To: Karen E. Joynt, MD, MPH
Cardiovascular Division, Brigham and Women's Hospital and VA Boston Healthcare System
Department of Health Policy and Management, Harvard School of Public Health

From: Anthony Galanos, MD Professor of Medicine
Associate Professor in the School of Nursing
Medical Director, Inpatient Palliative Care
Duke University School of Medicine

One great piece of advice I received from a mentor was in a clinical setting, but it applies equally well to research life. When I was an intern at Duke, a wonderful geriatrician, Tony Galanos, told me to run a mental code before going into a patient room: stop, take a deep breath, and take my own pulse—literally and figuratively. I've used this when running to codes, but also when preparing to do a procedure, running a complex family meeting, giving a research presentation, or doing an interview about a paper or project. Assessing your own emotions and fears when heading into an intimidating situation, naming them, and taking a moment to compose yourself can make all the difference in whether you're able to perform at your best despite the stressful environment.

From: Edward T. A. Fry, MD
Chair, Cardiology Division
St. Vincent Medical Group
St. Vincent Heart Center

I try to practice this every day and pass it on to our residents and fellows. It's an assimilation of lessons learned from my mentors, Cass Pinkerton, MD; Burton Sobel, MD; and my father R. J. Michael Fry, MD: "Treat everyone with respect; pay attention to details; scrutinize information objectively; and always remember that the patient you are caring for is someone's daughter or son, mother or father, aunt or uncle, grandparent, spouse or partner."

From: Ken Kutscher, MD
Hunterdon Cardiovascular Associates
Flemington, NJ

In this age of appropriate use and the "oculostenotic reflex," I often reflect on what my cardiology preceptor, Henry Greenberg, MD, from Roosevelt Hospital in New York City told me when I was a resident in 1978. We were taking time to figure out how to devise a plan of action for a difficult patient where the treatment benefits versus potential negative outcome was uncertain. I was impatient, but he told me, "Don't just do something, sit there!"

From: Stuart F. Seides, MD
Physician Executive Director
MedStar Heart Institute
MedStar Washington Hospital Center

When you're not sure what to do, always do what you believe is in the best interests of the patient. We live in a complex medical world of often-competing interests: patients, patients' families, other providers, lawyers and the legal system, payers, health care institutions and hospitals, regulators, appropriate use criteria, etc. When you are being pulled in different directions without a clear path, simply do what you, in your best judgment, believe is right for the patient—you will never be sorry.

From: Matthew Phillips, MD
Austin Heart Group, PA
Austin, TX

I can think of two mentors, one who taught me the value of professionalism; the other, our role as physician.

John Quinn, MD, was a cardiologist and leader of an eight-person cardiology practice in Winchester, Virginia. I was the first invasive cardiologist in the group. Dr. Quinn taught me professionalism and collegiality, welcoming me to town and offering to help anyway he could. He told me, if I was a good physician, I added value to the community. If patients chose my services over his, well, that was his problem and it would just encourage him to improve. He kept his word and was very supportive of my professional growth as a private practice physician helping with cases and procedures. We have had clinical conferences in our group and I have tried to engage as many cardiologists in the region as possible to both share cases and jointly grow professionally.

James Laidlaw, MD, was a noninvasive cardiologist and senior partner in the private practice group I joined in Winchester, Virginia. Jim took care of the most affluent, as well as the poorest, people on the planet. Jim managed all of his patients expertly and gave everyone the time they needed. He was calm and composed (despite being chronically late), and while patients griped about his tardiness, they all knew that when it was their turn, he would be 100% for them. His mere presence at the bedside was a calming force for the patient and their families. He taught me the value and privilege of coming to know and respect our patients as unique people and not as a disease state. He appreciated his role in their lives and how it enriched his own. I try to actively replicate his practice style, and when I have been successful, it has been very rewarding.

To: D. Scott Lim, MD
Associate Professor of Pediatrics and Medicine
University of Virginia

From: Amnon Rosenthal, MD
Professor of Pediatrics and Communicable Diseases (ret.)
University of Michigan

Figure out the right thing to do and then, no matter how scary it is, just do it. After that, let the chips fall where they may.

