Call for Formalized Pathways in Vascular Medicine Training: JACC Review Topic of the Week

Robert T Eberhardt1, Marc P Bonaca2, Hussein Abu Daya3

  • 1Division of Cardiovascular Medicine, Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA.

Insights

Limited funding and recognition hinder vascular medicine training, restricting the number of specialists. Expanding training programs is crucial for better vascular disease management and patient outcomes.

Area of Science:

  • Vascular Medicine
  • Medical Education
  • Healthcare Workforce Development

Background:

  • Growing burden and complexity of managing vascular diseases.
  • Potential role of vascular medicine specialists in multidisciplinary teams to improve care.
  • Current limitations in the number of trained vascular medicine specialists.

Purpose of the Study:

  • To identify obstacles in vascular medicine training programs.
  • To advocate for increased recognition and funding for vascular medicine specialization.
  • To address the need for more vascular medicine specialists to manage growing disease burden.

Main Methods:

  • Analysis of established pathways for vascular medicine training.
  • Identification of barriers to completing dedicated training programs.
  • Review of recognition by national accrediting and credentialing organizations.

Main Results:

  • Lack of funding due to inadequate recognition by key organizations is a significant obstacle.
  • Existing training pathways face challenges that restrict program completion.
  • There is a limited pool of vascular medicine specialists.

Conclusions:

  • Concerted efforts are needed to overcome obstacles and expand vascular medicine training.
  • Increased funding and recognition are essential for program growth.
  • Expanding the number of vascular medicine specialists will improve patient outcomes and disease management.

Related Concept Videos

Overview of the Vascular System01:20

Overview of the Vascular System

The vascular system comprises an extensive network of arteries, capillaries, and veins. The vascular system can be broadly divided into the blood and lymphatic systems. Typically, blood vessels can be categorized into three histological regions: tunica intima, tunica media, and tunica adventitia. The tunica intima consists of a single layer of endothelial cells attached to the basal lamina. Underlying the basal lamina is a connective tissue layer and an elastic lamina that gives stability and...
Regulation of Angiogenesis and Blood Supply01:24

Regulation of Angiogenesis and Blood Supply

Rapidly dividing tumors, embryos, and wounded tissues require more oxygen than usual, lowering the oxygen concentration in the blood. At low oxygen or hypoxic conditions, an oxygen-sensitive transcription factor called the hypoxia-inducible factor 1 or HIF1 is activated. HIF1 is a dimeric protein of alpha (ɑ) and beta (β) subunits.  Under optimal oxygen conditions, HIF1β is present in the nucleus while HIF1ɑ remains in the cytosol. HIF1ɑ is hydroxylated by prolyl hydroxylase and factor...
Extrinsic and Intrinsic Pathways of Hemostasis01:20

Extrinsic and Intrinsic Pathways of Hemostasis

Blood clotting or coagulation involves extrinsic and intrinsic pathways, which ultimately merge into the common pathway, forming a fibrin clot.
The Extrinsic Pathway
The extrinsic pathway of coagulation is typically initiated by tissue damage that exposes blood to tissue factor (TF), a protein released by the damaged tissue cells outside the blood vessels—this interaction with TF triggers biochemical reactions involving specific clotting factors. The key player here is Factor VII, which forms a...
Overview of Blood Vessels01:14

Overview of Blood Vessels

The human cardiovascular system comprises five primary types of blood vessels: arteries, arterioles, veins, venules, and capillaries, each serving unique functions.
Arteries and Arterioles: Arteries are muscular and elastic vessels that primarily carry oxygenated blood from the heart to body tissues, except for the pulmonary artery, which carries deoxygenated blood. They have thick walls to withstand high pressure and contain a layer of muscle tissue, allowing them to expand or contract as...
Development of Blood Vessels01:07

Development of Blood Vessels

The development of the vascular system in a fetus is a complex and intricate process that begins as early as 15 to 16 days post-conception. This process starts outside the embryo, specifically in the mesoderm of the yolk sac, chorion, and connecting stalk. Approximately two days later, the formation of blood vessels occurs within the embryo itself.
The initial formation of this system is facilitated by the small amount of yolk present in the ovum and yolk sac. Blood vessels originate from...
Regulation of the Cardiovascular System01:27

Regulation of the Cardiovascular System

The regulation of the cardiovascular system allows the body to adapt to various demands and maintain homeostasis.
The regulation of the cardiovascular system involves the autonomic nervous system (ANS), baroreceptors, and chemoreceptors, ensuring that heart rate and blood pressure are appropriately modulated in response to varying physiological demands.
The ANS comprises two main divisions: the sympathetic and parasympathetic nervous systems. The sympathetic nervous system enhances...