cardiology fellow – The Early Career Voice

Who Am I? Ruminations of a Cardiology Fellow

July 14, 2022June 30, 2022 Andi Shahu, MD, MHS

I walked out of the hospital after my last inpatient shift of my first year of Cardiology fellowship and let out a sigh. It felt like I was releasing a breath I’d been holding in for years. Four years ago, as I started intern year, I told myself that I would dedicate the first years of my career to becoming first the best internist, and then the best cardiologist that I could be. This decision was borne out of a desire to fully invest in my training, but also to some extent out of imposter syndrome. I worried (as many new interns do) about not being smart enough or good enough, so my natural reaction was to work hard to become a better physician.

The ensuing four years, during which I immersed myself in clinical medicine, have been transformative. My experiences as a budding internist and cardiologist reaffirmed time and time again that I chose the right path for me. Though I cannot say that my initial insecurities totally went away, somewhere along the way, I learned to accept and set aside feelings of inadequacy so that I could do my job and take care of my patients. My patients have been my guiding light and have taught me everything I know. Moreover, as a first year Cardiology fellow, I spent countless hours learning the amazing intricacies of cardiovascular pathophysiology. While I have much left to learn in the remainder of my fellowship, I feel much more adept at managing typical cardiovascular problems.

However, these incredible experiences have also come at a personal cost. I have missed weddings, birthdays, funerals of loved ones. I have relinquished hobbies that I used to cherish so that I could prioritize self care, sleep or precious moments with friends and family. Some days I can’t help but wonder if I lost a little bit of myself in devoting myself so wholly in caring for others. Have I sanded away the aspects of my personality that made me unique in service of my training? Who am I, beyond my job as a physician?

Now, don’t get me wrong – I love my job. There’s nothing I’d rather be than a cardiologist. I love being in the echo lab or the cath lab. The cardiac intensive care unit is my happy place. Being in the hospital feels like being at home. But my job also can’t be all that I am.

In my favorite AHA Early Career Voice blog post, Dr. Nasrien Ibrahim wrote about how important it is to “bring your whole self to work.” I loved the piece so much that it inspired me to apply to be a blogger for the AHA Early Career Blogger program myself. I loved the concept that we should bring all parts of ourselves with us in our daily life. “The authentic you,” as Dr. Ibrahim called it. Now, reading that piece back two years later, I ask myself – what parts of myself do I bring with me? What parts have I left behind? What other parts of myself do I need to cultivate and nurture again?

When I move on to my second year of Cardiology fellowship, I hope to have more time to answer these questions and rediscover who I am outside of my day job. It is a given that I will continue to improve my skills as a cardiologist. But I also hope to continue current hobbies, reignite old passions, and maybe even discover some new ones. I hope to write more. I hope to travel more. I hope to spend more time with my loved ones. Only then can I bring “my whole self” with me every day.

To every rising Cardiology fellow reading this, I say: The ride will be wild, but enjoy it as much as you can. Never forget why you decided to become a cardiologist in the first place, especially when you feel overwhelmed by all the demands being placed on your time or the seemingly endless consults you are seeing. Give yourself a chance to do the things that make you happy when you are not at work, but also give yourself some grace and recognize that it can also be ok to do nothing if that is what you need to recharge your battery. When in doubt, look to your patient and ask yourself what you would want from your cardiologist if you were in their shoes. And when you have the time, space and mental bandwidth, ask yourself: who am I and how do I ensure that I preserve myself in this journey?

“The views, opinions, and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness, and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions, or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your health matters. If you think you are having a heart attack, stroke, or another emergency, please call 911 immediately.”

Social Media Advice for Early and Mid-Career Professionals from #AHA21

November 15, 2021November 15, 2021 Jessica Monterrosa Mena

The schedule of events as a first-time attendee to AHA Scientific Sessions can be overwhelming! As an early career blogger, I decided to attend sessions to get advice from professionals on managing social media presence in “Social Media in Cardiology- Managing Misinformation as Fellows in Training”. It was reassuring to take part in a lively discussion with many participants asking questions ranging from, “How do I start developing my social media presence” to “How do I deal with mansplaining?” We were lucky enough to have experienced panelist give their insights.

