Interview With Thais Coutinho, MD: Lessons Learned From an International Medical Graduate’s Journey

April 27, 2017 | Fernanda Erthal, MD

Thais Coutinho, MD, is a staff cardiologist at the University of Ottawa Heart Institute and assistant professor of medicine at the University of Ottawa. She is a Brazilian doctor who graduated at the Universidade Federal do Rio de Janeiro, Brazil. Early in her career, she decided to move to an academic center in North America for post-graduate medical training. In a recent interview, she shares her experience and lessons learned during her successful career journey.

Can you tell us about your career journey?

TC: I earned my medical degree from the Universidade Federal do Rio de Janeiro, in my hometown of Rio. It was a fantastic six years, when I was exposed to excellent clinicians and mentors. I decided fairly early on that I wanted to be a cardiologist, and that I wanted to be in academic medicine. With this goal in mind, after graduating from medical school, I moved to Rochester, MN, where I spent eight years training in internal medicine, cardiology, advanced echocardiography, vascular medicine and research at the Mayo Clinic. It was a very productive time and with amazing clinical and scientific mentors, my clinical and research skills improved significantly. The specific training path I chose allowed me to carve a niche for myself that made me competitive in the job market. Upon completion of my training, I decided to join the University of Ottawa Heart Institute, in Canada, where I currently work as a cardiovascular specialist and clinician scientist. I have been on staff for three and a half years. 

We know that after completing medical school in a developing country, moving to North America can be challenging. When did you decide to take this big step and what was your motivation?

TC: My career goals have always included academics and leadership; and I realized that in order to not only reach but maximize these goals I had to train and work abroad. I was very inspired by my cardiology professor and mentor, Nelson A. De Souza E Silva, MD, FACC, – a superb clinician and teacher who had trained at the Mayo Clinic in the 1970s. My experience with him motivated me to check out the Mayo Clinic, which I did as a visiting medical student. It was a transformational experience that corroborated my academic goals, so I went home and started studying for the USMLEs, applied for residency, and was fortunate to match there for all of my postgraduate training.

What were the biggest challenges you faced? What do you believe was the most difficult for you at the beginning and what kept you anchored?

TC: I believe the biggest challenge early on was to prove my worth. In Brazil, people knew I graduated from a prestigious university, but abroad people did not have a clue of my caliber and potential as they were not familiar with the Brazilian medical education system. It was very scary to think that my application could be easily screened out by an administrative person and never reach the eyes of the program directors. For this reason, I knew that I needed to look good on paper, so I could have the chance to meet people in person and show them my potential. I did this through my scores – I made sure I had very high scores that would set me apart and make it harder for someone to simply toss my application. The strategy worked – the interviews came in, and I matched at my first choice for residency and then fellowship.

During training, proving my worth was once again a challenge. Academic jobs are few and competitive, and I knew that in order to land a good academic job at the end of my training (especially as a foreign grad) I had to set myself apart – do something different, do it well and get recognized for the work. I worked incredibly hard to build my academic portfolio, under the excellent mentorship of Iftikhar Kullo, MBBS, FACC, and Francisco Lopez-Jimenez, MD, FACC. During those eight years I went from not even knowing what a t-test was, to getting multiple research awards.

Do you think being a foreign woman was an extra difficulty to your journey?

TC: I honestly cannot say that being a woman has made my journey any different. I believe I have been given the same opportunities as my male colleagues. Being a foreign graduate made it more difficult for the reasons I mentioned above – showing people my capabilities and potential, and getting doors to open as a foreign medical graduate added an extra layer of complexity, but it all worked out in the end!

You are now a very respected cardiologist, specializing in echocardiography and vascular medicine and have received several young investigator awards in the U.S. and Canada, and have been very successful in obtaining several research grants. How would you describe the importance of facing the international journey on your achievements as a cardiologist?

TC: This journey has been instrumental to my professional achievements. I am extremely grateful for the opportunities I have been given and the mentorship I have received. Without these opportunities and mentors, I would not be in the position I am today. I am still in my first few years as an independent clinician and investigator, but I am confident about what the future brings because of the solid skillset I built during my clinical and research training in North America.

Do you have any advice for other FITs?

TC: Yes! This is a long and strenuous career, so do something you love! It is very easy to be excited about lots of different things, but focus and carve a niche. This will increase your marketability (especially in academics) and increase your chances of academic success. Remember that we don’t live to work; we work to live. It is important to work hard and be studious, but also keep a decent work-life balance. “Work hard, play hard” are words I live by.

This article was authored by Fernanda Erthal, MD, a Fellow in Training (FIT) at the University of Ottawa Heart Institute, Ontario Canada.