention for fellows-in-training (FITs) and residents. We also highlight the challenges and future directions for CVD prevention as a field and propose a structure for an inclusive CVD prevention training program. RECENT FINDINGS At present, there is a lack of centralized training resources for FITs and residents interested in pursuing a career in CVD prevention. Training in CVD prevention is not an accredited subspecialty fellowship by the American Council of Graduate Medical Education (ACGME). Although there are several independent training programs under the broad umbrella of CVD prevention focusing on different aspects of prevention, there is no unified curriculum or training. More collaborative efforts are needed to identify CVD prevention as an ACGME-accredited subspecialty fellowship. Providing more resources can encourage and produce more leaders in this essential field.
Collapse
Affiliation(s)
- Anum Saeed
- Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
- Center for Cardiometabolic Disease Prevention, Baylor College of Medicine, Houston, TX, USA
| | - Kaustubh Dabhadkar
- Division of Cardiology, Department of Medicine, Alpert Medical School of Brown University, Providence, RI, USA
| | - Salim S Virani
- Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
- Center for Cardiometabolic Disease Prevention, Baylor College of Medicine, Houston, TX, USA
- Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
- Health Policy, Quality and Informatics Program, Michael E. DeBakey Veterans Affairs Medical Center Health Services Research and Development Center for Innovations, Houston, TX, USA
- The Aga Khan University, Karachi, Pakistan
| | - Peter H Jones
- Center for Cardiometabolic Disease Prevention, Baylor College of Medicine, Houston, TX, USA
| | - Christie M Ballantyne
- Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
- Center for Cardiometabolic Disease Prevention, Baylor College of Medicine, Houston, TX, USA
- Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Vijay Nambi
- Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
- Center for Cardiometabolic Disease Prevention, Baylor College of Medicine, Houston, TX, USA.
- Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.
- , 6655 Travis Street, Suite 320, Houston, TX, 77030, USA.
| |
Collapse
|
11
|
A Deficiency of Nutrition Education and Practice in Cardiology. Am J Med 2017; 130:1298-1305. [PMID: 28551044 DOI: 10.1016/j.amjmed.2017.04.043] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 04/17/2017] [Accepted: 04/18/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND Nutrition is one of the foundations of cardiovascular guidelines for risk reduction and treatment. However, little is known about whether cardiologists, cardiology fellows-in-training, and cardiovascular team members have the nutrition education and knowledge necessary to implement these guidelines. The aim of this study was to describe the educational experiences, attitudes, and practices relating to nutrition among cardiovascular professionals. METHODS Surveys completed by cardiologists, fellows-in-training, and cardiovascular team members inquired about their personal dietary habits, history of nutrition education, and attitudes regarding nutrition interventions. RESULTS A total of 930 surveys were completed. Among cardiologists, 90% reported receiving no or minimal nutrition education during fellowship training, 59% reported no nutrition education during internal medicine training, and 31% reported receiving no nutrition education in medical school. Among cardiologists, 8% described themselves as having "expert" nutrition knowledge. Nevertheless, fully 95% of cardiologists believe that their role includes personally providing patients with at least basic nutrition information. The percentage of respondents who ate ≥5 servings of vegetables and fruits per day was: 20% (cardiologists), 21% (fellows-in-training), and 26% (cardiovascular team members). CONCLUSIONS A large proportion of cardiovascular specialists have received minimal medical education and training in nutrition, and current trainees continue to experience significant education and training gaps.
Collapse
|
12
|
|
13
|
Affiliation(s)
- Jerome L Fleg
- From the Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD.