There are many benefits to taking part in social media as an early career professional. It can be used as a platform to find role models and mentorship or start project and publication collaborations. These connections can be established by simply joining broad dialogues, tagging experts in a conversation, or sending a direct message to interesting people. Establishing a social media persona can also include creating a place to ask questions, sharing expert consensus, and guiding dialogue in a specific discipline. As field experts and early career scientists, we are uniquely positioned to gather cutting edge information and share our knowledge with broader audiences. In order to be successful in these endeavors, choose your social media platform carefully. Understanding the age-group audience predominating that specific platform can inform the type of content you decide to post and will influence how you frame your ideas.

While participating in an environment that is not curated can allow you the freedom of sharing pictures of your dogs along with scientific news, panel experts also reminded us that everything on social media lives forever. The downsides of social media include hostility, mansplaining, and being discredited and turned into a meme. Not everything you post can be edited, and typos can be an annoyance for yourself and others when conversations are picking up speed. However, when your post turns out to be factually wrong or misguided, a public apology might ensue. Being transparent about how you gathered information and why you are sharing it with others can help establish and maintain trust in quickly developing online discussions.

Things can also get tricky when dealing with misinformation or with patients asking for medical advice. Many patients seek to educate themselves by seeking information online, and practitioners have a responsibility to educate and be effective leaders in this online space. In fact, social media training is becoming a desirable and valuable skills set for many early and mid-career professionals. Professionals can use social media to spread scientific evidence for the greater good but will also need to develop an approach for responding to misinformation. When engaging in difficult conversations, be explicit about the limits of what you are offering and avoid driving more traffic to misinformation pages. Be cautious when engaging with misinformation posts; give others the benefit of the doubt but stay concise in your responses and only provide the correct information. If you are unable to engage in a meaningful discourse you can move on, or if you are so inclined you can call out, block, ignore, or mute hostile people. There is a balance between the benefits you gain from social media and the time you spend online. Overall, to make social media a positive part of your career, make sure to set boundaries, build trust, and be accurate about what you post. Social media can be an effective way to build your professional persona, make meaningful connections, and communicate science if you develop the right approach.

This program is part of the FIT Program at #AHA21. The panelists Danielle Belardo MD, Amir Goyal MD MAS, Martha Gulati MD MS FAHA, Virginia Bartlett, and was moderated by Christina Rodrigues Ruiz, MS and Sasha Prisco MD, PhD.

“The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.”

A Fellows to a Fellow: resources for cardiology fellows

April 1, 2021March 29, 2021 Adnan Khalif, MD

The excitement continues as 3rd year general cardiology fellows wrap up their training in these last few months. Those pursuing advanced training in interventional cardiology find themselves at a crossroads as they begin a year of procedural training. Being one of those lucky fellows, I recently began searching for resources to help me get started with the transition. This list is definitely not exhaustive, but I hope you find it helpful for those going down this pathway.

Here are my go-to resources to help me get started in interventional cardiology training.

