As I look back on this extraordinary year, I am overwhelmed with gratitude, pride and a sense of accomplishment. Stepping into the role of ACC President, I carried the aspirations of so many who came before me, and those who will lead after me. This year has been exhilarating, unique and undeniably one of the most momentous of my career. As we close this chapter, I reflect on our milestones, the lessons learned, and the unforgettable moments that have defined this journey.

Top Three Accomplishments

1. Executing the First Year of Our Strategic Plan

   The launch of our Strategic Plan marked a critical turning point for the ACC. We focused on increasing communication, ensuring our members understand the Board's initiatives, and demonstrating our commitment to transforming cardiovascular (CV) care delivery. We defined, delivered, measured and expanded quality – integrating it into every aspect of our daily work.

2. Advancing Dyad Leadership and Team-Based Care

   Dyad leadership is not just a concept for hospital administration – it is the backbone of effective health care transformation. Together with the ACC Presidential team, we implemented critical programs and guidelines to empower physician-led teams in adopting guideline-directed medical therapy. What was especially rewarding was witnessing the global embrace of team-based care, proving that this is not just a U.S. goal, but a shared global mission.

   Watching colleagues embrace dyad leadership, participating in meaningful discussions at Chapter meetings, and witnessing inclusivity and diversity in leadership made this year one I will cherish forever.

3. Global Engagement

   The warm welcome I received wherever I traveled was nothing short of amazing. As the first nonphysician ACC President, I was uncertain of how I would be received. Yet, from nurses in Saudi Arabia discussing ethical dilemmas to attending Grand Rounds at top institutions worldwide, these experiences affirmed that ACC truly is the international home for the entire CV team.

   This travel also reinforced how interconnected our challenges and goals are in the fight against cardiovascular disease. Every place I visited – whether a bustling city or a remote village –reinforced how much we have in common. The technology in Asia, the emphasis on quality in Saudi Arabia, the drive for patient access in Africa, and the camaraderie in South America all serve as testaments to our shared mission. I cannot pick a favorite destination, but I deeply appreciate the humanity and dedication I encountered across the world.

The Most Unexpected Part of the Year

Never in my wildest dreams did I imagine being elected ACC President. An equally surprising honor was my induction into the Royal College of Physicians in Ireland. Beyond the personal milestones, what struck me most was the overwhelming similarity of our global struggles and aspirations. Regardless of borders, our shared commitment to tackling cardiovascular disease remains steadfast.

Lessons Learned and Advice For Future Leaders

If I've learned anything, it's that leadership is about alignment – not just overcoming challenges. Our members and stakeholders share a common goal, and with strong leadership and commitment, we can drive meaningful change.

For those pursuing leadership, especially women and underrepresented groups, my advice is simple: There is nothing you cannot achieve. If the glass ceiling is unbreakable, find a way around it. Seek mentors, develop emotional intelligence, surround yourself with people smarter than you, and embrace your unique path with confidence and determination.

A Legacy of Leadership

As we close out our 75th Anniversary year and look to the future, I hope my tenure is not remembered solely for being the first nonphysician president. Instead, I hope it is marked by our efforts to transform cardiovascular care delivery, champion dyad leadership and elevate quality in everything we do. I aspire to have played a role in inspiring individuals to believe in themselves, step beyond their comfort zones, and embrace leadership at every level.

What's Next?

Retirement? I've flunked that test before! Instead, I will continue to educate, advocate for system change, and champion dyad leadership and care transformation. Staying involved with ACC and MedAxiom will remain a priority, ensuring that our Mission and Vision continue to thrive.

Above all, I look forward to spending time with my 13 incredible grandkids, watching them grow into the leaders of tomorrow. And while my husband might hope for more horseback rides together, he knows that's unlikely!

Passing the gavel to Christopher M. Kramer, MD, FACC, will be the honor of a lifetime. With his leadership and the guidance of ACC's CEO Cathleen C. Gates and the entire Board of Trustees, I am confident that ACC's strategic plan will continue to deliver immense value to our 56,000 members.

As we move forward, let's keep member engagement, responsible artificial intelligence implementation, scientific integrity, team-based care, and global collaboration at the forefront. The future of cardiovascular care is bright, and I am deeply honored to have played a part in shaping it.

This article was authored by Cathleen Biga, MSN, FACC

Keywords: Cardiology Magazine, ACC Publications, Leadership, ACC History, ACC25, ACC Annual Scientific Session, Delivery of Health Care, Goals