November 30, 2016 | Fernanda Erthal, MD
International

"There is no elevator to success. You have to take the stairs." – Zig Ziglar

Recently, I was watching the Olympics games - yes, I am from Brazil and have to admit that even abroad I could not take my eyes from it – and was fascinated with the athletes. Watching the games, we get the false impression that the difference between a gold medal and no medal is a millisecond, one point, one detail. But if we take some time to look deeper, we realize that the real difference is the effort, dedication and passion of each athlete.

This is true for all fields in life. A child can keep crawling, but some day he decides to stand up and start walking. There will be many falls, but one day she will be running, jumping and one day, succeeding at what he or she wants to do.

But, is it possible to achieve success in life alone? Behind the best swimmer is a tireless coach, a great training center, modern equipment and a team of physiotherapists, physicians and psychologists. A parallel comparison can be made with a cardiology fellowship. After several years studying hard to become a thoughtful and competent cardiologist, many will have the feeling that it is possible to achieve more. We want that “one millisecond” difference and decide to apply for a fellowship position.

Besides all hard work we have already done, we must now work even harder – to become a subspecialist – the reference in your field of interest – and we need to find our fit within these future expectations.

The first step, and the most important one, is to decide which area to pursue. It’s time to choose and follow what you really love to do. As Steve Jobs said, “Your work is going to fill a large part of your life, and the only way to be truly satisfied is to do what you believe is great work. And the only way to do great work is to love what you do.” Everything becomes easier when we do what we love to do – success will be a consequence of the hard work.

The second step is choosing your future training center. A good runner can train on the streets, but the best one needs a coach and more infrastructure. Investing some time in researching the hospitals to understand the fellowship program, the research interests, and who the leaders in the field may be, are all keys. Having a match between expectations and what can be offered is already half way to a good fellowship. At this point, big decisions have to be made and may include moving (perhaps with one’s family), starting from the beginning and very hard work – but it’s worth it!

An excellent fellowship needs a good environment, institutional resources, great staff, research opportunities and mentors. Ah, mentors - perhaps one of the most important pieces. A mentor may be  a coach, a cardiology-example, someone who is supportive and wants to enable you to ‘grow up’ in the field! A coach with whom you want to work together, be helpful and (even if a small) part of his or her work and success. The exchanges between a mentor and a fellow can be multiple and very rich. The fellowship is a great opportunity to create ties with leaders, absorb their knowledge and wisdom and be proud of working with them.

A fellowship is like a marathon though, rather than a sprint. Everyone starts together in medical school – 10 – 12 years pass. Life is different for each one, and sometimes we decide to take short-cuts, run 15 km or half-marathon – and there is no problem with that. For others, to run 42 km is the goal, since all preparation was done to perform in the best way possible. Some will need to change and adapt the pace along the run – and they too will achieve the 42 km. The time may be different for each one, but enjoy the run, make friends along the path, working hard, having a great mentor and choosing a great training center will put you in a position taste victory. The rest is up to you – good luck!

But, like a great race, in the end, a great fellowship is something that fulfills your expectations where you will discover that “the harder you work, the more luck you seem to have” (adapted from Thomas Jefferson).

The author would like to express sincere gratitude to Rob Beanlands, MD, FACC, chief of the division of cardiology at the University of Ottawa Heart Institute for his contributions and guidance to this article. 

This article was authored by Fernanda Erthal, MD, a Fellow in Training (FIT) at the University of Ottawa Heart Institute, Ontario Canada.