This Advanced Training Statement  from the AHA addresses the added competencies required of sub-sub specialists in advanced heart faliure and transplant cardiology (AHFTC) for diagnosis and management at a high level of skill of patients with advanced heart failure who may also undergo placement of mechanical circulatory support devices or cardiac transplantation. It is intended to complement the basic training in heart failure required of all trainees during the standard 3-year cardiovascular fellowship. The training requirements and designated clinical competencies in this report focus on the core competencies reasonably expected of all AHFTC specialists.