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Cardiologists and others took to Twitter this week to debate whether non-physicians should be allowed to win fellowship in professional societies.

Eligibility for was expanded in 2019 to officially recognize distinguished leadership and service to the ACC and the cardiovascular (CV) community, in addition to existing academic and professional requirements.

Non-physician cardiovascular professionals have typically been granted Associate of the American College of Cardiology (AACC) designation if they are nationally board certified and CV Team membership if they aren't.

Now, members of the greater CV care team may also apply for FACC designation with a $150 application fee; those who are successfully elected pay annual dues of $785.

Awarding fellowship designation to nonphysicians did not sit well with many on social media. The dustup was apparently sparked when , announced on Twitter that she'd been .

"I was never a believer in the letters after 'MD' on doctors' signature line," , pasting a copy of Perpetua's tweet. "What do they mean, really? Now, after seeing the ACC giving the 'fellow' designation to non-MDs too, my skepticism is now officially justified."

Likewise, he "will not renew" ACC membership because of the FACC policy: "What was wrong with AACC that you had to change it to FACC for everyone? Pay $, become fellow MD or otherwise."

The ACC "must be having a tough time with dues this year," surmised a cardiologist with the Twitter handle .

Still others called it "shameful" and warned that "academic integrity" was in jeopardy.

Yet others defended the professional society's move toward greater inclusivity.

"I actually don't see an issue with this and congratulate @ACCinTouch for being inclusive -- It's not just MDs that look after pts with CV disease or advance CV practice/science...(MDs are a minority) @escardio also supports non-MDs in becoming FESC. Institutions need 2B inclusive," .

"Entirely agree with you," . "I can think of several specialist nurses, pharmacists and other allied health professionals who contribute just as much and many times more to patient care than some MDs. We need to shed our egos and work as a team."

In a statement, Andrew Miller, MD, chair of the ACC Membership Committee, defended the eligibility expansion.

"The ACC believes in the strength and the necessity of the entire CV care team to advance its Mission of transforming CV care and improving heart health," Miller wrote. "By expanding the FACC designation, the College is realizing its strategic goal of serving as the Professional Home for the global CV Community and providing a path to Fellowship to those whose education, professional achievements and involvement in the College merit special consideration based upon accomplishments across a variety of professional dimensions."

FACC holder Geoffrey Barnes, MD, MSc, of the University of Michigan in Ann Arbor, said the designation should not be limited to physicians, because it represents a commitment to excellence in cardiovascular care in all its forms.

He cited the "physician assistant who masterfully manages cardioversion for patients with atrial fibrillation, the nurse practitioner who ensures that adult patients with congenital cardiovascular conditions are properly cared for in the clinic and hospital settings, and the pharmacists who teach me daily about emerging drug therapies for heart failure and ensure that patients taking anticoagulants do not have dangerous drug-drug interactions."

"For me, the title FACC represents someone who has dedicated themselves to caring for patients with cardiovascular disease using the best available evidence, dedicated themselves to continually improving their own medical knowledge, and dedicated themselves to sharing their expertise with colleagues, patients, and families," Barnes told 乌鸦传媒.

In any case, it is not new for non-physicians to be awarded FACC designation: 30 care team members have received it since 1982, according to an ACC representative.

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