Surviving Cardiology: A Ten-Point Cheat Sheet

From someone who breathes #WomenWithoutBorders and #ACCWIC.

Who am I?
Cardiac electrophysiologist.
Mother, wife (dual invasive cardiologists' family), sister, friend and daughter.
Passionate about patients, education, women and children.
Strong voice for the oppressed.

Without further ado, here is the 10-pointer survival cheat sheet:


Set Your Goals

Know what you want. Consolidate the means to reach those goals sooner. I wanted to do either cardiology or cardiothoracic surgery in medical school, which helped me make a realistic timeline, plan research and find the right resources. If the plans are put off until second- or third-year residency, you might be at a disadvantage due to time crunch.



Most of your colleagues sincerely want to improve your work environment; however, if you do not communicate, others will not know how to help you. Lack of communication can lead to misunderstanding. An unplanned twist in life that stops you from achieving your full potential needs introspection and an open talk – whether at home or at work. Asking for help is not a sign of weakness. When I lost my mother suddenly during fellowship, I reached out and received help from everyone (women and men) around me. I am grateful to this day for their kind gestures!


Cut the Excess Off Your Calendar

A big part of this is to embrace the word "no." Try not to fill your schedule with jam packed agenda. You will not be able to do it all without "burn out." A busy calendar used to make me feel unfulfilled at the end of the day, as I could not get it all done. While it is very important to organize and plan, going to extremes can leave you chronically exhausted.


Do Not Compare

You have to believe in your uniqueness and stick to your path. Otherwise, guilt and resentment become your life-long partners. Never second guess your decision. Marriage, family, career and leadership can be achieved, but may be not all at once. Live your life in priority-phases. You customize this for unique "you." You might have to sit in the back seat for a few years. You will get your chance in the driver's seat when it is the right time. Moreover, reassure yourself that you cannot be perfect at everything you do. I always remind myself, "perfect" does not exist in "happy's" dictionary. I want to be "happy!"



Life is busy with work-life-equilibrium (WLE). It is a juggling act. I decided not to work full time because I wanted to be with my newborn (I have no family and did not want to rely 100% on a nanny). A colleague commented that he is a better physician because he worked full time (who did apologize later). My response?

#1. "You are lucky, because if I worked full time, you would not have had a chance towards directorship. I will have my turn once my children are older."

#2. "I made a choice to work part time for WLE by taking a fair pay cut."

Over time, I put in more hours than what I was getting compensated, which was my choice as I wanted to be there for my peri-procedure patients, do extra procedures or I just could not turn down a patient who requested me (I would fit them in when my children were at school). However, this allowed me the freedom to coach my children's robotics team, get involved in the local American Heart Association chapter, volunteer at the women's shelter or be active in community initiatives as a part of "Empower Women" programs. Striving towards WLE is something to be proud of – not to be ashamed of. Accept that WLE will have its highs and lows. You might have a tough case at work or your child might have forgotten to take his or her lunch. Do not let these small hiccups rattle you. Ultimately, save your frustration and tears for the roughest of the days.


Job Negotiation

Compensation needs to be looked at in the context of one's work expectation, time off request, flexibility in schedule, productivity and intangible components such as effort to build the practice. In addition, call coverage is another issue which is compensated differently. Know what you want, do your research, take advice, and negotiate by customizing to your individual needs and wants. Do not be afraid to ask for fair treatment and fair compensation.


Hobbies and Exercise

Hobbies help re-energize. It is "me or my family" time. After I multitask to the nth power (like most of us do), I retire to write poetry or listen to music or read a book with my children. Exercise is another part of this equation. Yoga or running or swimming – make time for yourself. It is good to be selfish to stay "sane." The medical profession comes with physical and emotional stress that only we can relate to. Use relaxation techniques as an anchor to fight the rough tides.


Share Hard Work

Hard work has no substitute! Bringing best game to work (just like we do at home) helps us fulfill our duty towards our patients. Our patients need our time, dedication and empathy. As a chief resident, I reminded the few residents – who were chronically tardy or who hindered patient care by their lack of attention to detail by cutting corners – that someone else is doing double the duty, which is unfair. Carry your load and help others along the way because that is the right thing to do. It also makes work enjoyable and less stressful for all.


Pick Your Battles

Life comes with conflicts – intentional or unintentional. They can leave you feeling drained. Do not waste your energy responding to every irksome moment or lose sleep. However, this does not mean you should not stand up for your dignity. By all means, hiss when absolutely needed. Hurtful comments can come from not knowing how to express oneself, or from curiosity or insecurity. Be comfortable in your own skin. Of course, if the conflict is due to malintent, or repetitive, then switch gears from politely-firm "stop" to action. Know the steps to conflict resolution in your organization, talk to your mentor and be assertive.


Confidante or Mentor

We all need mentors. It could be your attending, friend or spouse. You might have two or three life-lines. They will give you advice and will help you think logically when you are at your wits end. They will be your loyal ears when you want to vent. My mentor who guided me throughout my fellowship and guides me even today is Claire Duvernoy, MD, FACC. I could relate to her especially because of our shared "EP-Interventional marriage."

Realistic Optimism is the key to Happy Dynamism!

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This article was authored by Kamala P. Tamirisa, MD, FACC, cardiac electrophysiologist with Texas Cardiac Arrhythmia in Southlake, TX.