For Institutions

The EMD&T Fellowship Program

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

Program Structure

Fellowship Overview

The EMD&T fellowship is a minimum 1-year training program beyond core specialty residency, designed for physicians who want to develop advanced competencies in exercise diagnostics, therapeutics, and scholarship.

The fellowship 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 open to 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.

Duration
Minimum 1 year (flexible models available)
Structure
6 EPAs with competency-based progression
Entry
IM, Peds, FM, PM&R + subspecialties
Model
Full-time, part-time, or blended options
Sites
16 institutions developing programs
Curriculum Framework

6 Entrustable Professional Activities

The fellowship 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.

Trainee Pipeline

Eligible Entry Specialties

EMD&T draws from a large pipeline of trainees across multiple core specialties and subspecialties. Recent enrollment numbers demonstrate the scale of potential applicants.

SpecialtyRecent Enrollment
Physical Medicine & Rehabilitation532
Pulmonary Disease (Internal Med)777
Pulmonary Disease (Pediatric)177
Cardiovascular Disease (Internal Med)1,108
Pediatric Cardiology462
Endocrinology349
Family Medicine4,511

Source: ACGME Table 5, recent academic year enrollment

Program Synergy

Complements Existing Programs

EMD&T does not replace existing subspecialties — it fills a gap that none currently address. The table below shows 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
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
Developing Sites

Institutions Developing EMD&T Programs

16 academic medical centers are actively developing fellowship programs with the Academy's curriculum framework and organizational support.

Beth Israel-Deaconess

Jeremy Robbins, MD

Boston Children's Hospital

Dawn Ericson, MD, Naomi Gauthier, MD

Cedars-Sinai Medical Center

Nicolas Musi, MD

Duke University

William Kraus, MD, Brian Coyne, MEd

Harbor-UCLA

William Stringer, MD, Kathy Sietsema, MD

Mayo Clinic

Alex Niven, MD, Michael Joyner, MD

Northwestern University

Kendra Ward, MD, Peter Koenig, MD

Oregon Health Sciences University

Jennifer Huang, MD

UCI CHOC Children's

Dan M. Cooper, MD, Dawn Lombardo, DO

University of Cincinnati

Adam Powell, MD

University of Florida

Kevin Vincent, MD, PhD, Heather Vincent, PhD

University of Illinois, Chicago

Cemal Ozemek, PhD

UT Southwest

Katie Barnes, MD

University of Utah

Matt Hegewald, MD

University of Minnesota

William Roberts, MD

University of Colorado

Wendy Kohrt, PhD

Get Started

Bring This Program to Your Institution

Ready to establish an EMD&T fellowship at your academic medical center? Submit your interest and the Academy team will reach out to discuss next steps, curriculum integration, and organizational support.

We'll respond within 2 business days.