From: John Cogan, MD
Queen's Health Care Centers
Honolulu, HI

I tell learners there are three roles a physician must fulfill—three legs to the doctor stool:

• Patient advocacy (do the right thing: Primum non nocere)
• Teach (give it back)
• Lifelong learning (stay current)

There could be other roles—leadership, administrator, research—but those three are fundamental.

From: Michael Lee, MD
Assistant Professor and Assistant Clinical Professor
Department of Medicine
David Geffen School of Medicine, UCLA

A leader is not judged by how many followers he has but how many leaders he can produce. I encourage the trainees who have worked with me to contribute to the field of cardiology through high-quality research that will benefit society. I also believe in open collaboration with other investigators to build relationships and share ideas.

From: Michael Mansour, MD
Chair, ACC Board of Governors
Cardiovascular Physicians
Greenville, MS

Most mentoring has been by example from those that I have been privileged to work under:

• Arthur Guyton, a physician and physiologist, showed me how exciting science could be.
• Robert Copeland, a clinical cardiologist and master clinician, taught me to be confident in my abilities.
• Donald Erwin, my chief of medicine, showed me the importance of sincerity when dealing with patients.
• Thad Waites, always the gentleman, demonstrated how important the quality of being a gentleman is for a patient's comfort, confidence in, and acceptance of a physician's treatment.
• Richard Conti and Carl Pepine showed me how a physician could be a master clinician, investigator, and teacher and have a lot of fun practicing medicine.
• Donald Baim, showed me the importance of preparation, thinking several steps ahead, and decisive judgment in practicing interventional cardiology.
• My parents gave me the most important mentoring: a strong sense of volunteerism, a willingness to help others, and a sense of duty to carry out obligations to one's best ability.

I have been very fortunate. I hope I live up to these qualities and pass on some of these lessons to others.

To: Hector O. Ventura, MD
Director, Section of Cardiomyopathy & Heart Transplantation
Ochsner Clinic Foundation
Professor of Medicine
Tulane University School of Medicine

From: Edward D. Frohlich, MD
Alton Ochsner Distinguished Scientist
Ochsner Clinic Foundation

Edward Frohlich, would say: I treasure every paper I receive from a trainee. I analyze it critically but will be positive because the trainee will then be encouraged to continue to do research and writing. With time, the trainee will improve and he/she will become more capable in asking important questions and writing better manuscripts. Also, he advised that you spend time with trainees who want your advice.

Dr. Frohlich does both: he spends time with fellows and continues to encourage them to become better every day.

To: Dalane W. Kitzman, MD
Professor of Internal Medicine: Cardiology and Geriatrics
Kermit G. Phillips Chair in Cardiology
Wake Forest University School of Medicine

From: Edward Orgain, MD
Emeritus Chief of Cardiology
Duke University Medical School

I learned this lesson the hard way. Dr. Edward Orgain told me it's not about how much money you make, it's how much you enjoy your day. Only by finding and pursuing an area you are passionate about will you be able to maintain interest and joy during a 30- to 40-year career. And your career fulfillment, or lack thereof, will strongly impact all other areas of your life.

I ignored Dr. Orgain's advice. I left a junior faculty position at Duke, which I was enjoying immensely, for a private practice job with a higher salary. It was not long before I was bored with the routine of clinical medicine and longed for the additional challenges and stimulation of teaching the next generation of physicians and the thrill of discovering new knowledge through my research. I became despondent and felt trapped in a position much less fulfilling than the one I had known, and felt I was not living up to my potential to make a lasting contribution to mankind. The extra money did not come close to compensating. Thankfully, my wise and caring wife noticed and insisted I make another career change, and gave me the courage and support to return to an academic position that I absolutely love. That was 23 years ago and I still look forward to getting up in the morning to pursue work that I feel is important, challenging, and fulfilling.

To: David M. Safley, MD
Saint Luke's Health System
Associate Professor of Medicine
University of Missouri School of Medicine - Kansas City

From: Mentors at Saint Luke's Health System

David J Cohen, MD
Professor of Medicine, Cardiovascular Research, University of Missouri-Kansas City,
University of Kansas School of Medicine

Steven P Marso, MD
Medical Director, STEMI Program
Medical Director of Quality, Catheterization Laboratory
Professor of Medicine, University of Missouri-Kansas City School of Medicine

John A. Spertus, MD, MPH
Adjunct Professor of Medicine, Washington University School of Medicine
Professor, Daniel J. Lauer Missouri Endowed Chair in Metabolism and Vascular Disease Research,
University of Missouri-Kansas City

From my mentors:

• Make sure that you are passionate about what you do.
• Surround yourself with good people.
• Anything worth doing is worth doing well.

