What's old is new, what's new is old-or something like that! I read with gratification, and some amusement, that Fuster and Nash [1] have designated my training program in internal medicine and cardiology of 30-plus years ago as "a new generalist/cardiovascular specialist training track" and a wave of the future.

My training (and that of many others like me) in the 1960s included 1 year of a "straight medicine" internship (roughly equivalent to today's PGY-1 training) and then 2 years of internal medicine residency, the second year of which was taken up by at least 4 months of cardiology training by my choice. The third year of residency was spent as a cardiology fellow. The focus of that fellowship year was on clinical cardiology, including pediatrics and perisurgical consultation, although plenty of time was also spent in the catheterization laboratory.

After training, I was in private practice in internal medicine and cardiology in a primary care setting, practicing what Fuster and Nash are now preaching. We did in 4 years of training what is now being proposed as a 5-year program, although clearly the necessary fund of knowledge today is greater than that of 30 years ago.

Why must we try to reinvent the wheel? So many of the proposed "new" things in medical education and training have already been done and refined.