Farewell Advice for Graduating EP Fellows

The June 2011 EP Lab Digest editorial (“Ten Commandments for EP Fellows”; Volume 11, Issue 6) was devoted to advice for incoming EP fellows with the purpose of optimizing the training experience. This editorial is devoted to advice for EP fellows who are graduating and beginning their career.

#1.  Carry the patient on your back.   
When you perform a procedure on a patient, he or she is in your hands during and after the procedure until the condition has been treated. You are ultimately responsible for the patient and managing any complications.

#2.  Maintain and improve your procedural skills.    
It is important to have sufficient procedural volume during your career to not only maintain your current skills, but to build on them as you transition from being simply competent to being an expert. 

#3.  Adopt new technology.  
Since its inception, the field of EP has been frequently disrupted by new procedures and technologies, such as advanced mapping systems, cardiac resynchronization therapy, and catheter ablation for atrial fibrillation. It is easy to quickly become obsolete unless you adapt and learn new skills.

#4.  Treat each patient as an individual.   
Try to balance the need for high procedural volume with caring for each patient as an individual and customizing your treatments.

#5.  Have an adjustable speed. 
Learn how to stay in first gear and unhurried during critical components of EP procedures, but also be able to shift to a high gear during less critical parts of procedures when speed is important. This will allow you to be efficient while maintaining good outcomes.

#6.  Learn to avoid distractions in the EP lab.
When you are in the middle of a critical part of a procedure in the lab, learn how to ignore distractions from ancillary staff, side conversations, pagers, cell phones, etc. Multitasking in the EP lab can be dangerous.

#7.  Communicate with referring physicians.    
A phone call should be made after every procedure to update the referring physician.

#8.  Communicate with the families.
Family satisfaction is as important as patient satisfaction. Establish a relationship with the family before the procedure if possible, and keep the family updated during and after the procedure.

#9.  Balance your time.    
Figure out how to balance your family life and your work life. Hobbies come second.

#10. Follow your interests.    
Career decisions should be made based on your interests, strengths, and opportunities rather than finances, trends, or peer pressure.

Good luck to all of the graduating EP fellows! May you live long and prosper… and remain in sinus rhythm.