I think these three things contribute greatly to a productive and successful career in research, cardiology in general, and in life.

To: Eduardo Marban, MD, PhD
Director, Cedars-Sinai Heart Institute
Mark S. Siegel Family Professor

From: Myron "Mike" L. Weisfeldt, MD
Director, Department of Medicine
Johns Hopkins University School of Medicine
William Osler Professor of Medicine
Physician-in-Chief, Johns Hopkins Hospital

Start by seeking opportunities that are one level more basic than the level you thought you would end up focusing on. So, for example, if you want to be a clinical researcher, first study epidemiology or participate in translational research. It is sound advice that helped shape my own career development choices.

To: Michael J. Blaha, MD, MPH
Director of Clinical Research, Ciccarone Center for the Prevention of Heart Disease
Assistant Professor of Medicine
Johns Hopkins Medical Center

From: Roger Blumenthal, MD
Director, Ciccarone Center for the Prevention of Heart Disease
Professor of Medicine
Johns Hopkins Medical Center

The best advice I received was from Roger Blumenthal, who repeatedly encouraged me not to shy away from involvement in academic projects. I can remember at least three instances where I had opportunities to give important talks while still a cardiology fellow. I wasn't sure I was up for the task, and I was concerned that I wasn't qualified to take the stage. Each time he encouraged me to go for it, and each time I reluctantly did. The talks went fine, and from those experiences I developed academic contacts that have been incredibly important to my career. Doors would never have opened had I shied away from those talks.

From: James Jollis, MD
Duke University Medical Center
University of North Carolina/Rex Heart and Vascular

My cardiology training preceded digital images, electronic health records, and mobile devices. We began rounds in radiology viewing hard copies of X-rays, completed ward rounds, and viewed echocardiograms on VCR (video cassette recorder) tapes and angiograms on cine projectors – each of these happening in different parts of the hospital. My mentor, the late Dr. Ron Lauer at the University of Iowa (who led the Muscatine Study that confirmed a sentinel finding that cholesterol and body weight in children leads to premature atherosclerosis), stressed the importance of "showing up no matter what" as the quality for success.

From: Geetha Raghuveer, MD, MPH
Associate Professor of Pediatrics
University of Missouri-Kansas City School of Medicine Missouri

I tell my trainees that one should not plan a career path with certainty soon after completion of training; it is good to try out a thing or two. Life, serendipity, and luck presents opportunities that, if recognized and utilized, can change one's career trajectory.

From: Michael A. Solomon, MD
Head Cardiology Section, CCMD, CC, NIH
Senior Staff, CPB, NHLBI, NIH
Bethesda, MD

My clinical mentor was Clyde Yancy, MD, and my research mentors were Charles Natanson, MD, and Robert Danner, MD. What I learned from them by word and example are what I pass on to others.

1. Find a niche in medicine you are both good at and love doing and you will have the best chance of succeeding.
2. Do not push the accelerator too soon. Get the training you need to be successful and never stop learning. Strive for a bench-to-bedside understanding of your field.
3. Practice clinical medicine with humanity and perform science with integrity.
4. Surround yourself with motivated individuals that complement you without duplicating you.
5. Keep an open door, open ear, open mind policy.
6. Put yourself in situations that foster your communication skills.
7. Put yourself in situations that foster your communication skills.
8. Setbacks are part of the natural order. Accept them; even the best baseball sluggers only get on base about one-third of the time.
9. Above all, family first. They are walking side by side with you and you should always be there for them. Your successes are their successes and theirs are yours.
10. Don't forget how to have fun.

As Captain Barbossa from the Pirates of the Caribbean would say these are "more what you'd call guidelines than actual rules."

