Interventional Cardiologists Take Another Stand Against Maintenance of Certification

Leaders in interventional cardiology are urging an end to reporting procedural volume as part of maintaining professional certification, arguing it is an unnecessary burden. The Society for Cardiovascular Angiography & Interventions (SCAI) has released a draft position statement recommending the American Board of Internal Medicine (ABIM) discontinue the current requirement of 100 percutaneous coronary intervention (PCI) or equivalent procedures within two years, as well as an alternative for low-volume operators.

SCAI President J. Dawn Abbott, MD, highlighted the challenges faced by low-volume operators in rural areas, which could limit patient access to emergency PCI. SCAI President-Elect Joaquin Cigarroa, MD, noted that the community of interventional cardiology is questioning the value of reporting volume as a surrogate for quality in their certification process.

No other medical specialty faces such requirements, and the SCAI believes volume thresholds are not a reliable indicator of competence or risk-adjusted outcomes. Evidence does not support the use of an operator volume threshold to discriminate between competent and inadequate clinicians. The American College of Cardiology (ACC), a major partner society, agrees with the proposed changes, stating that procedure volume is not the best measure of competency and should be removed as a condition for maintaining certification.

The ACC emphasizes that certification programs should focus on continuous learning and competency-based assessment that align with real-world practice. The SCAI stresses that once the volume requirements are eliminated, they should not be replaced with new performance, credentialing, or quality metrics, as competency in interventional cardiology is already well-established through outcomes, peer review, credentialing, and quality systems.

This latest challenge to maintenance of certification (MOC) under the ABIM comes after previous efforts by the SCAI and other professional societies to establish an independent American Board of Cardiovascular Medicine (ABCVM), which was ultimately rejected.