AMA agrees to help after initial request for an independent cardiovascular board was denied

"The last couple of years, the ABCVM has been working on creating an independent board for certifying cardiologists in the United States, and it was reviewed by the ABMS and declined. We feel like that that decision didn't fully reflect the content of that application and there's some room to revisit it," explained David Winchester, MD, chair of the ACC Board of Governors, a professor of cardiology and radiology at the University of Florida, and an ACC delegate to the AMA HOD.

He said ACC sees an opportunity to review the ABCVM application and also look more broadly at what board certifying bodies in the United States look like.

"We feel like it's time for us to blaze our own path in this regard that we have the knowledge, the skillset to do it. That's the direction we, as a cardiology community, wanted to go. There's a lot of legacy of these sorts of things with how departments are structured and how board certifications are done, and ABMS hasn't changed their board structures and admitted new boards in decades. We think that is part of what maybe needs to change moving forward," Winchester explained.

New cardiovascular board gains support from cardiac imaging societies

One of the criticisms ABMS cited for its denial was that they did not feel there was enough support for a new board from the cardiovascular community. The original application was cosigned by ACC, American Heart Association (AHA), Heart Rhythm Society (HRS), Society for Cardiovascular Angiography and Interventions (SCAI) and the Heart Failure Society of America (HFSA). Cardiac imaging societies were not part of that initial group.

However, this latest resolution seeking AMA involvement was supported by the American Society of Echocardiography (ASE), American Society of Nuclear Cardiology (ASNC), Society of Cardiovascular Computed Tomography (SCCT) and the Society for Cardiovascular Magnetic Resonance (SCMR).

Winchester said this additional support from the cardiac imaging community could play a key role going forward.

How can the AMA help with establishing a new cardiology board?

The resolution received mixed in-person testimony when it was discussed in an AMA reference committee last week. Physicians argued both for and against it. Testimony was presented in support of the belief that board certification is paramount in professional self-governance, and that the AMA should not interfere with the ABMS process. Others argued that the issue of board-certifying bodies has already been examined in an AMA Council on Medical Education Report 4-I-23 from 2023, which looked at how the AMA recognizes specialty certifications for physicians.

That report stated that, in the early 1900s, there was a major proliferation of new medical boards that wanted to differentiate themselves as clearly divided specialities from other types of doctors with specialized training. The first board was the American Board of Ophthalmology, incorporated in 1917, followed by several others.

The AMA established the ABMS in 1933 to bring order to the proliferation of these specialty boards and to address conflicts arising between them. Other entities later emerged as certification boards that established standards for obtaining initial board certification and maintaining continuing certification over time. The report states that continued AMA support of these entities is contingent with the certification program meeting accepted standards, including offering an independent, external assessment of knowledge and skills for both initial certification and recertification, or continuous certification in the medical specialty.

The AMA said the idea is to demonstrate speciality physician competency sets the qualifications above other health professionals without specialized training. The AMA said this is needed to demonstrating ongoing competency to build and maintain public trust in the medical profession.

The ACC and other cardiology societies supporting the creation of a new cardiovascular board believe cardiology has now reached a point where it has clearly diverged from its parent speciality of internal medicine. They say that specially trained cardiac specialists are now required to perform certain complex heart procedures. Similarly, supporters of the new cardiovascular board argue it is unfair for the Board of Internal Medicine to dictate training standards and certification for cardiologists, or require testing for internal medicine metrics that might not be applicable to what cardiologists do today.

People can learn more about the new board and its status at CVboard.org.