To: Emmanouil Brilakis, MD
Director of the Cardiac Catheterization Laboratories
VA North Texas Healthcare System
Associate Professor of Medicine
University of Texas Southwestern Medical School

From: Peter Brady, MD
Associate Professor of Medicine
Electrophysiology
Mayo Clinic

I distinctly remember the day in my last year of fellowship when a young faculty member reviewed my CV. Genuinely perplexed, he commented on the lack of focus of my research efforts and wondered why I had done projects all over the map: electrophysiology, acute coronary syndrome, interventional techniques, and biomarkers, among others. Initially, I did not take these comments well. I thought I had done a pretty good job getting involved in research and being productive, and that the comments were unfair. After some time, however, I started realizing that he was more right than I was willing to admit.

Why is focus important, especially early in an interventional career?

• Because time is limited, especially in the current era of rapid developments. Learning to do everything well is not feasible.
• Focus allows development of true mastery of a topic, and better appreciation of what is known and most importantly, what is not known in an area. Understanding what is not known allows meaningful research to be performed.
• Focus enables you to (gradually) become an expert in an area, and therefore someone whom people would think of when questions arise on a particular topic. You will be asked to review manuscripts and grants and give presentations on this area. This can lead to a geometric growth, as you get exposed to cutting-edge facets of the topic and interact with other leaders in the field.

To: Claire Duvernoy, MD
Chief, Cardiology Section
VA Ann Arbor Healthcare System
Associate Professor of Medicine
University of Michigan Health System

From: Markus Schwaiger, MD
Director of Department of Nuclear Medicine
Technische Universität München
Dean of the School of Medicine
Technische Universität München
Munich, Germany

The best advice I ever got was from my wonderful mentor, Dr. Markus Schwaiger and from his wife, a pediatric neurologist. She told me very early in my career that it was more important in academic medicine to be truly outstanding in one area, even if it is small, than to be merely good in many things. I think this is sound advice for anyone looking to have a successful academic career. The other piece of advice came later in my career from Markus himself, when I was deciding whether or not to go after an administrative leadership position. Telling me that he thought it would be perfect for me, Markus matter-of-factly told me what I needed to do in order to successfully compete for the position. He was right on both counts, and thanks to his advice, I went for it and was successful!

From: G. Michael Felker, MD
Associate Professor of Medicine
Chief, Heart Failure Section
Director, Heart Center Clinical Research Unit
Director, Advanced Heart Failure Fellowship
Duke University School of Medicine

The best advice I received was to pursue what I was interested in, not what I thought would be in demand, fundable, or easy to publish.

From: G. Michael Felker, MD
Associate Professor of Medicine
Chief, Heart Failure Section
Director, Heart Center Clinical Research Unit
Director, Advanced Heart Failure Fellowship
Duke University School of Medicine

The best advice I received was to pursue what I was interested in, not what I thought would be in demand, fundable, or easy to publish.

To: Stuart F. Seides, MD
Physician Executive Director
MedStar Heart Institute
MedStar Washington Hospital Center

From: Mark Josephson, MD
Chief, Division of Cardiovascular Medicine
CardioVascular Institute at Beth Israel Deaconess Medical Center
Herman Dana Professor of Medicine
Harvard Medical School

"Trust your own intelligence, you're a smart guy; if something doesn't make sense to you—it probably doesn't make sense."

Valuable encouragement, especially when training in the 1970s when a great deal of what was "known" in medicine and cardiology was based on anecdotes and opinions but not necessarily on science. (I vividly recall being criticized as an intern by a world-famous cardiologist in Boston for giving sublingual nitroglycerin to a patient with angina pectoris in the ER; his rationale made no sense to me then and of course, nitroglycerin subsequently became standard treatment for unstable coronary syndromes.)

To: Sunil Mankad, MD
Associate Professor of Medicine
Mayo Clinic

From: Christopher Kramer, MD
Professor, Radiology, Radiology Research
University of Virginia Medical Center

Christopher Kramer, MD, taught me to never give up, to always persevere, and to keep trying. If you believe in the work you are doing, don't let initial rejection or lack of success get you down. The first paper I ever published in Circulation was rejected five times; each time they requested a "de novo" submission. Although I could have submitted our study to a lesser journal, we believed in the work we were doing. Eventually, we "killed them with the data" and the paper was accepted. This first publication helped propel me to an academic career in cardiology and cardiovascular imaging. Life will always challenge us with obstacles and there are no shortcuts. My former mentor taught me the important lesson of working hard to find solutions, to overcome. When you are knocked down, get back up!

