In this recent poll, we surveyed the ACC community to gauge views on how to best cater physician training to meet the complex needs of patients presenting with multiple cardiometabolic conditions, including obesity, type 2 diabetes, hypertension, and cardiovascular disease. Given the persistent epidemic of metabolic syndrome, the expanding landscape of therapies to treat individual metabolic conditions, and the emergence of SGLT2 inhibitors and GLP-1 receptor agonists that simultaneously treat multiple risk factors across several medical specialties, many physicians have argued for novel training pathways focused specifically on cardiometabolic medicine. These programs would be designed to better equip physicians to manage complex patients and to consolidate care that is currently fractured across multiple specialties. Whether new types of training are needed, and the way in which they should be structured, continue to be hotly debated.

In our poll, which received 117 votes, the vast majority (82%) of respondents acknowledged the need to move beyond the status quo regarding training, with only 18% advocating against a new training pathway in cardiometabolic medicine. Among those that wanted to see a novel training model, however, there remained substantial disagreement about the best way to structure this training. About half of respondents favored a certificate program for clinicians in any specialty (length of certificate training not specified), a quarter advocated for a 1-year fellowship model, and a small minority (9%) preferred a standalone cardiometabolic subspecialty within internal medicine. Additional points to consider moving forward include where newly trained cardiometabolic specialists would fit within the current landscape of multi-specialty healthcare, what components the training would include, and how physicians/health systems would respond to the blurring of traditional specialist boundaries. We appreciate all those that have contributed to this poll and look forward to continued discussion about this topic.

Clinical Topics: Acute Coronary Syndromes, Diabetes and Cardiometabolic Disease, Dyslipidemia, Prevention, Vascular Medicine

Keywords: Diabetes Mellitus, Acute Coronary Syndrome, Metabolic Syndrome, Dyslipidemias, Primary Prevention, Secondary Prevention, Vascular Diseases, Aneurysm, Cardiovascular Diseases, Mortality, Premature, Nephrology, Quality of Life, Specialization, Follow-Up Studies

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