Deficiencies in Global Health Training for Cardiovascular Fellows.

B y 2020, 7 of 10 deaths in developing countries are predicted to be due to noncommunicable diseases—the majority of which would be due to preventable cardiovascular diseases (CVDs) (1). Section IV.A.5 (a) of the Accreditation Council for Graduate Medical Education’s Program requirements for graduate medical education (GME) in cardiovascular disease recommends that fellows-in-training (FITs) must demonstrate competence in the practice of health promotion, disease prevention, diagnosis, care, and treatment of patients of each sex, from adolescence to old age, during health and all stages of illness (2). However, there is an unmet and unrecognized need for U.S. cardiology fellowship programs to offer an opportunity to incorporate global health training in cardiology during the 36 months of core training (2). A unique aspect of the U.S. GME program is the systematic integration of physicians trained outside of the United States (international medical graduates) into the post-graduate medical training programs alongside American medical graduates, often creating a melting pot of shared knowledge. More than 25% of the 797 positions for cardiovascular disease in the 2014 match were filled by non-U.S. international medical graduates (3). This tremendous pool of shared cultures and diversities is an asset that can be tapped when formulating and implementing a national global health training policy. As an international medical graduate, I have witnessed the tremendous burden of cardiovascular disease on the socioeconomics of a developing nation. I spent most of my time during my internship in rural India treating coronary heart disease, hypertension, diabetes, and heart failure. As I began my post-graduate medical training in the United States,