To: Sunil Mankad, MD
Associate Professor of Medicine
Mayo Clinic

From: Christopher Kramer, MD
Professor, Radiology, Radiology Research
University of Virginia Medical Center

Christopher Kramer, MD, taught me to never give up, to always persevere, and to keep trying. If you believe in the work you are doing, don't let initial rejection or lack of success get you down. The first paper I ever published in Circulation was rejected five times; each time they requested a "de novo" submission. Although I could have submitted our study to a lesser journal, we believed in the work we were doing. Eventually, we "killed them with the data" and the paper was accepted. This first publication helped propel me to an academic career in cardiology and cardiovascular imaging. Life will always challenge us with obstacles and there are no shortcuts. My former mentor taught me the important lesson of working hard to find solutions, to overcome. When you are knocked down, get back up!

To: Dipti Itchhaporia, MD
Immediate Past Chair, ACC Board of Governors
Robert and Georgia Roth Chair for Excellence in Cardiac Care
Director of Disease Management
Hoag Memorial Hospital Presbyterian, Newport Beach, CA

From: Pravin Shah, MD
Chair and Medical Director
Hoag Heart Valve Center
Hoag Hospital Newport Beach
Medical Director of Non-invasive Cardiac Imaging and Academics Program
Jeffrey M. Carlton Heart and Vascular Institute

One of the best pieces of advice came from Pravin Shah, MD, who told me early on that "nothing in life is ever wasted." If you can imagine an empty canvas and a dot appears with each of our experiences and interactions, it is hard to imagine how these will come together. But one day these dots connect in ways that you would not have imagined and that is when things come together and this is the beauty of life.

All the work we do has meaning, all the people we meet have a meaning, we just have to remember Dr. Shah's message: nothing in life is ever wasted.

To: Daniel J. Humiston, MD
Chief of Cardiology and Internal Medicine
Davis Hospital and Medical Center
Director of Clinical Research
Utah Cardiology, PC

Perhaps the best advice that I received was during medical school, when most of us are riding on our "high horse" for making it that far. One of our clinical professors in internal medicine at the Mary Imogene Bassett Hospital in Cooperstown, New York, advised us all on rounds one day to "be as willing to accept responsibility for your failings as you are to take credit for your successes." I suspect it was many years later before that advice clearly came in to focus. During medical school and internship/residency/fellowship training, your mentors provide an adequate safety net during times of inadequacy and failure. Upon completion of that "grace period," however, it is unavoidable: all of us will fail at times.

I am happy to say that over the last 19 years in cardiology, this sage advice has allowed me to develop a humility necessary to be a compassionate and effective physician. This would be the same advice that I would offer to our young colleagues today who are either entering medical practice or finishing their formal education to begin serious clinical endeavors. As right, capable, and enthusiastic as we all need be, we should never forget that striving for perfection is important, but anticipating and learning from our failures may prove more valuable over time to our professional growth and development.

To: Lambert A. Wu, MD
Cotton O'Neil Heart Center
Topeka, Kansas

One important piece of advice I give: listen 10 times more than you speak. This involves a great deal of humility. Most of the time, we want to speak our thoughts and biases before we understand the background, complex thought processes, and "worlds" of those whom we are conversing with. By truly listening to others, we show our respect for their viewpoints—even though we may not fully agree with them—and broaden our own understanding of the issues. A follow-up piece of advice, which also involves a good deal of humility, is to seek collaboration rather than competition.

To: Smadar Kort, MD
Professor of Medicine
Director, Valve Center
Director, Non-Invasive Cardiac Imaging
Director, Echocardiography
Stony Brook Medicine - Stony Brook University

The best advice I give young physicians is to learn how to network. Although important at every stage, as we advance in our careers it's a little easier as we develop and maintain relationships with our colleagues. Young physicians, on the other hand, need to learn how to network effectively and create such relationships. Joining a professional organization like the ACC allows physicians to belong to a community of like-minded professionals with whom they can network. A person should belong to different communities based on geographic location (local chapters), common professional interests (imaging, academic section, etc.) and special personal interests (women in cardiology). Through these networking activities one can learn of professional advancement opportunities, research opportunities, and other opportunities that will help them thrive both professionally and personally.