SPCTPD Perspective on ABP CBME Fellowship Pathways

In recent weeks, the American Board of Pediatrics (ABP) announced a new competency-based medical education (CBME) model for pediatric subspecialty training. The earliest implementation will be for fellows entering training in July 2028.

The model introduces two potential pathways:

• 2-year clinically focused pathway, allowing earlier completion based on readiness for practice defined by entrustable professional activities (EPAs)
• 3-year scholarly pathway, preserving dedicated time for research, academic development, or advanced training

Following discussions with ABP leadership and broad input from pediatric cardiology fellowship program directors, the Society of Pediatric Cardiology Training Program Directors (SPCTPD) recommends and supports continuation of a 3-year scholarly pathway for pediatric cardiology fellowships.

This position reflects several key considerations:

1) Training complexity and evolving competency needs:

The current pediatric cardiology fellowship structure includes 24 months of clinical training and 12 months of scholarly activity. Increasing clinical complexity and acuity in the field, coupled with recent ACGME changes to pediatric residency, has made achievement of true readiness for practice within 24 months of clinical training increasingly challenging. Recent data (Starnes JR et al.) highlight that pediatric cardiology program directors often identify the need for additional individualized training beyond the existing 24 month clinical requirement to ensure readiness for independent practice.¹ The 3-year scholarly pathway provides critical flexibility to support individualized curricula, research development, and broader academic growth.

2) Strong consensus among program directors:

In May 2026, SPCTPD convened an informational session with ABP leadership (Dr. David Turner), with representation from 60 pediatric cardiology training programs. Following this meeting, a survey was distributed to program directors listed in the SPCTPD directory. The response rate for the poll was 89%, and 57 of 58 respondents supported continuation of a 3-year training pathway for now, reflecting a clear and consistent consensus across programs.

While the transition to a CBME model is complex and raises important questions, SPCTPD recognizes and appreciates the opportunities it presents to improve training in meaningful ways. We are committed to ongoing engagement and collaboration with ABP leadership, subspecialty representatives (including advanced cardiac imaging, cardiac critical care, interventional catheterization, electrophysiology, heart failure/transplant, and ACHD), division chiefs, and other key stakeholders. Our shared goal is to thoughtfully evolve the training model in a way that maintains rigor, supports trainee development, and ensures readiness for independent practice while advancing the field of pediatric cardiology.

SLOE Tools

This year marks an important evolution in our pediatric cardiology fellowship recruitment process with the introduction of two new Standardized Letter of Evaluation (SLOE) tools. Designed specifically by the Society of Pediatric Cardiology Training Program Directors for use by categorical residency program directors and pediatric cardiologists/cardiac intensivists, these tools replace the traditional narrative letter of recommendation with a more structured, consistent, and high‑yield format. For this year, non-cardiologists will continue to submit a traditional narrative letter. Future directions may include a form for these evaluators as well.

The SLOEs were developed to streamline the evaluation process, reduce variability across letters, and ensure that each applicant is assessed using a shared framework. By focusing on clearly defined competencies, comparative assessments, and concrete examples of performance, the tool enhances the clarity and utility of the information we receive.

Ultimately, the goal is simple: to improve our ability to identify, discern amongst, and recruit exceptional pediatric cardiology fellowship candidates. A standardized approach allows us to better understand each applicant’s strengths, readiness for advanced training, and potential for success in pediatric cardiology—while reducing the burden on letter writers and improving fairness for applicants

SLOE Resource and FAQs