Training the modern sports cardiologist: Designing a fellowship curriculum for a growing subspecialty

Background: Sports cardiology is a rapidly evolving subspecialty addressing the prevention, evaluation, and management of cardiovascular disease in athletes and highly active individuals. Despite rising demand, no Accreditation Council for Graduate Medical Education (ACGME)-accredited fellowship exists, resulting in limited and inconsistent training pathways. Objective: We describe the development of a nonstandard training (NST) fellowship curriculum in sports cardiology at our institution, outlining its rationale, structure, and competencies to provide a potential model for other programs. Methods: Guided by American College of Cardiology (ACC) and European Society of Cardiology (ESC) frameworks, we designed a curriculum integrated into the third year of general cardiology fellowship. Core elements include structured clinical rotations, didactic teaching, case-based learning, pre-participation screenings, and scholarly activities. A multidisciplinary consortium of regional cardiologists was formed to expand clinical exposure and mentorship opportunities. Results: The curriculum emphasizes key competencies: pre-participation screening, distinguishing exercise-induced cardiac remodeling from pathology, management of symptomatic or diagnosed athletes, and shared decision-making. Clinical experiences are complemented by formal educational sessions, research opportunities, and collaborative conferences. Conclusion: A rigorous, competency-based NST fellowship in sports cardiology is feasible within existing fellowship structures. Our model may serve as a framework for institutions seeking to formalize training in this emerging subspecialty.