ABC | Volume 113, Nº4, October 2019

Viewpoint Godoy et al. Cardiology training in Brazil Arq Bras Cardiol. 2019; 113(4):768-774 Figure 2 – Geographical representation of all Cardiology training programs in Canada. 1: University of British Columbia (Vancouver, BC); 2: University of Calgary (Calgary,AB); 3: University ofAlberta (Edmonton,AB); 4: University of Saskatchewan (Saskatoon, SK); 5: University of Manitoba (Winnipeg, MB); 6: University of Western Ontario (London, ON); 7: McMaster University (Hamilton, ON); 8: University of Toronto (Toronto, ON); 9: Queen’s University (Kingston, Ontario); 10: University of Ottawa (Ottawa, ON); 11: McGuill University (Montreal, QC); 12: Université de Montréal (Montreal, QC); 13: Université de Sherbrooke (Sherbrooke, QC); 14: Université Laval (Quebec City); 15: Dalhousie University (Halifax, NS). 31 the present text is the lack of data in the literature describing and comparing different cardiology training programs around the globe. This impairs our ability to make a more evidence- based comparison and many inferences presented in this manuscript are derived from the authors’ opinions and experiences. With these points in mind, in our understanding the main strengths of the cardiology Residency Programs in Brazil are: 1) one centralized national coordination (CNRM), responsible for the supervision and the rules that are valid for all programs; 2) the rigorous selection process candidates must go through to advance to the next level of training. On the other hand, this international perspective identifies opportunities for improvement, such as the fact that two years for training in General cardiology is likely too short, given the complexity of modern cardiology. In countries like Brazil, with huge regional differences, it is imperative to make proposals for an equal provision of good Medicine all over the country. Yet, given the differences observed among the cardiology Residency Programs worldwide, it would be very useful if our professional governing bodies defined a minimum standardized curriculum for the training of new Cardiologists, considering the characteristics of the country. Possibly, a three-year residency, with a competency-based curriculum, offering a balanced amount of patient care, procedures and diagnostic test training, organized in time-limited rotations and longitudinal activities (such as an integrated outpatient clinic), and a time dedicated to research, would be a starting point for discussion about harmonization of the residency programs. Further, it would be important that medical societies across the world recognize these training differences, so that they could tailor educational programs in cardiology (including scientific meetings and conferences) for the needs of the developing world. Besides giving better care to our underserved population, these initiatives would facilitate collaboration and exchange experiences with cardiologists internationally. In conclusion, the development of an international standardized minimum curriculum for the cardiology residency training programs, to be customized according to individual country characteristics, would be very useful and promote exchange of experience internationally. In our opinion, the cardiology training in Brazil needs to be improved based on the programs conducted in developed countries. In order to achieve this goal, it is necessary an urgent mobilization of different sectors of the cardiology community, such as the cardiology Residency programs, the BSC, and the CNRM, among others. Author contributions Conception and design of the research: Godoy LC, Farkouh ME, Manta ICKA, Furtado RHM, Nicolau JC; Acquisition of data: Godoy LC, Manta ICKA, Furtado RHM, Nicolau JC; Analysis and interpretation of the data and Critical revision of the manuscript for intellectual content: Godoy LC, Farkouh ME, Manta ICKA, Dalçóquio TF, Furtado RHM, Yu EHC, Gun C, Nicolau JC; Writing of the manuscript: Godoy LC, Nicolau JC. 772