Distinguished guests on the dais, newly elected Fellows and Associates of the College, past presidents, Board of Trustees, Board of Governors, Assembly of International Governors, members of the College, ACC staff, family, friends, and guests. Thank you for this last opportunity to address you tonight during the Convocation Ceremony and before turning the reins of leadership over to my friend and colleague, Dr. Kim Williams.

Let me again offer my congratulations to all of our award winners, as well as to our newly inducted ACC Fellows and Associates.

Tonight I'd like to share some thoughts on the past year and a few personal lessons learned. Many would point to the American Board of Internal Medicine's (ABIM's) revisions to their Maintenance of Certification program as the defining issue of 2014-15. But, as noted in my remarks during our opening showcase, I think much of the uproar has been a manifestation of a larger frustration with the seemingly unbridled increase in external regulations that have been aimed at clinicians, researchers, and educators.

Our discussions with ABIM, and the administrative pause we have achieved in the process of recertification, have created a template that can be used to influence the direction of other policy deliberations, especially when we think our mission to improve cardiovascular care may be compromised. The College is well positioned to continue its tempered deliberations with ABIM and other stakeholders to refine the process and provide our members with the relevance and value they seek, while also demonstrating our professionalism and competence to the patients and public we serve. I have not met a single ACC member in my travels over the past year who is interested in lowering the bar. In this effort, it is important for us to lead by example, from the heart, for our patients, and with our professional members.

As for lessons learned, the first to emphasize is that the College is blessed with a wealth of talent and experience in every corner of its far-flung operations, within each Chapter (both domestic and international), across committees, sections, and councils, and most importantly, throughout the ranks of our Board of Governors and Board of Trustees. Our highly professional staff, under the leadership of our CEO Shal Jacobovitz and executive vice-presidents, has helped place us on firmer strategic footing and kept us disciplined in our initial year and a half of implementation.

You, as newly appointed Fellows and Associates, are at the cusp at which your responsibilities will grow. You are being welcomed into the next class of active participants in College affairs. We are better positioned today to match your skill set with the tasks confronting us. The challenge is how best to tap the incredible pool of talent you represent. A common frustration has been the inability to balance the supply of so many deserving individuals, especially from the ranks of our Fellows-in-Training and Early Career Members, against the demand of a relatively limited number of College openings. This is both a blessing and a curse, yet I think we have made great strides to make the process more transparent and equitable by re-establishing the principles of merit, diversity and opportunity. We have a ways to go; yet there is increasing acknowledgement that making way for those who follow is an organizational priority.

A second lesson I've learned — and one I have already shared — is that the time allotted to effect change is very limited and should not be wasted on process for its own sake, at the expense of purposeful action. We rightfully take great pride in the consensus-driven nature of our policy deliberations, our guideline and AUC development processes, and in our iterative conversations with our partners — many, but not all of whom, are represented here on the dais. But sometimes the chance to make a difference is gone in what seems like the blink of an eye, exacerbated to some extent by the fact that we meet infrequently in person and do not engage the more difficult aspects of our conversations, be they internal or external, for weeks at a time. The incubation times, length and density of our clinical and policy documents are a related concern. We've tried to address these issues at the College and set clear milestones and timelines to assess progress; some of our constituents have yet to be convinced we're serious. I think we are. Perhaps I have also become less patient, sensitized in part by the untimely deaths of very close colleagues in recent times.

A third lesson learned is that the needs and demands of our members and patients are very different than they were just a few years ago — maybe even just last year. Past practices will not suffice to solve present-day and future issues. Medicine and technology are accelerating so rapidly that it seems difficult to predict what will happen from 1 year to the next; except perhaps for Washington gridlock and indecision. This rate of change underscores the need to innovate — with new programs, new voices, and new strategies, all within the confines of an overarching plan and all openly debated in the marketplace of ideas. Passion helps, especially when defending a minority position that will eventually overcome majority inertia.

At the risk of leaving many off the list, there are several people I want to recognize who helped make this year a very special one. My heart-felt thanks to my colleagues on the Board of Trustees, Executive Committee and Presidential Team for keeping me on the reservation. John Harold deserves special mention for his immediate mentoring.

I'm grateful for the many interactions I've had on behalf of the College with my counterparts from other professional organizations, government, foundations, and industry. I think the Brigham and Women's Hospital should take pride in the fact that three of us, myself, Dr. Elliott Antman, and Dr. Mark Creager, will have served in ACC and AHA leadership roles over the 2014-2015 time frame. ACC Executive Vice President for Science, Education and Quality, Dr. Bill Oetgen, deserves special mention for being such an outstanding professional and voice of reason. His steady influence extends widely and has helped me, and the Board of Trustees, frame several important issues.

This past year saw the arrival of my former chief, Valentin Fuster, as Editor-in-Chief of JACC and my close friend and colleague, Kim Eagle, as Editor-in-Chief of ACC.org. As many of you know, Rick Nishimura is a role model whose vision regarding our educational programs has challenged us to design and implement interactive learning experiences. BWH colleagues and staff were unfailingly helpful in providing coverage for my practice. I understand that my dance card has been filled for the next two years in repayment. My patients and their families are most grateful to my Nurse Practitioner, Janet Keyes, for her expert and compassionate care.

The true guiding light and inspiration behind the scenes, however, has been my wife, Laurie, whose radiance is matched only by her fierce loyalty and her uncanny ability to find life's simple truths in the midst of our shared experiences as life partners. She is here with her sister, Jeanne, who is also one of my closest friends. Our adult children, daughter-in-law, and soon-to-be daughter-in-law, are represented here in spirit.

Tonight we face another inflection point in our journey. While welcoming the next incoming class of Fellows and Associates, we also embrace the arrival of our new president, Dr. Kim Williams, our president-elect, Dr. Richard Chazal, and our vice president, Dr. Mary Norrine Walsh. Transitions in the ranks of the Boards of Trustees and Governors allow for new voices to be heard. We celebrate the extraordinary accomplishments of the 2015 awardees assembled here and recognize their contributions to our legacy, hopeful that we will be able to achieve the very high standards they have established. As well, we look forward to including you, the 2015 class of Fellows and Associates, in activities meant to fulfill our mission.

We have arrived back at the point from which we embarked last year. I believe the time is ripe with extraordinary opportunities, filled with challenges, yet desperate for informed leadership. Let us continue to focus on our patients and the care they deserve, strive to rekindle the altruism that drew us to this extraordinary profession, and remember to lead from the heart.

Thank you.