| |
Collapse
|
14
|
Smith SC, Bittner V, Gaziano JM, Giacomini JC, Pack QR, Polk DM, Stone NJ, Wang S. COCATS 4 Task Force 2: Training in Preventive Cardiovascular Medicine. J Am Coll Cardiol 2015; 65:1754-62. [DOI: 10.1016/j.jacc.2015.03.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
15
|
Nguyen LT, Maul TM, Hindes M, Daniels CJ, Gurvitz M, Cook SC. Current and future status of adult congenital training in North America. Am J Cardiol 2015; 115:1151-3. [PMID: 25711436 DOI: 10.1016/j.amjcard.2015.01.552] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 01/13/2015] [Accepted: 01/13/2015] [Indexed: 11/19/2022]
Abstract
Adult congenital heart disease (ACHD) presents a unique and growing patient population, but there are no data to suggest there are sufficient training programs available to train specialists to meet the needs of this population. The objective of this national survey was to determine the current status of ACHD fellowship curricula and training. An online questionnaire was provided to adult and pediatric cardiology fellowship programs to determine program demographics, status, duration, faculty teaching responsibilities, volume or patient exposure, and institutional obstacles. Of the 225 programs surveyed, 81 responded (36%). Nearly all were university affiliated (93%) with <1/3 (29%) reporting an ACHD fellowship program. Most offered either a 1- (42%) or a 2-year (47%) fellowship. ACHD fellowship funding was provided by hospital budget (68%). Half reported an increase in applicants to their fellowship. Applicants were more likely to have had previous training in adult cardiovascular medicine (56%). Respondents ranked "Volume of Outpatients/Year" and "Lack of Institutional Support" as the most important aspect of an ACHD program to applicants and greatest obstacle to ACHD training, respectively. After training, ACHD fellows obtained adult cardiology/ACHD positions (47%) and were within an academic center (88%). In conclusion, the results demonstrate a deficiency in the number of currently available ACHD fellowship programs. Measures should be taken to strengthen and standardize ACHD training to meet the increasing workforce requirements of this population.
Collapse
Affiliation(s)
- Lan T Nguyen
- Department of Cardiology, The Adult Congenital Heart Disease Center, Heart Institute Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania
| | - Timothy M Maul
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Morgan Hindes
- Department of Cardiology, The Adult Congenital Heart Disease Center, Heart Institute Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania
| | - Curt J Daniels
- Department of Cardiology, The Columbus Ohio Adult Congenital Heart (COACH) Program, Columbus, Ohio
| | - Michelle Gurvitz
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts
| | - Stephen C Cook
- Department of Cardiology, The Adult Congenital Heart Disease Center, Heart Institute Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania.
| |
Collapse
|
16
|
Lenders CM, Deen DD, Bistrian B, Edwards MS, Seidner DL, McMahon MM, Kohlmeier M, Krebs NF. Residency and specialties training in nutrition: a call for action. Am J Clin Nutr 2014; 99:1174S-83S. [PMID: 24646816 PMCID: PMC3985219 DOI: 10.3945/ajcn.113.073528] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Despite evidence that nutrition interventions reduce morbidity and mortality, malnutrition, including obesity, remains highly prevalent in hospitals and plays a major role in nearly every major chronic disease that afflicts patients. Physicians recognize that they lack the education and training in medical nutrition needed to counsel their patients and to ensure continuity of nutrition care in collaboration with other health care professionals. Nutrition education and training in specialty and subspecialty areas are inadequate, physician nutrition specialists are not recognized by the American Board of Medical Specialties, and nutrition care coverage by third payers remains woefully limited. This article focuses on residency and fellowship education and training in the United States and provides recommendations for improving medical nutrition education and practice.
Collapse
Affiliation(s)
- Carine M Lenders
- Division of Pediatric Nutrition, Boston Medical Center, and Department of Pediatrics, Boston University School of Medicine, Boston, MA (CML); the Department of Community Health and Social Medicine, City College of New York, New York, NY (DDD); Harvard University Medical School, Boston, MA (BB); University of Texas Medical School, Houston, TX (MSE); the Vanderbilt Center for Human Nutrition, Vanderbilt University Medical Center, Nashville, TN (DLS); the Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN (MMM); University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC (MK); and the Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO (NFK)
| | | | | | | | | | | | | | | |
Collapse
|
17
|
Pack QR, Keteyian SJ, McBride PE. Subspecialty training in preventive cardiology: the current status and discoverable fellowship programs. Clin Cardiol 2012; 35:286-90. [PMID: 22570190 DOI: 10.1002/clc.21959] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Revised: 12/03/2011] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Preventive cardiology is currently not an American Board of Medical Specialties-recognized subspecialty. However, several programs offer non-accredited fellowships throughout the country. No source currently exists listing all available programs, and finding programs requires time-intensive search strategies. Our aim was to find all current preventive cardiology fellowships in the United States and describe their basic structure, duties, and faculty. METHODS We searched the Internet, contacted national organizations, and networked through any institution thought likely to have a fellowship. RESULTS We found 15 programs currently offering subspecialty training in preventive cardiology but with considerably different styles, structures, duties, clinical time, lengths, and hosting departments. CONCLUSIONS We provided a list of these programs and discussed the implications for the future of formal subspecialty preventive cardiology education.
Collapse
Affiliation(s)
- Quinn R Pack
- Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan, USA.
| | | | | |
Collapse
|