#Choose Cardiology: Ramyashree Tummala, MD

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FEATURE | One Friday evening, I got a text from my friend asking if I was free for happy hour. I had to decline since I was on call. In addition to happy hours, most fellows will find that they often have to miss other events in training, like baby showers, family events, birthday parties or holidays. People often then question: what motivates me to take on such a challenging and demanding profession like cardiology? To answer this question, I want to share my personal stories on how cardiology excites me every day.

People often then question: what motivates me to take on such a challenging and demanding profession like cardiology?

To answer this question, I want to share my personal stories on how cardiology excites me every day.

Why did I choose cardiology?

As a medical student, my first exposure to the 11-ounce organ "heart" was in the anatomy dissection hall. When I held a frozen human heart in hand, I wondered how a small, complex and efficient organ could serve as the genesis of life.

This very organ has inspired my personal journey through medical school and residency training, and fueled my pursuit of fellowship training.

As a medical student in India, I trained in a hospital that did not have a cath lab. I saw many deaths of myocardial infarction (MI) patients because their "golden hour" was missed due to lack of medical resources.

I had the knowledge to understand an EKG, understand the pathology of an MI, and knew the next steps in treatment, yet we did not have the appropriate medical treatment. I was disappointed and wanted to train further.

My resolve to pursue cardiology became stronger when a cardiac issue became personal. During my medical school years, my father developed symptoms of shortness of breath, which were unexplained by both cardiologists and pulmonologists.

However, I insisted he get second opinion from another cardiologist with me reviewing the 2D-echocardiogram only to discover an atrial septal defect (ASD).

The cardiologist explained the importance of ASD closure, and at that time, I felt relief that I could save my father's life. The immense gratitude and satisfaction that I felt that day in diagnosing and treating cardiac patients guided me further in choosing cardiology.

These experiences kindled a desire in me to become a keen and focused cardiologist for my patients.

Who has been a role model or mentor for you?

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As I realized my passion for cardiology, reality struck me that it had the least number of women among medicine subspecialties. I started reading and noticing pioneers in the field of cardiology who are women, and I told myself that I could make it in field as well.

I spoke to many other female cardiologists, asking them the challenges they face so that I can prepare myself for it. The one phrase by Maya Angelou that keeps me going every day is, "Success is liking yourself, liking what you do, and liking how you do it."

I try to bring this mindset with me as I pursue my training in cardiology.

The most inspiring part for me, however, are the interactions I have with my patients. Behind the countless cardiac cases are suffering patients, each with a unique story.

I get immense satisfaction when I successfully diagnose and treat these patients, as well as see the relief and happiness it brings to my patients and their families.

In addition to all the clinical experiences, I have gained invaluable lessons of leadership, efficiency and teamwork working as a medicine chief resident.

What do you like best about cardiology?

The most fulfilling part of cardiology is the wide breadth of cases that I see every day and having a direct impact on patient care. This field offers numerous challenges on a daily basis, from treating the sickest patient in intensive care units, to managing heart failure patients with advanced ventricular support devices, to managing complex electrical rhythm disturbances and to utilizing various cardiac imaging modalities to arrive at diagnoses.

Team-based learning is the most important part of being a cardiologist as you work with a team in the CCU, create structural heart team decisions for new innovative heart valves, or work with your cath lab team to intervene on critical lesions.

There are always multiple subspecialties to choose per your interests in in preventive cardiology, interventional, electrophysiology, imaging, vascular medicine and many others.

Why did you choose this area of cardiology (or what area are you considering)?

I find cardiac imaging a tool that is most fulfilling within cardiac subspecialties, as it includes a wide variety of pathology and cardiac physiology.

The simplicity of using echocardiograms in diagnosing diseases is what fascinated me the most in this field.

I choose to subspecialize within adult cardiology and pursue an advanced fellowship in noninvasive imaging, receiving training in advanced echocardiography, cardiac MRI and cardiac CT.

Upcoming research and technology of using noninvasive imaging and safe techniques as a daily routine in patient care has encouraged me to pursue this subspecialty.

"A picture is worth a thousand words" feels right to me as I diagnose complex cardiac pathology with an echocardiogram or MRI, or CT scan. Imaging also gives me the opportunity to use pathology/physiology knowledge to help treat patients in a cost-effective way.

Would you choose cardiology again? What advice would you give women considering cardiology?

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I am proud to be a woman in cardiology, and will encourage other women to pursue cardiology if they are passionate about it. It is a challenging field for women, but life is full of challenges and you go through them with your skills and experiences.

Many people discouraged me when I told them I wanted to pursue cardiology. However, their negativity did not stop me. I believed in my will power and went to chase my dream. Being in this field also gave me a chance for personal development, like multitasking and self-confidence.

To all the female aspirants: "Follow your dreams, do not let someone else make a decision for you."

The field of cardiology has a lot to offer, from a career in research to clinical medicine. You should explore career opportunities and find your success story.

If given a chance to choose cardiology again, I will confidently say "yes."

This article was authored by Ramyashree Tummala, MD, Fellow in Training (FIT) at Mount Sinai Hospital in New York, NY. This article is part of the ACC WIC Section's #ChooseCardiology series, where women in residency, fellowship and early career are encouraged to share why they would choose cardiology again.