Investing in our future: Update on the SCAI Emerging Leader Mentorship (ELM) Program

The field of interventional cardiology has undergone rapid and spectacular transformation. In the last decade alone, we have witnessed the evolution of coronary, structural and peripheral interventions, including transcatheter aortic valve replacement (TAVR), novel mechanical support devices for high-risk percutaneous coronary interventions (PCI), bioabsorbable coronary scaffolds, as well as new catheter-based therapies for venous thromboembolic disease, alternative arterial access approaches for critical limb ischemia, and drug-eluting technology for endovascular arterial interventions. Our field has benefited from inspirational and innovative leaders like Drs. Gruentzig, Judkins and Hildner who have propelled us forward with their spirit, creativity and vision. Although the future of our specialty is bright, it is not without its challenges. We live in an era of ongoing health care reform, stricter industry relations policies, and fewer resources to support academic medicine. Now, more than ever, we need strong leaders to help develop a system that works not just for physicians, policymakers and payors but, importantly, for our patients. Emerging young leaders, mentored by current societal and organizational leadership, are needed on multiple fronts—to advance a culture of technological innovation, research, education, advocacy and quality, so that we may continue to “save and enhance patients’ lives.” How do we identify individuals with great leadership potential? How do we help them acquire and hone the tools necessary to become tomorrow's leaders? How do we help them find and choose paths toward leadership? In 2010, rather than passively waiting for “born leaders” to declare themselves, the Society for Cardiovascular Angiography and Interventions (SCAI) proposed to the American College of Cardiology (ACC) and the Cardiovascular Research Foundation (CRF) that we embark on a novel, active approach and launched the Emerging Leader Mentorship (ELM) Program. The idea was simple yet bold: To identify early career interventionalists proactively, and by doing so, create an interventional cardiology leadership pipeline. The three organizations, by combining their efforts, hoped to inspire these individuals to achieve greater goals, motivating them and giving them the tools needed to realize their full leadership potential. Inspired by the words of John F. Kennedy, Jr., “Efforts and courage are not enough without purpose and direction”; ELM would provide this “purpose” and “direction” to our young leaders. The ELM program sought to tap into the large pool of young, talented and willing individuals who were not yet fully engaged in a leadership capacity. The potential talent pool was to include early career interventional cardiologists from a variety of practice settings. Ten to twelve ELM Fellows, selected through a formal application process, would embark upon two years of intense leadership training. At its inception, the training program included pairing with established leaders who would serve as mentors, and invitations to serve on organizational committees and/or as faculty in scientific programs. Iterated over time, the program now includes opportunities to participate in a number of formal training and satellite sessions on topics such as professional societal history and vision and prospective leaders are taught about health care reform, ethical and effective industry relations, media relations, the Food and Drug Administration (FDA) and the Centers for Medicare & Medicaid Services (CMS) approval process, political advocacy, professional education and scholarship, and how to succeed in various practice settings. A variety of noteworthy speakers have presented material on the changing landscape of interventional cardiology and the relationships between academia, the private sector and government. As an example, at the ACC Annual Scientific Sessions 2016, ELM fellows participated in a pivotal Q&A session with a distinguished panel of experts including Dr. Robert Califf (FDA Commissioner) and Dr. Charles Simonton (Chief Medical Officer, Abbott Vascular). In addition, there have been several planned trips to the ACC Heart House, SCAI headquarters in Washington, DC and CRF in New York City. The ELM fellows have had the opportunity to interact with faculty and staff, provide input and strategize for future meetings, and develop ways to engage younger faculty and fellows-in-training. To date, three classes—including 34 ELM fellows—have participated in the program. Many have already assumed prominent leadership positions at their institutions or within the interventional community. The application process for the ELM program begins in the Fall on a two-year cycle. Candidates must be 3-8 years out of interventional cardiology fellowship training and can be in either private practice or an academic setting, and from either an adult or pediatric field. At least one fellow specializing in pediatric interventions is selected each cycle. Selection has historically been competitive, with a steering committee carefully selecting less than 10% of candidates. An added value of applying to the ELM program is that the SCAI ELM committee provides guidance and mentorship to those who expressed an interest even if not selected as ELM Fellows. A number of the ELM program noteworthy accomplishments follow: These are a few successes among many. We are extremely proud of the ELM program and the way in which ELM fellows contribute to the initiatives of our professional societies and organizations. In a recently conducted survey of ELM fellows, aimed at quantitatively assessing the impact of the ELM program and identifying potential areas of improvement (Figure), ELM fellows were asked if they would recommend the program to colleagues with leadership potential. The overwhelming response was “yes”, weighted average 9.5 (0/no-10/yes scale). When ELM fellows were asked to reflect about the program and the best features of the program, the feedback was incredibly positive: “networking and professional development”, “enabled me to identify the best way forward”, “becoming a part of SCAI family and contributing to its growth”, “building relationships with new colleagues and friends”, “camaraderie”. The feedback from the mentors and ELM fellows has been an important driving force to continuously improve the program as it has evolved over the last 6 years. New initiatives include the creation of regional SCAI-RITE teaching courses, establishment of an ELM FIT track with mentorship by the exiting class of ELM Fellows, and the creation of 2-year ELM research track fellow positions with financial support. The success of the program has been fostered by the great collaboration between various stakeholders and visionary senior leaders within SCAI, ACC, and CRF, as well as the unwavering support from our partners in industry through educational grants. Our field may have many challenges ahead, but the future of our specialty will be bright if enthusiastic individuals continue to apply to the ELM program, demonstrate willingness and ability to contribute to the field, and set an example for others to do the same. Applications for the 2017–2019 ELM class are due November 30, 2016 through an online process available on the SCAI website at: www.scai.org. Figure legend: Survey questions and responses by the ELM fellows (24 participants). Scale 0-10 (0 – Not at all helpful, 10 – Extremely helpful).

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