2015 SPCTPD/ACC/AAP/AHA Training Guidelines for Pediatric Cardiology Fellowship Programs (Revision of the 2005 Training Guidelines for Pediatric Cardiology Fellowship Programs): Introduction.

e43 Since the 2005 publication of the first “Training Guidelines for Pediatric Cardiology Fellowship Programs,” the field of pediatric cardiology has undergone significant growth and change, and thus, the Society of Pediatric Cardiology Training Program Directors (SPCTPD) in conjunction with the Joint Council of Congenital Heart Disease recommended the guidelines be revised accordingly. The SPCTPD board assembled a Steering Committee that nominated 2 chairs for each of the 8 Task Forces (7 as in the original document plus 1 for “advanced medical therapies,” [ie, heart failure, pulmonary hypertension, and cardiac transplantation]). Six to 8 members were selected from a list of potential committee members representing a wide range of program sizes, geographic regions, and subspecialty focuses. Representatives from the American College of Cardiology, American Academy of Pediatrics, and American Heart Association participated. These participants, along with 1 Steering Committee member, comprised each Task Force. A Steering Committee member was added to provide perspective to each Task Force as a “nonexpert” in that field. The authors developed the Task Force reports under guidance from the Task Force chairs, approved them for review by individuals selected by the participating organizations, and addressed the 258 comments submitted. The peer reviewers for each report are listed in an appendix in each Task Force report along with their employment information and affiliation in the review process. The final, complete document was approved by the Society of Pediatric Cardiology Training Program Directors, American Academy of Pediatrics, and the American Heart Association in February 2015 and by the American College of Cardiology in March 2015, and individual Task Force reports were endorsed by the organizations noted in each report. During the process of updating the guidelines, a paradigm shift in medical education occurred. The change to competency-based training now requires trainees to achieve an expected level of competency in defined tasks (clinical and academic) rather than simply spending a predefined amount of time on a subspecialty service or performing a certain number of procedures to be considered fully “trained.” The Task Forces were instead asked to outline the minimum amount of time or number of procedures required so that evaluators can make informed decisions on whether the fellow is competent, and if not, recommend further work in that area. The responsibility will be on the training programs to observe fellows in all aspects of their training and have the newly developed clinical competency committees review their performance and evaluations, and provide feedback on their degree of competency. The American Board of Pediatrics, the certifying agency of graduating fellows, has directed that the concept of entrustable professional activities (EPAs) be utilized as a framework to identify and evaluate a trainee’s ability to independently