My name is Aniruddha Singh, and I have been practicing cardiology in a hybrid setting for five years. It has been an amazing experience for me to be involved in a busy clinical practice at The Western Kentucky Heart and Lung Center while concurrently being involved in teaching and research at the University of Kentucky College of Medicine in Bowling Green, KY. To elaborate on practicing in a hybrid setting, I will be highlighting the experiences of our two graduating fellows this year: Megan Smith, DO, and Kristopher Pfirman, DO. They have been an invaluable addition to our cardiovascular program and have helped our program improve in multiple ways.  

Aniruddha Singh: Megan, tell us a little about the practice setting you will be joining and what motivated you to select that job setting.

Megan Smith: I am excited to be joining a very busy practice located in a rural setting in Georgia. Our training experience has been high volume in terms of patient care and procedures, while at the same time, maintaining high expectations for academic endeavors. Not only did this teach me how to multitask on any given day, but it also gave me confidence in performing procedures and taking care of a variety of cardiovascular conditions. I think this will be invaluable moving into a rural setting. Every person deserves high-quality health care, regardless of where you live.

Singh: You have taken extraordinary efforts in strengthening the academic environment at the cardiovascular program in Bowling Green. You have been involved closely with the ACC Kentucky Chapter as an FIT representative, you have presented research every year at national and state ACC meetings, this year you helped our team to get to the ACC Jeopardy semifinals and, most importantly, I know you have worked hard for a year to get our echocardiography lab accredited. Please tell us how you balanced the clinical workload with academic activities during your fellowship.

Smith: I feel that most physicians struggle with balance, whether it be work-life, or as in this case clinical-academic. I always deem patient care of the highest importance; they deserve our best. This sentiment drives my motivation to better both myself and the environment that I work in. I try to make time at some point during the day, sometimes just a few minutes depending on the workload, to focus on academic endeavors. I set short- and long-term goals to keep myself motivated.

This fellowship program in a hybrid setting here offered me opportunities to get into academics and research activities form the beginning. We were motivated to excel academically, and I feel fortunate to have authored many first author publications and presentations at the state and national ACC level. As you said, getting the echocardiography lab accredited took significant efforts but it felt very satisfying and fulfilling and I am grateful for the opportunity.

Singh: Kris, you recently won the best researcher award. You have been very motivated to do research, having won grants and being involved in presentations locally and nationally. Tell us how you did all of that in a hybrid program knowing hybrid programs are typically not too geared towards research.

Kristopher Pfirman: Easy answer: A lot of long nights and a very patient wife!

I have always thought research to be a quintessential part of education. Being a busy community program, I only had four weeks of dedicated time in three years for "research," so I incorporated research in my day-to-day work. Keeping an open line of communication and networking with residents and fellows through social medial and meetings was incredibly helpful. It is amazing how small the world has become! We are lucky to have resources and personnel available through the Western Kentucky Heart and Lung research foundation to be able to design and complete research studies locally.

Singh: And congratulations on getting accepted to imaging fellowship in Pennsylvania. Knowing that most of the community hospitals have limited resources when it comes to cardiovascular fellowship, tell us how prepared and comfortable you felt with your decision to pursue imaging fellowship.

Pfirman: As you said, I did not have a great exposure to the imaging world. I did have a chance to go to the University of Kentucky main campus in Lexington, KY to do an elective in advanced imaging. I learned a great deal, but more importantly, I realized the potential implications that this technology has to offer. Even though I did not have a firsthand experience with imaging in our community program, I was able to get brief but meaningful exposure to imaging through my elective rotations. Although I wish we had an imaging program at our center, I am happy and grateful for the high volume of general cardiology pathology and procedures I have been exposed to. It has laid a solid general cardiology foundation for me, and I am confident in proceeding to the next level of training. I am very excited.

Thank you, Megan and Kris for sharing your experiences of training in a hybrid setting with us. I am sure a lot of early career physicians will find this useful!

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This article was authored by Aniruddha Singh, MD, FACC, Western Kentucky Heart and Lung and University of Kentucky College of Medicine.

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