Rahul Sharma, MD
A multifaceted structural interventional cardiology fellow, Sharma says the best piece of advice he’s received is to have many mentors.
Rahul Sharma, MD, is currently completing an advanced fellowship in structural heart interventions at Swedish Medical Center (Seattle, WA). A graduate of St. George’s University School of Medicine (Grenada, West Indies), he completed his internal medicine training at Pennsylvania State University Milton S. Hershey Medical Center (Hershey, PA)—where he also served as chief resident—and his cardiology training at Wake Forest University Baptist Medical Center (Winston-Salem, NC). He completed an interventional cardiology fellowship at University of Florida-Jacksonville Shands Medical Center. Sharma currently serves as a Fellow Talk blogger for TCTMD’s Fellows Forum. After training, he will be seeking a career in structural interventions, preferably in an academic environment, but is open to private practice opportunities with allowance for clinical research.
What has surprised you most about becoming an interventional cardiologist?
I’m now in my ninth consecutive year of training, so I’m sure the real world is very different from what I’ve known over the past near decade. I’m not so sure that I’ve reached the point where I can fully answer this question, but I will say that I’m getting a glimpse of it this year because the institution where I’m currently training is a large private hospital, albeit with an academic feel. Specifically, it has a private practice type of environment with some really great faculty members who are academically very productive. This has been very refreshing for me to witness, because prior to this year I was in traditional university medical center models. But now I’m starting to see how important it is for your own individual success to maintain relationships with referring doctors in the community, so that patients are referred to you when they have certain forms of heart disease that you have chosen to make your niche. In an academic setting, it’s often a given that certain patients will be referred to you. But in a large city with a lot of healthcare systems, the growth of a particular hospital and the success of a procedural-based physician are heavily linked to reputations, outcomes, bedside manner, and personality. That’s a totally different side of the business of medicine that I’m seeing now.
How do you see the field changing in the next 5 years?
As time goes on, there’s going to be less of a demarcation between where you work or what health system you are affiliated with and more of an emphasis on outcomes and the appropriateness with which you do procedures. Physicians are interestingly becoming more like individual entities as opposed to being part of a large group. Individual physicians are going to start getting scored on their application rates, their appropriateness with regard to heart catheterizations or coronary interventions, and their coronary outcomes. That information is going to be increasingly available to the public and will drive the speed at which patients are either self-referred or referred by other physicians for certain procedures. You can already see hospitals, heart and vascular institutes, and cardiac cath labs placing more of an emphasis on outcomes and performance measures, and there may be some operators who are very low volume who may be asked to stop doing procedures. That’s one of those areas that people don’t like to talk about but could very well happen.
For patients, it may become increasingly difficult to get appointments with physicians or get a test in a timely fashion compared with what it might have been 5 or 10 years ago. Even now, you often have to wait a month or two before you can get in and be seen by someone, so these changes are going to happen as some of the new initiatives with healthcare are carried forward. Whether that’s for better or worse, I don’t know. But those changes are going to have an impact on cardiology, and we’ll see how it affects the payer rates and compensation for physicians.
What is the best piece of advice your mentor has given to you?
One of my earliest mentors said to me that a smart person has many mentors. Everywhere I’ve gone I’ve been very blessed to have mentors that have invested themselves in me and my career or research goals. The best piece of advice I got was that sometimes you have to seek out that mentor/mentee relationship. It’s not always necessarily waiting for you when you show up at a new place. The fact that I prioritized that and sought that out everywhere I have gone has greatly benefitted me and has allowed me to achieve a lot of the dreams I set for myself.
Aside from that, the biggest thing I try to remember from some of my other mentors is owning the care of my patients and investing myself in their care beyond just their procedure or hospital stay. I am constantly reminding myself of the importance of that and what a great responsibility it is to take care of patients. Oftentimes they present to us in extremis and they are very sick, particularly in a cath lab setting, and I approach them with a great sense of humility and try to do the best I can for as long as they are in my care.
What are you most looking forward to after you finish fellowship?
The biggest thing is, honestly, settling down. I’ve moved around so much in the last several years and at this point I’m looking for a job where I can grow and practice the procedures and clinical skills that I’ve been taught, take care of patients, and hopefully be involved in education. But really settling down and investing in a particular job will be great. I’ve heard it said that interventional cardiologists have on average between two and three jobs in their entire career. So the idea of going at a particular place and staying there forever may not be realistic, but I am looking forward just focusing on actually practicing my career.
If you weren’t a physician, what else could you see yourself doing?
Something that people might not know about me is that when I was in college I was very interested in politics, particularly law and social policy. I got into the University of Michigan Ross School of Business and a 1-year program at the London School of Economics, but I had this moment of epiphany where I realized I wanted to be a physician. I think if I had stayed on that previous track, I probably would have been a corporate attorney. Sometimes I think about what it would have been like to go down that other path. It would have been very different for sure. But luckily I’ve been able to follow my passion.
What his nominator, Dominick Angiolillo, MD, PhD, says:
From his first days in the cath lab and throughout his year of training, Rahul demonstrated a passion for teaching our general fellows and exemplified great affinity for the technical and procedural aspects of coronary and peripheral intervention. He also engaged members of our cath lab staff in the day-to-day clinical and procedural operations of the lab, which truly demonstrated his team building skills. He was involved with many of our ongoing interventional research trials, serves as a fellow-in-training on the Society for Cardiovascular Angiography and Interventions Quality Committee, and published editorial and review articles during his year. Perhaps one of the most unique aspects about Rahul’s mindset is that even before starting his interventional fellowship, he was dedicated to pursuing an additional year of advanced fellowship training in structural heart disease. He understood that the skills and experience needed to achieve his career goals required more than a single year of training, and it is this commitment to learning and education that truly sets him apart from many of his colleagues and makes him a trendsetter for future fellows interested in pursuing subspecialties within the growing field of interventional cardiac therapies. It has been rewarding to see him grow as an autonomous operator in the lab in complex and high-risk cases with resolute decision-making skills and tremendous compassion for his patients. I am confident that he will continue to build on his strong skill set and make significant contributions to our field.