Session 71 Dr. Serena Sah is an academic Pediatric Cardiologist in the California area. We talk about what drew her to the specialty, what she likes about it, and more. Serena has been out of training now for three years. By the way, do you know of someone whom you think would make a great guest on this show? Email me at ryan@medicalschoolhq.net. [01:25] Her Interest in Pediatric Cardiology Serena enjoys working with kids so she knew she wanted to do Pediatrics. She had a six-month-old cardiac patient that had an interesting physiology. Knowing nothing about cardiac disease, she was freaking out and that encounter with the patient was what really got her intrigued by the physiology of the heart. Additionally, pathophysiology made sense to her. She likes being able to figure out the causes of the disease. Going through medical school, she initially didn't have that interest in Cardiology as much as when she encountered that experience. She thought she would do general pediatrics at first but she already had the mindset of going into cardiology. She admits her intern year was rough and thought of not going any further. But that rotation in cardiology and her interest just peaked again. She also considered neonatology which had intensive care to it. Still, she was interested in the cardiac patients. [07:11] Traits that Lead to Being a Good Pediatric Cardiologist Serena says you have to enjoy working with kids and being around kids a lot. Understand that pathophysiology is interesting to you. Some of these kids can get pretty sick so just having a sense of calm under stressful situations. "You have to be able to know that you'll see kids of both spectrums of severity of illness. You have to be comfortable in that kind of environment." [08:25] Types of Patients and Her Typical Week A lot of the patients that get referred into their clinic are teenagers with chest pains, fainting spells, arrhythmia, or minor heart diseases. She would also have a portion of patients where she does neonatal surgery or infant surgery where patients are born with a single ventricle. They would need to have a series of operations and you need to follow them throughout their life. Basically, it's a good mixture of people who have cardiac-related symptoms, heart murmurs, and those diagnosed during their neonatal period and she just follows them through. Of her patients who come in already diagnoses, Serena calculates it's about quarter to a third of them and she's just following them up. The next quarter to half of them are people that come in with symptoms and they diagnose it. Also, a quarter of them get screened but get discharged without any cardia diagnosis. Serena works at an academic institution with a large group of cardiologists or pediatric cardiologists so majority of their time is spent on outpatient. Then they do a rotation of inpatient service a week at a time and it happens less frequently. Her typical week would be one to two days of outpatient clinic. She reads heart ultrasounds for 2 to 2 1/2 days of the week. She also does a couple of half day sessions of administrative time or research time. [12:37] Academics vs. Community Serena chose academics over community for convenience. She felt she could go either way. But she enjoys teaching trainees. In fact, she looked to both places but it just worked out that her home institution had a position that opened up so she grabbed it. And it worked geographically. "It wasn't the only thing I was looking at, but it ended up being where I was at." [13:40] Doing Procedures, Work-Life Balance, and Taking Calls As a pediatric cardiologist, cardiology is one specialty in pediatrics that is a medical specialty but provides a way for you to do hands-on things. They have a specialty in catheterization and put on cats and heart stents. You can also go into cardiac ICU as a subspecialty which is a third level of training. Then you can do a lot of procedures. Doing ultrasounds is not invasive but these are tw