A Look Into Academic Cardiology
In 2002, the first transcatheter aortic valve replacement (TAVR) was implanted in a patient with severe symptomatic aortic valve stenosis. More than 15 years later, TAVR has transformed the cardiovascular landscape and is considered one of the greatest medical advancements. Concurrently, many other technologies are under development and being evaluated to improve and transform medicine.
We are fortunate to be in a specialty that has many subspecialties, which offer a wide range of research activities and allow many trainees or young physicians to pursue higher degrees (e.g. MPH or PhD) aiming for a career in academics. This career path requires commitment and passion for advancing patient health care and the ability to cope with pressure and failure when it ensues. Aspiring researchers need to be able to evaluate and identify potential science gaps and willing to experiment on projects that may or may not be successful.
In Greece, a PhD degree is necessary for young physicians who are planning to follow an academic career. When picking a topic or theme for a research proposal, it is crucial to take into consideration many factors such as its clinical significance and the possible positive clinical effect, recruiting eligible patients, securing funding and running the actual study or trial. Besides receiving a PhD, there is no official track that must be followed in order to become an academic cardiologist. One might choose to become engaged with basic or clinical research, focus on teaching or combine research with teaching and clinical work.
I developed a research interest during my medical studies and got involved with data collection and input early on. Even though my main research focus is interventional cardiology and structural heart disorders, my PhD thesis was about non-invasive diagnostic imaging in the clinical setting. This gave me a valuable insight on non-invasive imaging and how to implement what I learned into daily clinical practice and training. During my doctoral thesis, overcoming the bureaucratic obstacles for study approval and limited funding were factors that impacted my overall research experience. However, it was still great to be a part of the whole procedure and the direct contact with patients was an additional benefit when conducting clinical studies.
One of my professors and mentors, Konstantinos Toutouzas, MD, an interventional cardiologist and associate professor of cardiology at Athens Medical School, kindly agreed to express his thoughts about combining clinical work and academic endeavors:
"Academic medicine is extremely challenging and demands a lot of time and effort. If deciding on an academic career path, a fellow or young physician should be willing to be involved in basic science or clinical research, teaching, protocol design and execution, among others. Genuine curiosity is always a good ally and perseverance especially under stressful conditions is a necessary trait. For trainees who wish to subspecialize in interventional cardiology, it is imperative that they get involved early with hands-on training and closely follow all the latest developments. Structural heart interventions are increasingly being performed and exposure to these technologies should be a top priority for aspiring fellows. It is an exciting time to be an academic interventional cardiologist since this subspecialty offers ample research potential and there are many areas to focus on. From coronary artery disease to structural heart disorders, clinical trials and studies are constantly evaluating newer drugs and devices to improve cardiovascular care. Cardiology is a stimulating and constantly evolving specialty and future advancements are set to change the way we manage patients. Technology integration is becoming the norm in daily practice and the concept of big data is revolutionizing the way we evaluate the enormous set of patients' data, with an ultimate goal of personalizing treatment strategies for the patient. Designing and implementing clinical trials that test the newer technological advancements will be a major challenge for academics and investigators alike. I believe that in the future we will witness an even greater progression on how we evaluate and treat cardiovascular disease patients, and I would prompt all the younger trainees and physicians to be involved in cardiovascular research."
From 3-D printing and holograms to artificial reality and big data, technology is poised to have a central role in shaping the future of medicine. Whether this will lead to affordable health care and better patient outcomes is still to be proven. Nonetheless, it is both a privilege and an obligation as physicians whether in an academic setting or not to evaluate these novel technologies and medical devices and implement them to our patients' best interests.
This article was authored by Konstantinos Stathogiannis, MD, PhD, Fellow in Training (FIT) at Hippokration General Hospital in Athens, Greece.