Birth of new subspecialty: adult congenital heart disease

The American Board of Medical Specialties (ABMS) has created physician certification in a new subspecialty: adult congenital heart disease.

The ABMS board of directors and ABMS reserved powers board approved the subspecialty at its September meeting. The subspecialty will be offered by the American Board of Internal Medicine (ABIM) and will create a pathway for certification for cardiologists previously certified by either the ABIM or the American Board of Pediatrics (ABP) with the expectation that the certification exam will be available within the next three years. The Accreditation Council for Graduate Medical Education will be approached to develop accreditation standards for training programs "very shortly," according to ABMS.

“Children who suffer from pediatric congenital heart disease are now surviving into adulthood, with specialized medical needs that will be best met by trained specialists in adult congenital heart disease,” noted Eric S. Holmboe, MD, ABIM’s senior VP and chief medical officer. “This new subspecialty will enable patients to identify those clinicians with the competence and skill necessary to deliver quality care.”

The association said the subspecialty will:

  • Meet the needs of the growing population of adults with congenital heart disease by ensuring there are enough physicians with the appropriate training to care for them in a consistent and comprehensive manner that is in compliance with recently published guidelines.
  • Enable adult congenital heart specialists to work in an environment that specializes in caring for this patient population and provides a mechanism for transition of care from adolescence to adulthood that would eliminate gaps in medical care.
  • Develop well-defined training pathways for internal and pediatric medicine cardiology trainees through the ABIM and the ABP. These pathways would culminate in a final common examination and subspecialty certification.

“The new subspecialty to treat adult congenital heart disease is an illustration of the advances pediatric cardiologists and surgeons have made in treating congenital heart disease,” said American College of Cardiology's President William A. Zoghbi, MD. “Congenital heart disease is our nation’s number one birth defect. With the tremendous advances in care over the past decades there are now more adults than children living with congenital heart disease and a growing need to ensure physicians are trained to meet the unique needs of these patients.”

More than 1 million adults in the U.S. live with congenital heart disease, nearly half of whom require lifelong cardiac care, according to the Adult Congenital Heart Association. Currently, there are an estimated nine adult congenital heart disease training programs in the U.S. Estimates are that there are 500 to 600 certified adult congenital heart disease cardiologists needed to serve patients, and this will continue to grow with advances in care for the treatment of congenital heart disease.

The addition of adult congenital heart disease brings the number of specialty and subspecialty certificates to 160 offered through the 24 ABMS member boards.