June 22, 2017 | Georges Ephrem, MD
Education

Mark Victor Hansen once said, “You control your future, your destiny. What you think about comes about. By recording your dreams and goals on paper, you set in motion the process of becoming the person you most want to be.” Nowhere is this more relevant than in medical education.

Being an FIT is a great, yet challenging experience. The amount of knowledge garnered, the skill set learning curve, the management know how and the preparation for employment are inspiring tasks managed at a time where the burden of loans and the responsibilities of “life” (e.g., housing, transportation, cost of living, education) lurk on the horizon. Nowhere is this more felt than in the field of adult congenital heart disease (ACHD). It requires a commitment from FITs after at least six years of training. It is also a fairly heterogeneous field: the diversity of FITs is represented by a wide spectrum of training backgrounds at the residency (internal medicine, pediatrics, or Med-Peds) and cardiology fellowship (adult or pediatric) levels.

Understandably, developing a common teaching curriculum was, is, and will be a real challenge. Defining the job market is an even more daunting task. In ACHD, we are blessed with a whole generation of pioneers who embodied the field before people heard of it or even thought of its necessity. These “giants” brought ACHD from this vague notion navigating between the pediatric and adult realms into a board-certified, Accreditation Council for Graduate Medical Education (ACGME)-accredited training.

The current generation of ACHD FITs decided to organize themselves in order to better their present and influence their future. Having met on the interview trail, we appreciated how isolated each of us was at the level of their current or future institution and how fruitful our collaboration would be. We could share our experiences and help each other out. Our initial efforts were carried over via individual email addresses and cell phones until the group felt that it would be judicious to create a mailing list that would serve as a “speed dial” for all. That proposal was taken to the next level as ACHD FITs saw that the best step forward would be to structure this initiative into a formal group in order to secure its sustainability. Given its high degree of professionalism, its successful track records in starting and growing councils and sections, its keen interest in ACHD, and its commitment to fellows’ education, the ACC was to be our home. The ACHD FITs were welcome with open arms and the concept of an ACHD FIT work group was set up. Surrounded by a friendly, professional and experienced group of ACC staff, the structure, charge and membership of the work group were created under the umbrella of the Adult Congenital and Pediatric Cardiology (ACPC) Section.

On July 20, 2016 the Work Group (WG) was announced by Robert H. Beekman III, MD, FACC, immediate-past chair of the ACPC Section, and Curt J. Daniels, MD, FACC, chair of the ACPC ACHD Work Group. The inaugural leadership of the ACHD FIT Work Group consisted of Laith Alshawabkeh, MD, from Boston Children’s and Georges Ephrem, MD, MSc, from Emory University, as co-chairs and Asma Habib, MD, from the University of Washington as a communications liaison.

The work group leadership set a strategic plan for their term based on the content of the dialog among current ACHD FITs. As the ACGME accreditation process hasn’t been completed, there was no unified way to account for all ACHD FITs. The leadership reached out to all known training centers and was able to include all ACHD FITs in one email listserv. At the inaugural meeting of the work group, in conjunction with the AHA’s 2016 Scientific Sessions, the group decided to work on a webpage which would serve as a common repository of all useful resources to ACHD FITs. At the following meeting of the work group, in conjunction with ACC’s 66th Annual Scientific Session , plans were made to include education about ACHD training and employment prospects a part of ACC.18. A dialog was also started with the ACHD Program Directors Work Group to convey the trainees’ perspective as the future of the ACHD training curriculum is being molded. With the default enrollment of ACHD FITs in the work group, trainees are directly linked to the group’s leadership and as such at the forefront of all the initiatives of the work group.

It is undeniable that starting a work group and running it is a lot of work, and entails an enormous amount of upfront investment in time and effort. However the ultimate goals, namely the advocacy for ACHD fellowship training and support of ACHD FITs in their career path, are worth it. More importantly FITs with an understanding of the contemporary nature of academic dynamics realize the necessity to organize and structure in order to influence the course of things. To quote Mark Victor Hansen once more, “Put your future in good hands – your own.”

This article was authored by Georges Ephrem, MD, a Fellow in Training (FIT) at Emory University, Atlanta, GA.