What I Wish I Had Known as an Early Career Physician: Advice For My Younger Colleagues

Thirty years having passed since I finished my cardiology fellowship and became a proud Board certified cardiologist entering practice, opening the first 2D echo lab at a VA hospital and starting a stress echo program in the era of 30-degree mechanical sector scanners. I wish I had more pearls of wisdom to offer my young colleagues. Indeed, I have made some – many – mistakes during this long period, changed directions a few times, experiencing both success and failure; I don't think it is hubris speaking when I say I wouldn't change much, or humility in speculating that I may have forgotten more important lessons than I have learned. I am still learning that it is more important to focus on the path rather than the destination, and am resolute in recommending the cardiology path to you for the opportunities and challenges it continues to offer.

I have been an unapologetic copycat from the get-go, trying to follow the path of those I admired, emulating the passion, dedication and motivation of those around me, especially the examples set by my trusted mentors and more experienced physicians, but also by my colleagues, junior physicians and other members of "my" team, including nurses, physician extenders, and the friendly fellow who greets patients at the hospital entrance, parks their cars and helps them find their destinations in the beehive we like to refer to as an integrated health care enterprise. There are many people all around us, including our patients, who will help us find a path through the maze if we listen to them.

I still see myself as an early career physician, believing that it is my career – the path – that is changing as time passes, not me, not the excitement I feel when challenged to always learn more, or the inspiration I experience seeing altruism in action all around me, especially when expressed by my younger colleagues, whether it be pride in mastering a new procedure, making a tough diagnosis, publishing a good paper, establishing an empathetic relationship with a difficult patient, or leaving work early to attend a son or daughter's little league game.

What you set out to do may or may not come to pass, but flexibility, resilience and dedication to helping others will lead to contentment. I am fortunate to have experienced this feeling among cardiologists around the world, under many different political and economic conditions, and in many different practice settings, academic, private practice, prominent hospitals and volunteer clinics, in practitioners young and old, famous and not so famous, rich and not so rich. Profound changes are occurring in the structure of cardiology practice, incorporating rapidly expanding science and clinical knowledge, as well as changes of regulatory burden, professional autonomy, workflow, scope of practice and income. The path is winding. I am confident that my early career colleagues will meet these challenges.

This article was authored by L. Samuel Wann, MD, MACC, a member of the American Medical Association's House of Delegates.