Philipp Wiesner, MD
Realizing that his planned career in basic science wasn’t what he wanted, this German-born interventional fellow shifted gears into clinical work.
Philipp Wiesner, MD, is a second-year interventional cardiology fellow in structural heart disease interventions at the Banner – University Medical Center (Phoenix, AZ). Originally from Germany, Wiesner was educated at Ulm and Regensburg University, Germany, and moved to the University of California, San Diego, to complete a postdoctoral fellowship with the intention of staying within basic science. After a change of heart, he completed his internal medicine residency at the same institution and then moved on to the University of California, Los Angeles, to train in general cardiology. During that time, he completed an interventional cardiology rotation at the Second Affiliated Hospital of Zhejiang University (Hangzhou, China). From there, he completed a fellowship in interventional cardiology at Columbia University Medical Center (New York). Wiesner has co-authored more than a dozen articles in peer-reviewed journals and has presented research around the country. After his fellowship, he will join Ferrell-Duncan Clinic/Cox Health (Springfield, MO), where he will be able to perform both coronary and structural cases in a setting that also allows him to stay connected with clinical research.
Tell us about yourself and how you’ve gotten to this point in your career.
I was born and raised in Germany in a small town called Amberg. I first came to the United States during my final year of medical school for an away rotation. I was always interested in research, so I applied for and received a 2-year research scholarship at UC San Diego in California. My plan back then was to do 2 years of basic science research and then return to Germany to embark on an academic career as a basic scientist. But when one of my research mentors took me to the hospital during my time in San Diego, I ended up liking the clinical side more. I decided to do my USMLE steps and then eventually applied for residency at UC San Diego. This is also where I met my fiancée. After finishing my cardiology training at UCLA, I moved to Columbia University in New York for interventional cardiology. When my fiancée was offered a position as a chief medical resident back at UC San Diego, I had to find my way back closer to the west coast. Dr. Ashish Pershad had an open position in Phoenix, which was very much to my liking and was a great fit, so I decided to come here for a year to finish up my training. It's been a long journey.
Why did you decide to pursue a career in interventional cardiology?
Initially I was very interested in procedures. My father was a trauma surgeon at the local hospital in the town where I grew up. He was extremely hardworking, and as a kid I sometimes would go with him to the hospital at night when he got called back to the emergency room for evaluations. I really liked that it seemed very easy for him to make a difference in patients' lives, sometimes even within minutes—somebody would come in with a cut or a broken bone and he could fix it on the spot. When I got to medical school and was exposed to research, I became more interested in basic science and thought I wanted to pursue a research career. However, I had a change of heart when I became re-exposed to clinical work. During residency and fellowship, I noticed that I missed the procedural aspects of my training and I decided to spend more time in the cath lab. I realized that interventional cardiology allowed me to integrate my interest in procedure-based clinical work with clinical research. There are not many specialties where you can make such an immediate difference in patients’ lives.
What advice would you give to someone who might be thinking about making a similar kind of transition from more basic science to clinical work like you did?
I think most of us have to decide to do one or the other. It's very hard to be active in both basic science and a procedural field like interventional cardiology and do them both well. When you are a basic scientist, you're competing with people who dedicate their entire day to experiments as well as reading and writing grants and papers. All of those activities take a lot of time. As a proceduralist, I think you owe it to your patients to dedicate yourself to improving your skills, and that takes a lot of time too. The day has only so many hours. From my experience, there’s a time when you have to decide where your heart is and focus on that. Ask yourself: do I want to be more of a proceduralist or do I want to be more of a basic scientist? I learned in my career that doing both at the same time is very, very challenging and I’ve seen a lot of other trainees, and even some of my colleagues, fail trying. Everyone has the idea at the beginning of their careers that they can excel at both simultaneously, but I have found that to be exceedingly difficult to do.
Looking back, what would you say has been your most meaningful clinical experience so far?
Hands down, it was my time spent at the Second Affiliated Hospital of Zhejiang University (Hangzhou, China) on an interventional cardiology exchange program with UCLA. As a second-year fellow, I was the second person who participated in this 1-month rotation. We were able to be interventional fellows in China and we were treated like one of their fellows. Over there, the volumes are a lot higher compared with the United States—a single cath lab in China can accommodate up to 30 interventional procedures a day compared with maybe 10 here in the US. It's a mix between diagnostic and interventional cases, but their efficiency is mind-blowing and observing their skills was a true eye-opener for me. This was such a meaningful clinical experience, because I saw how interventional cardiology is practiced in a different country and in a different healthcare system. There’s a big difference in how fellows are trained and how much autonomy they get. In China, I was able to do my first supervised interventions as only a second-year general cardiology fellow, which was nice because that rarely happens in the US.
What do you think is the biggest challenge facing interventional cardiology fellows today?
One big challenge right now, especially as we look for jobs, is that the first job that you get might not exactly allow you to do everything that you trained for. The standard 1-year interventional cardiology fellowship for most programs covers coronary work, maybe some peripheral and structural work, but usually has a low volume for structural cases. After that, you have to decide if you want to add on another year to do more advanced training, whether it is for CTOs, peripheral, or structural interventions. While that is certainly neat and nice, you also have to find a job eventually. Unfortunately, especially for those with advanced training, there are not as many jobs out there as there are for coronary operators. Making the decision to spend the time to do another year of training and then possibly facing the challenge of not finding a job where your advanced skills are actually needed is one of the biggest challenges right now. I hope in the future that our system will change to a standard 2-year fellowship for everybody. As most of the interventionalists nowadays are getting more involved in more complex coronary procedures, large-bore access, and structural and peripheral procedures, I think it might make sense to add on a standardized second year to better cover those procedures as well, at least to some extent.
What are you most looking forward to after you finish your fellowship?
Being able to live together with my fiancée. That has been a struggle in the last several years, because we have been separated due to being at different training programs. Now as we both finish our training, we will finally be able to make this a reality. That is what I am looking forward to the most.
What is something that people might not know about you?
I'm actually a pretty good chef, when I have the time to cook. My grandfather got me into it. He was an amazing chef and I loved watching him in the kitchen as a child. He grew everything in his backyard and given that we had pretty strong winters in Germany, it really required a lot of skill and creativity on his end to get dishes together that tasted good and came out well. I liked that and have always maintained my cooking skills on the side. It's a nice change to come home from the hospital at night and do something completely different to clear your mind. My favorite dishes to cook are traditional German dishes that my grandfather taught me like krautwickel or rouladen. I also love pizza.
What his nominator Ashish Pershad, MD (Banner – University Medical Center, Phoenix, AZ), says:
Philipp came to us from Columbia University Medical Center's Interventional Fellowship. His leadership and mentorship of the interventional and general fellows at the university is apparent on a daily basis. He takes the time to support their cases in the lab and guide them through research. He invested in our program from day one, helping even attending physicians become more proficient in newer techniques, such as brachial access for right heart catheterizations and nuances to negotiate tortuosity in the arm regarding radial access. He has even helped to broaden our perspective regarding use of specific catheters. Philipp's reach goes far beyond those who work side by side with him as he has improved processes and procedures that affect the entire hospital.
*To nominate a stellar cardiology fellow for the Featured Fellow section of TCTMD’s Fellows Forum, click here.