May 17, 2017 | Mary Norine Walsh, MD, FACC
Education

'Conversations With Cardiologists' highlights prominent cardiologists throughout the country and shares their invaluable insight on cardiology and sage advice for Fellows in Training (FITs). In a recent interview with Poonam Velagapudi, MD, MS, Mary Norine Walsh, MD, FACC, the third female president of the ACC, shares her insights on the beginning of her journey in cardiology and the road to ACC presidency.

Did you always envision a career in medicine?

MW: I grew up in a big family in south Minneapolis, and I decided early on that I wanted to go into health care as a field. I was hospitalized at the age of 7 for several days and that was the real turning point. From then on until high school I planned on a career in nursing. But once in high school, after courses in biology, chemistry and physics, I knew that medical school was what I wanted.

What made you chose cardiology as a specialty?

MW: I had some fantastic opportunities in high school and college. I worked as a nursing assistant in a nursing home, community hospital and county hospital for eight years before I went to medical school. I put myself through college with those jobs. I had exposure to many physicians and because of my experiences working in the emergency departments of two different hospitals, I initially considered training in both internal medicine and emergency medicine. A rotation on cardiology at the VA hospital in Minneapolis when I was a third-year medical student changed my course, though. By the time was an intern at the University of Texas Southwestern in Dallas, I had decided to pursue cardiology as a subspecialty.

Who were your mentors and how did they help shape your career?

MW: I have had many mentors. My house staff training under Donald Seldin, MD, who was chair of internal medicine at UT Southwestern, was very rigorous, and my experience at UTSW introduced me to the broader world of academic medicine. Burt Sobel, MD, and Steve Bergmann, MD, were my research mentors during my fellowship at Washington University, and they nurtured my development as a clinical investigator. Also, Mark Josephson, MD, who recruited me to the University of Pennsylvania early in my career, helped guide me in many important decisions.

How did you first become involved with the ACC? Could you share some of your most impressionable memories with the College and its activities in your journey to presidency?

MW: My first role in the College was as a member of the ad hoc task force on Women in Cardiology. Getting involved in a task force exposed me to more senior leaders and ACC staff who helped me understand how the College worked and all the possibilities for involvement and volunteering. I also got involved early on in my state chapter in Indiana, first running for a position on the chapter council and then eventually becoming chapter governor. Being a member of the Board of Governors gave me a broader view of the College, as I was exposed to our advocacy issues and priorities, as well as the wide variety of issues faced by the chapters on the state level.

What is your vision for the College this year? How can FITs contribute towards this?

MW: Team-based care is a passion of mine, and the time is ripe for these models of care to be disseminated more widely. As we move from a volume-driven to a value-driven payment model, team-based care is going to be more important than ever. We in cardiovascular medicine are way ahead of some other fields in our models of patient care via teams, but not all cardiologists and other clinicians are familiar with these models. The College can help with dissemination of best practices and show team models that work.

FITs often have less exposure to other members of the team than your attending physicians and program directors do. Since you will all be working in teams after finishing your training, I suggest that you begin now to familiarize yourselves with the functions of the various members of the team such as the nurse practitioners (NP), pharmacists, dieticians and social workers. If it is an option in your health system, refer your patients for education and medication reconciliation to your NP, physician assistant or pharmacist colleague. In this way, you can better prepare yourself for practice and take a lead in team-based care after your training.

What is your typical day consist of?

MW: Most days I am in the office seeing advanced heart failure and transplant patients. Our entire team meets every morning for a half hour to discuss all hospitalized patients, so that's how my day starts off. I travel quite a bit now, so I spend fewer weeks in the hospital on our inpatient service than I used to. Most days, I have a conference call or two, and I try to keep up with urgent emails throughout the day as I can. Research and administrative tasks are scattered throughout my days, too.

How do you balance family life and work?

MW: This is probably the question that I am asked most often by younger cardiologists and those in training. I think that everyone has to find the balance of family life and work that works for him or her. For me, I slowed my meeting travel and volunteering when my children were young. I truly didn't want to leave them, and I made the choice not to involve myself in lots of projects and research during their early years. As they got older, I accelerated into my career a little more. It is not a choice that many would have made, but it worked for me and for my family.

In present day where there are multiple professional societies within cardiology (and its associated subspecialties), what is the role of the College? What advice would you give FITs about getting involved in the College versus other societies?

MW: I truly believe that the College is the home for all cardiologists. Through our councils and sections, that have a focus on member interests and needs, it is easy to find likeminded people and work that you find valuable. Also, the College is unparalleled when it comes to advocacy and policy influence on a state and federal level, so it is important for cardiologists to be active and have their voices heard via input to the ACC. That said, our sister societies are robust organizations that have a focus and mission that often complements the College's. I encourage FITs to get involved in our sister societies as well as the College. I belong to and have been active in many of our sister societies and have found my involvement to be very professionally rewarding.

What are your experiences as a woman in cardiology? What advice do you have for women in cardiology particularly FITs?

MW: I have been very fortunate to have many friends along the way during my training and throughout my professional life. One thing that I have made a priority is to nurture my friendships and connections with other women in our field. I would advise other women to adopt that strategy, too. I long ago learned that travel and meetings are more fun and relaxing if I plan to meet or have dinner with a friend. That early strategy has resulted in my having a strong group of women friends who serve as a sounding board and a source of support. I believe that all women have a responsibility to help other women succeed. For the FITs, that includes realizing that you are important role models for medical students, residents and even your fellow FITs. Going out of your way to help other women along their journey should be a priority for all of us.