CRF (Cardiovascular Research Foundation) Fellows Course Connect
– This year, it will be presented in a virtual live-streamed format from May 7th-9th. One of the go-to courses every year that features key concepts in interventional cardiovascular medicine. Yes, it’s free for fellows.
https://www.crf.org/fellows/register
ARCH (Advanced Revascularization) Course – Hybrid
– Takes place both online and with limited in-person registration in St. Louis Missouri at the Ritz-Carlton Hotel. Has a dedicated Fellows course on Wednesday, April 14th, with the goal to prepare cardiology fellows for interventional practice. (Full scholarship included with registration)
https://archsymposium.com/april-2021-fellows-course/
SCAI 2021 (Virtual) Scientific Sessions
Can’t miss the scientific sessions from SCAI, it’ll be loaded with tons of educational content geared towards interventional cardiology. Dr. Quinn Capers is scheduled as a Keynote speaker discussing “Black Lives Matter….In the Cath Lab, Too! A Role for Interventional Cardiology in Combating Racism”
https://scai.org/scai2021
SCAI Fall Fellows Course
Tentatively scheduled for Dec 3-7th in Miami, Florida. Always considered one of the best interventional fellow courses to attend. Looking forward to this happening.
https://scai.org/event/2021-fall-fellows-courses
Interventional, Early Career, & FIT Monthly Case Discussions: High Risk and Complex PCI and Mechanical Circulatory Support
https://www.acc.org/Education-and-Meetings/Meetings/Meeting-Items/2021/02/18/19/44/Webinar-Int-EC-FIT-Monthly-Cath-Case-Discussions-High-Risk-PCI
CRT 2021 Virtual
From Feb 13 – April 24, 2021, every Saturday Morning. From live-stream discussions with the latest in interventional cardiology to live cases. Free registration is a plus.
http://www.crtmeeting.org
Emmanouil Brilakis’ youtube channel. The Manual of PCI (A Step-by-step approach) https://www.youtube.com/watch?v=ELu-yJ7USOU&list=PLrg6KBVL0GBqabghGLCgqbplSrGQEiHh4
Probably one of the most important youtube channels for all interventional cardiology trainees. If you haven’t started watching these videos, you’re missing out. The accompanying textbook (https://www.pcimanual.org/) is also a must-have.

Now there are also plenty more resources out there, but I felt that this was a good starting place for me. Hopefully, it helps someone.

HOW TO SAY NO: R5

September 25, 2020September 25, 2020 Sherry-Ann Brown, MD, PhD

American Heart Association Early Career Guest Blog

Sherry-Ann Brown MD PhD FAHA, Mehnaz Rahman MD

For many of us, to nurture our continuous and whole sense of well-being, we are in a constant process of learning to say “no”. Here is one scenario that can help provide an effective framework for saying “no”.

Consider a new junior attending faculty member at the same academic institution where she trained as a Cardiology fellow. Her pursuit of wellness in this new role has fallen to the sidelines, as she first tries to establish a sense of authority within a society that has only ever known her as a trainee. While navigating this unfamiliar territory, a surprising source of anxiety has come from responding to requests to collaborate on projects. She consistently accepted almost every single one. The fellow in her aimed to please.

Although she approached each with the same work ethic, her interest in them was not as equitably distributed. At the end of her first year, her cup had “runneth over” – she was overworked and overcommitted admittedly she felt by her own doing.

She then realized that she had agreed to those undertakings because she did not quite have the words ready at the tip of her tongue to say “no”. When respectfully declining a specific ask, she determined that it can help to have a practiced approach to the conversation, one that can produce a beneficial result for both parties.

As we discuss this scenario, we can recognize that in general, people appreciate ideas and potential solutions. Accordingly, we may not be able to fulfill every request, yet we can still be a resource and offer alternatives.

One framework for saying “no” is grounded in R5: Reframe, Refer, Reduce, Reorient, and Recommend. Saying “no” can be challenging. Sometimes we need to say “no” to the way the ask is presented or the specific focus of the ask.

If we can perceive benefit from modifying the ask so that it actually fits with our career goals and specialty interests, then we can say “no” to the original ask while reframing it to a more fitting ask for us.

If we choose not to reframe the ask, we can refer the asker to someone else who we feel could be interested in working on such a task.

Alternatively, we could reduce the original ask to limit the portion for which we would be responsible.

Further, often those asking do not know how full our plates are and may need to be kindly informed or reoriented, so that they can better understand your perspective as you say “no”; you can even solicit their input as you think about how to prioritize your time on pre-existing projects.

Finally, recommend a new deadline or seeking out more resources if you would find working on the opportunity valuable but time-consuming or limited in available resources.

Remember, those asking for your involvement are genuinely interested in working with you, recognize you as an asset, and will more often than not be receptive to your counteroffer. Saying “no” the right way will leave the door open to future opportunities that you may be waiting or looking for.

We can continue to recalibrate our expectations of ourselves, as we engage in projects that keep us passionate and hope that our journeys to wellness become smoother with time and practice.