This article was authored by Sandeep K. Krishnan, MD, a fellow in training (FIT) at Cedars-Sinai Medical Center in Los Angeles, CA.

The ACC has done it again! Another home run for the FIT team! I recently had the good fortune of attending the Teaching Tomorrow’s Teachers (3T’s) program embedded into ACC’s 38th Annual Cardiology at Big Sky conference. It was a conference like no other I have ever attended.

By itself, the ACC Big Sky conference is a unique entity. For five days starting every President’s Day weekend in mid-February, Kim Eagle, MD, MACC, and Patrick T. O’Gara, MD, MACC, host this highly-informative conference surrounded by the beautiful snow-capped peaks of Big Sky, MT, in and of itself a small, charming town located 1.5 hours away from the nearest airport.

The conference was started by a trio of cardiologists almost four decades ago, who envisioned a more secluded, more intimate, more relaxed atmosphere. The dress code is casual and attendees find themselves waking up early to listen to several hours of lectures in the morning, hitting the slopes for a few hours, and then studiously coming back to the same cozy amphitheater in the afternoon for several more hours of didactics, which can continue on into the late evening.

This year, though, the already innovative conference decided to change things up by adding FITs to the mix. Starting with Dr. Eagle’s and Dr. O’Gara’s vision for a special fellow’s training conference over a year ago to the hard work of the FIT Council (Craig Alpert, MD, Shashank S. Sinha, MD, and Michael W. Cullen, MD, FACC) – the 3T’s conference was born. This conference focused on answering an unmet need in medical education – what is the best way to teach and how does one foster those skills in trainees?

The conference focused on three simple objectives: developing skills, providing a safe forum to practice our skills and establishing a community. We were told that at the end of three short days, our public speaking, feedback giving and presentation skills would be markedly improved. We were promised that we would be given a forum to present case presentations to each other, master educators from across the U.S., and attendees of the Big Sky conference. And finally we were told that we would leave Big Sky with a cadre of fellows whom we could lean on and learn from for the rest of our careers. Was this too good to be true?

The adventure started on Sunday evening when all eighteen of us and our three fearless leaders gathered into a small room at 5 p.m. for an intense five-hour session. After reviewing the purpose of our trip, we got started right away with an ice-breaker wherein we had three minutes to learn about the person sitting next to us and introduce that person to the group by providing three interesting facts about them. From there Craig, Shashank and Mike provided some interactive didactics on presentation design, public speaking and how to give feedback. We then had to put these skills to the test: we were tasked with giving a five minute micro-teaching session on a non-medical topic.

After scouring my brain for a good topic, I settled on “How to Sell Your Stuff on Ebay.” My groupmates taught me a host of other useful things such as how to be a beekeeper and how to land after a parachute jump. Though this exercise was not medically focused, we learned more about each other and learned how to give honest, constructive feedback in a non-threatening manner. I found myself not just opening up to these strangers but growing my public speaking and feedback skills along the way. By the end of the night, I felt that I had just made an entire group of new friends and our community was born.

The next three days were a blur. Each of the eighteen fellows prepared and delivered five-minute case presentations in conjunction with the course faculty on the main conference stage. We collaborated with them prior to the conference to select a case and prepare slides. The purpose of our presentation was to set the stage for a discussion of the subsequent faculty’s talk. We went in groups of three, mirroring the didactic lecture pattern of the conference. Despite being extremely nervous, I have to say that we were very well received. The attendees thought having the fellows get involved brought new energy to the event. I thought it was amazing to have the chance to interact with some Fellows of the ACC (FACCs) who have been in practice both in the community and affiliated with academic medical centers across the country.

We started every morning with a special fellows’ session with master educators. They shared the stories of how they built academic careers and the things they would recommend for us moving forward. They also volunteered their time to critique our presentations immediately after each morning and evening session. We got to know them personally and interact with them in this same intimate environment. Prior to this meeting I had only seen many of them in the hallways of the mega-meetings where it was difficult, if not awkward, to approach them with questions. Here it felt natural and was encouraged.

As the conference moved forward, we became more comfortable with each other and hence more facile at giving one another feedback. But come Wednesday, we had to say our goodbyes as we met for our final feedback session on the course. After spending an intense four days alongside my colleagues in the trenches, it was especially tough to leave such a dynamic and engaging group.

However, the neat part of this story is that just as Craig, Shashank, and Mike had hoped, out of the conference came a community. We have been communicating almost daily since the conference concluded via e-mail. We set up a Google Drive account and we have also organized a way for us to critique each other’s case presentations and share teaching information in the future. Finally, we all plan to carry out mini-teaching sessions at the state and local levels to help disseminate our newfound knowledge. Moreover, I can say with confidence that my public speaking, feedback-giving and presentation skills have improved monumentally.

Getting the opportunity to attend the ACC Big Sky conference was a neat opportunity by itself. However, having the opportunity to be part of the inaugural 3T’s course was legendary. I feel so fortunate to my state ACC California Chapter and the national ACC for being so kind as to support and fund such a unique program. I have come to appreciate the innovative nature of the ACC, and the ACC has indeed done it again with this 3T’s program and hit it out of the ballpark. I certainly hope that I can pay it forward and share these techniques with my co-fellows in the southern California-area.

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