Acing the Transition: What FITs Need to Know to Launch a Successful Career

April 20, 2016 | Seth Sheldon, MD

Varsha K. Tanguturi, MD, and I had the pleasure of moderating the FIT session entitled, "Acing the Transition: What FITs Need to Know to Launch A Successful Career". We are grateful to the ACC for hosting this unique session and to our speakers, who shared a wealth of wisdom.

Hanna Kim Gaggin, MD, MPH, FACC, a cardiologist from Massachusetts General Hospital, kicked off our session with a talk on "How to Prepare for the Boards." She emphasized the predictability of the cardiology board exam, which matches the content breakdown published by the American Board of Internal Medicine. Her tips included reviewing the latest ACC/American Heart Association (AHA) guidelines documents (available on, knowing your physical exam findings, familiarizing yourself with the electrocardiogram (ECG)/echo/angiogram coding sheets and not over coding the ECG session.

Brigid Dolan, MD, an internist from Northwestern University, discussed "Negotiating Contracts." She divided her talk into four points of emphasis: 1) Know yourself (ideal position, goals, values); 2) Do your homework (learn the needs of institution you are considering, average salaries for the area, culture of the institution); 3) Have a backup plan (helps in negotiations, helps you learn what is important to you and the relative strengths/weaknesses of each position); 4) Enlist help (mentors/department chair at home institution, as well as people you meet on the interview trail, consider having your contract reviewed by an attorney). The audience learned valuable tips, as well as resources to further study contract negotiation.

Michael Merrill, a senior partner for The Finity Group and financial advisor, delivered a talk entitled, "Financial Planning for Future Cardiologists." He had several pearls of wisdom ranging from management of student loan debt (pay off high interest loans first, explore consolidation with private companies for high interest loans) and a recommendation during the first 6 – 12 months in your practice to keep your spending patterns similar to those in fellowship (delay unnecessary purchases, help your net worth, pay off debts and establish pattern of saving). He recommended saving/investing 20 percent of your income towards retirement (due to late start in savings after many years of training) and not financing more than 2.5 times your household income when purchasing a home.

Joseph S. Wilson Jr., MD, FACC, a cardiologist who is now the CEO of MagMutual, spoke on "Malpractice: Protecting Yourself in the Era of Defensive Medicine." He taught us that cardiology is at moderate risk for malpractice lawsuits and that it is best to prepare ourselves by making sure we have appropriate protection. Dr. Wilson finds that the majority of malpractice is due to improper performance, diagnosis errors, medication errors or failure to recognize complications. He also provided reassurance that the majority of lawsuits do not make it to a courtroom and that less than 75 percent of the time the physician is not found to be negligent.

Doreen Defaria Yeh, MD, FACC, an adult congenital cardiologist at Massachusetts General Hospital, closed the session by discussing "A Pragmatic Approach to Selecting the Right Professional Practice after Fellowship." She reviewed the multitude of career paths within cardiology and that, while it is not always possible, a "linear" path from your current point in training toward your career goal is ideal. Considerations when looking for a practice include: type of work/setting, geography, facilities, support, culture of practice, compensation model, and work-life balance. Lastly, she illustrated through her own example that we cannot always get it right the first time and that career goals and recognition of these goals change with time. She advised us to not be discouraged if we have to pivot to a different position at some point in the future.

Thanks once again to the wonderful speakers and for the helpful audience participation!

This article was authored by Seth Sheldon, MD, a fellow in training (FIT) at the University of Michigan Health Center.