Optimizing and coordinating a comprehensive treatment plan for a patient with cardiometabolic disease that takes into account all these factors can be extremely challenging, confined not only by deficiencies in training, but also financial and health system barriers. While there are no easy solutions to this, an interesting proposal is to create a new cardiometabolic subspecialty training track in internal medicine, so in the near future we can have physicians that are better equipped and specialized to address all these different aspects. The proposal, as laid out by Drs. Eckel and Blaha6 , would involve 3 years of specialized training that would be a composite of cardiology, endocrinology, and advanced concepts in lifestyle medicine. The endocrinology component would include extensive training in obesity, diabetes (both type 1 and type 2), as well as lipids and lipoprotein disorders, while the cardiology component would be focused primarily on the primary and secondary prevention of ASCVD. Lifestyle training would go beyond just inquiring about diet and exercise; the cardiometabolic clinician would have the ability to address nutrition and diet, smoking cessation, and recommend individualized physical activity goals. Although the idea is in its initial stages and a lot of groundwork needs to be done, the authors make a compelling argument for challenging the current status quo for the care of patients with cardiometabolic disease. As the authors conclude: “it’s time to move forward and not wait until we wish we had. The answer should not be to add more training, but to sharpen and focus existing education concepts to produce the product we know we need.”6
Shpetim Karandrea, PhD
Editorial Director
