indicates that IgG4-related cardiovascular disease should receive attention from not only cardiology physicians but also from physicians in other subspecialties, including ophthalmology, endocrinology, hematology, hematology, and orthopedic surgery. Funding Statement

Funding/SCH 900776 chemical structure Support: Dr. Ishizaka receives research funding from the Osaka Medical College. Footnotes Conflict of Interest Disclosure: The authors have completed and submitted the Methodist DeBakey Cardiovascular Journal Conflict Inhibitors,research,lifescience,medical of Interest Statement and none were reported.

Introduction In order to care for patients with cardiovascular disease, cardiologists spent thousands of hours studying the science of medicine in our undergraduate and medical schools. This was subsequently followed by years of training under the preceptorships of experienced mentors Inhibitors,research,lifescience,medical in residency, fellowship, and subspecialty fellowship programs. As we transitioned to practicing cardiologists, we took an oath to provide the best medical care for our patients, “to heal the sick and care for the well.” Physicians who have dedicated their career to patient care usually pride themselves as being “competent.” The physician was always held in high regard by the public and other

members of society, and society had in past years given us the privilege of self-regulation. Inhibitors,research,lifescience,medical Rarely was the competence of a physician questioned by patients who sought diagnosis and treatment for their illnesses. At present, however, the medical profession is under intense scrutiny by the government, external stakeholders, patients, and families. In some instances, the integrity and rationale for Inhibitors,research,lifescience,medical physicians’ decision making are being questioned. It is necessary, therefore, that we as a profession demonstrate our “competence” to practice in our chosen fields of medicine. It is equally important that we as a profession define the attributes of such competence.

There is much discussion among regulatory agencies and certifying boards regarding what physician competence is and, more importantly, how to measure it.1, 2 The following is a Inhibitors,research,lifescience,medical cardiologist’s perspective regarding physician competence. What is Physician Competence? Until recently, the medical profession has never assumed the responsibility to assure that physicians remain competent. It was only 75 years ago that the American Board of Medical Subspecialties only and its predecessors implemented a certifying test, which was a written examination of medical knowledge.3 This test was given once in a lifetime, and the vast majority of applicants achieved a passing grade. Once certified after passing the examination, physicians would provide patient care for the rest of their career, with the unaudited expectation that they would keep up with new knowledge and science relevant to their practice. The only requirement for the license to practice was self-reporting a certain number of hours in continuing medical education.