Author + information
- Matthew I. Tomey, MD∗ ( and )
- Tara Naib, MD, MPH
- Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York
- ↵∗Reprint requests and correspondence:
Dr. Matthew I. Tomey, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, New York 10029.
At sea, the Portuguese man-of-war (Physalia physalis) stands out for its beauty, its deadly effectiveness, and its composition (Fig. 1). An archetype of the Siphonophora order, the man-of-war takes form and function through the aggregation and physiologic integration of numerous individual zooids, each small and specialized, scarcely capable of life on its own. It is the organization of zooids into polyps that enables the man-of-war to float, feed, reproduce, and sting.
The beginnings of life as a cardiology fellow-in-training are not dissimilar from those of a zooid. We arrive as individuals with some preliminary specialization, but we are often in search of purpose and impact in an ocean of opportunity and need. For many, direction comes from the guidance of mentors and the camaraderie of peers at one's home institution. In our fellowship experience, we have been fortunate to observe how extending relationships across institutional boundaries can enhance a fellow's purpose and impact in the community.
In 1989, Dr. Valentin Fuster assembled the American Heart Association (AHA) Cardiology Fellows Society of Greater New York. Attracting fellows from institutions across the New York area, the Society assembled cardiologists-in-training of diverse backgrounds, skill sets, and aspirations into a common forum. Through periods of contraction and growth, the Society has evolved to incorporate fellows from 20 programs across New York City, Long Island, Westchester, and New Jersey, with interinstitutional leadership.
Maturation of the Society has been fascinating to observe. From early roots as a social connector, the group soon developed community educational activities, permitting fellows across the area to share in the wisdom of local master clinicians and thought leaders. Today, this takes the form of biannual “Controversies in Cardiology” panels, during which local senior physicians and surgeons debate difficult cases and unresolved questions. Accidentally at first, and later by design, the Society became a career kick-starter, connecting regional fellows and attending physicians, revealing new jobs, and ultimately providing direct guidance through annual “Careers in Cardiology” symposia.
Over the past year, the Society has begun to truly move. Expanding its engagement in outreach efforts sponsored by its parent organization, the Founders Affiliate of the AHA, the Society has created a growing presence in the community and a new conduit for fellows to promote public cardiovascular health. Symbolically, this began with teams of fellows running in the Wall Street Run and Heart Walk to raise funds for and broaden awareness of heart disease and stroke.
Outreach took further shape as the Society focused on the prevention of sudden cardiac death through promotion of bystander cardiopulmonary resuscitation (CPR) educational initiatives. Through this singular objective, the Society has opened myriad avenues for individual fellows to contribute to a common purpose with great importance to our community. In New York, the rate of survival to hospital discharge after ventricular fibrillation arrest has been reported to be as low as 5%, in contrast to survival rates approaching 50% in other areas with a high utilization of bystander CPR (2). Through the Society, fellows have participated in letter writing campaigns, lobbying, public speaking, and community fairs to educate media, elected officials, and community members about both the importance of CPR and the technique to save a life.
Out of this interinstitutional collaboration, the Society has discovered new potential for a next step in its evolution: coordination of multicenter, fellow-initiated, patient-oriented research. Several aspects of a regional fellows society make it a promising tool for this purpose. First and foremost, members are regularly in touch with patients and families in the local community who are affected by heart disease and stroke. Second, as fellows-in-training, members are both unified by a common commitment to advancing cardiovascular knowledge and privileged to have access to a rich pool of potential mentors. Third, members span multiple institutions, permitting enrollment of a diverse and representative sampling of the community. Finally, as residents of the community they serve, members often have both a personal appreciation of local needs and a special motivation to help.
The Society is not the only local fellows' organization: the AHA Fellows Society of Greater Boston thrives today, for which Dr. Fuster was also an inspiration. Within the American College of Cardiology and its state chapters, robust Fellows-in-Training committees offer opportunities for fellows to become involved in College governance, advocacy, and education. Committees within the subspecialty societies offer fellows similar opportunities to engage. Within institutions and across generations, fellows' societies permit current trainees to meet program graduates to network, gain wisdom, and find jobs.
Today, an ever-expanding array of tools permits fellows to network socially via computers and smartphones. Not instead of but complementary to these tools, regional fellows societies serve to generate a form of “social capital” that was once lamented to be in decline by Robert Putnam in his landmark 1995 essay, Bowling Alone (3). By engaging local cardiology fellows in human contact and conversation, fellow-driven societies create collective benefits to be shared by all.
Ideas spring from an open assembly of fellows, and with these ideas, a need to speak. In this issue, the Journal of the American College of Cardiology creates a precious new voice with which fellows and cardiologists in their early careers can speak and be heard. We congratulate the Journal on the addition of this editorial page. We would like to use this occasion and forum to urge our co-fellows to build connections beyond institutional walls. Through collaboration comes the opportunity to grow, to move, and, on occasion, to sting.
The authors would like to thank Susan Bishop of the American Heart Association for her guidance and contributions to this paper.
- American College of Cardiology Foundation
- ↵Pearson Scott Foresman. Line art drawing of Portuguese man-of-war. Wikimedia Commons, April 13, 2008. Available at: http://commons.wikimedia.org/wiki/File:Portuguese_man-of-war_(PSF).png. Accessed March 14,2014.
- Putnam R.