Skip to main content

The EMD&T Advanced Training Program

A competency-based advanced training program in Exercise Medicine, Diagnostics, and Therapeutics — designed to integrate with existing subspecialty programs at academic medical centers nationwide.

Bring This Program to Your Institution Review the Evidence Base
Program Structure

Advanced Training Program Overview

The EMD&T advanced training program is a minimum 1-year training program beyond core specialty residency, designed for physicians who want to develop advanced competencies in Exercise Medicine Diagnostics and Therapeutics.

The AEM advanced training program uses a competency-based progression model built on 6 Entrustable Professional Activities (EPAs), moving trainees from observation through supervised practice to independent clinical competence. This approach allows for innovative training models including part-time distribution over multiple years, blended pathways with overlapping competencies, and integrated research degrees.

The program is designed for physicians who have completed or are completing core residency training in internal medicine, pediatrics, family medicine, or physical medicine and rehabilitation, as well as their subspecialties.

Proposed Program

Duration
1 year curriculum with flexible implementation
Structure
6 EPAs reflecting relative skills and knowledge
Entry
IM, Peds, FM, PM&R + subspecialties
Sites
2 institutions developing programs
Curriculum Framework

6 Entrustable Professional Activities

The advanced training program curriculum is built on 6 EPAs that define the competencies trainees must achieve, with a 5-level supervision scale from direct observation to unsupervised independent practice.

1

Design & Oversee Clinical Exercise Evaluation

Select, conduct, interpret, and report standardized exercise assessments including CPET, muscle strength tests, and physical performance evaluations.

Knowledge of physiologic responses to exercise in health and diseaseSelecting context-appropriate tests for exercise capacity and performanceConducting and supervising exercise testsInterpreting and reporting results of exercise and performance tests
2

Laboratory Organization & Technical Operations

Engage in the organization, technical operations, and quality control of clinical exercise and physical performance laboratories.

Principles of laboratory measurements and instrumentationQuality control and validation of laboratory measurementsTechnical and operational aspects of performance testingPatient safety standards and laboratory policiesEffective team collaboration and data management
3

Exercise Medicine Consultation

Provide clinical consultation to other medical professionals regarding exercise capacity, limitations, risks, and intervention options.

Integrating exercise assessments with health information across clinical contextsCommunicating effectively with referring healthcare professionalsCommunicating exercise information with patients and familiesApplying evidence-based information to consultation practices
4

Exercise Prescription in Health & Disease

Provide exercise prescriptions for training or rehabilitation across a range of diseases and pathophysiology, as well as general health maintenance.

Principles of physiologic adaptations underlying exercise trainingStrategies and design of exercise prescriptionsExercise prescriptions for healthy individualsExercise prescriptions for patients with chronic diseaseCollaboration with rehabilitation professionals
5

Expert Advisor & Advocate

Serve as an expert advisor on exercise within healthcare institutions and in community-based environments and programs.

Interrelationships of exercise behavior, fitness, and healthElements of advocacy and ethical application to exerciseDeveloping and implementing educational programsQuality improvement within healthcare systems
6

Scholarship in EMD&T

Demonstrate scholarship through research, teaching, quality improvement, and evidence-based clinical practice.

Scholarship in medical and scientific literatureScholarship in clinical learning and practiceStructured scholarly activitiesClinical, translational, and basic research leadership

Supervision Scale: Each EPA uses a 5-level entrustment scale — (1) Observation only → (2) Direct supervision → (3) Indirect supervision → (4) Oversight with autonomous execution → (5) Unsupervised independent practice. Progression is competency-based, not time-based.

Program Synergy

Complements Existing Programs

EMD&T does not replace existing subspecialties — it fills a gap that none currently address. The tiles below show how it integrates with programs your institution may already run.

Cardiovascular Medicine
CPET interpretation, cardiac rehab prescriptions, risk stratification
Pulmonary Disease
Pulmonary rehab, exercise flow-volume loops, desaturation assessments, evaluation of exercise intolerance
Endocrinology
Metabolic assessments, exercise in diabetes/obesity management
Sports Medicine
Performance testing, return-to-play protocols, exercise physiology
Pediatric Rehabilitation
Exercise tolerance assessment, adaptive exercise prescriptions
Clinical Informatics
Exercise data interoperability, HL7 THEMES domain model, wearable integration

Academic Representation Within the AEM

Inaugural Sites for Program Starting in 2026

Harbor-UCLA

William Stringer, MD, Kathy Sietsema, MD

Stanford