Related Experiment Video
Updated: Jun 5, 2025

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
Joint British Societies' position statement on cardiology training in the United Kingdom
Oliver Ian Brown1, Holly Morgan2, William John Jenner3
1Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
Insights
UK cardiology training faces a crisis due to curriculum changes and mandatory general internal medicine (GIM) accreditation, risking consultant competency and patient care. Urgent reform is needed to improve training pathways and academic opportunities.
Area of Science:
- Medical Education
- Cardiology
- Healthcare Policy
Background:
- UK cardiology training is under significant pressure.
- Recent curriculum changes and mandatory dual accreditation in general internal medicine (GIM) have exacerbated these challenges.
Purpose of the Study:
- To analyze the current challenges in UK cardiology training.
- To identify risks to consultant competency and patient care.
- To propose essential reforms for the cardiology training curriculum.
Main Methods:
- Analysis of current UK cardiology training curriculum and its impact.
- Assessment of trainee experiences and competency acquisition.
- Evaluation of alignment with patient needs and emerging subspecialties.
Main Results:
- Mandatory GIM accreditation reduces training opportunities, necessitating post-training fellowships for competency.
- Training model misalignments exist, lacking coverage for complex structural interventions and inherited cardiac conditions.
- Academic training and research are hindered, risking future clinical academia.
Conclusions:
- Urgent curriculum reform is essential, including reduced GIM time, improved subspecialty pathways, and revised academic training.
- Failure to reform risks a generational crisis of inadequately skilled consultants and compromised patient care.
- Consideration of an independent regulatory framework for cardiology training may be necessary.
Abstract:
Cardiology training in the UK is facing significant challenges due to a range of factors. Recent curriculum changes have further compounded this issue and significantly risk the ability to produce adequately trained consultants capable of managing patients with increasingly complex cardiovascular disease. The introduction of mandatory dual accreditation in general internal medicine (GIM) alongside cardiology, by design, results in significantly reduced training opportunities, including procedural and subspecialty exposure. Despite prolongation in training duration to mitigate these effects, most trainees now report needing post-certificate of completion of training fellowships to gain the standard competencies required for consultant roles, undermining the curriculum's aim of fostering independent practice. Furthermore, the current training model is misaligned with patient needs, lacking provisions for training in key and expanding services, such as complex structural interventions and inherited cardiac conditions. The increasing complexity of expectations placed on trainees also has the potential to significantly hinder academic training, discouraging research and innovation, thereby risking the future of UK clinical academia. Urgent curriculum reform is not only desirable but also essential and should include limiting GIM training time, improving subspecialty accreditation pathways and revising academic training provisions. If current bodies overseeing cardiology training fail to implement these essential changes, additional options, including an independent regulatory framework for cardiology training, should be considered. Without immediate action, UK cardiology training risks facing a generational crisis of inadequately skilled consultants, which could compromise future patient care.
Related Concept Videos
Exercise and Cardiovascular Response
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
Cardiovascular Drugs: Classification based on Therapeutic Indications
Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
Assessment of the Cardiovascular System I: Subjective Data
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
Regulation of the Cardiovascular System
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...
Pathophysiology of Cardiac Performance

