Parallax by Ankur Kalra

In this week's Parallax, Dr Ankur Kalra is joined by guests, Dr Rama Ellauzi, Dr Nandan Anavekar and Dr Anthony Kashou, also known as The EKG Guy. Together, they delve into cardiovascular education and the Global Cardiology University (GCU). The genesis of GCU traces back to Dr Kashou's time as an intern at Mayo Clinic. Recognizing the challenges of postgraduate education, Dr Kashou embarked on a journey to enhance early-level training. Drawing inspiration from his own struggle to comprehend electrocardiograms (EKGs), he set out to build a comprehensive database. This eventually led to the birth of GCU. Dr Ellauzi, Dr Anavekar and Dr Kashou share their passion for education and the devotion that drew them to the GCU. They explore the vision of GCU, which revolves around creating a community space where knowledge is shared, aligning with educational trends, and empowering learners. Through scientific content evaluation and a commitment to providing premium yet affordable materials, GCU embraces community own

In this final episode of our mini-series on value in academic medicine, Dr Ankur Kalra welcomes back Dr Nandan Anavekar, a Professor of Medicine at Mayo Clinic College of Medicine and consultant for both the Cardiovascular and Radiology Departments at Mayo Clinic, who also serves as the Program Director for the Adult Cardiovascular Diseases Fellowship program. In this inspiring conversation, Dr Anavekar and Dr Kalra discuss the education of postgraduate medical students and reflect on Dr Anavekar’s role as a Program Director. Dr Anavekar shares his motivations and the moral framework he uses to approach his responsibility towards his students. The conversation then shifts towards the learning environment provided for medical students. Dr Anavekar contrasts the prevalent competitive culture and draws on Vedic philosophies to outline how we can strive for a student-centric culture that fosters a more collaborative environment and supports autonomous decision-making. Dr Anavekar asks listeners to look at medic

In the second part of our mini-series exploring the concept of value in academic medicine, Dr. Ankur Kalra once again engages in a compelling discussion with Dr. Nandan Anavekar. Dr Anavekar, a Professor of Medicine at Mayo Clinic College of Medicine and consultant for both the Cardiovascular and Radiology Departments at Mayo Clinic, also serves as the Program Director for the Adult Cardiovascular Diseases Fellowship program. In this stimulating and thought-provoking episode, Dr. Kalra and Dr. Anavekar delve into the topic of measuring success in medicine. Dr. Anavekar puts forward the argument that the ambiguous definition of academic achievement often results in damaging biases that have long-term repercussions on the medical field. As a program director, Dr. Anavekar believes that the number of published articles should not be the only or most crucial criterion for evaluating early-career faculty. He argues that it's important to also consider the "distance travelled" by candidates. Dr. Kalra raises perti

Bullying is a phenomenon that most of us are familiar with, whether through personal experience or through the stories of friends and colleagues. But what exactly is the impact of bullying on an individual and, in turn, on their community or field of work? In the context of medical science, the consequences can be particularly dire. In the latest episode of Parallax, Dr Ankur Kalra's guests are Dr Susanne Täuber and Dr Morteza Mahmoudi. Dr Täuber, an expert in organisational behaviour, was recently terminated for speaking out against discrimination at her institution. Dr Mahmoudi is a radiologist at Michigan State University and co-founder of @AcademicParity movement. Dr Mahmoudi and Dr Täuber teamed up to explore bullying in academic settings. Together with Dr Kalra they discuss why bullies thrive in such environments and the ways institutions enable such behaviour. Dr Täuber offers solutions and a critical overview of institutional narratives, while Dr Mahmoudi highlights the long-term effects on academic

In 2018, the loss of a friend to suicide compelled Dr Anavekar to embark on a profound journey of contemplative self-exploration. Now, he uses his experience to encourage and guide trainees to pose thought-provoking questions that challenge the status quo of the materialistic approach to medicine, ultimately leading to a more outcome-focused perspective. In this week's episode of Parallax, Dr Ankur Kalra sits down with guest Dr Nandan Anavekar, a Professor of Medicine at Mayo Clinic College of Medicine and Science. Dr Anavekar also serves as a consultant for both the Cardiovascular and Radiology Departments at Mayo Clinic and is the Program Director for the Adult Cardiovascular Diseases Fellowship program. In this episode, Dr Nandan Anavekar emphasizes the importance of inner exploration for physicians. He encourages questions such as "Who am I?" and "What is this world that I reside in?" to foster a deeper understanding of the human condition and patient care. Dr Anavekar also addresses the current cultura

In the latest episode of Parallax, Dr. Ankur Kalra invites Dr. Vijay Rao, the Governor of the Indiana Chapter of the American College of Cardiology, to share his experience and insights with the audience. Dr. Rao, who also serves as the Director of Heart Failure, Cardio-oncology, and Co-Director of Anticoagulation at Franciscan St. Francis Health, discusses what initially drew him to the Indiana State Chapter of ACC. As Dr. Kalra asks Dr. Rao about the ways in which early career faculty members can get involved with the organization at a state level. Dr. Rao shares his insider tips and highlights key events where individuals can further their participation. Dr. Rao also sheds light on the governorship election process and shares his learnings from his new role. He emphasizes the importance of advocacy and describes the chapter’s efforts to amplify the voice of cardiologists in relation to Roe v. Wade. Dr. Rao encourages healthcare professionals to reframe their perspectives and get involved with advocacy. Dr

“We're providing about 20,000 different ingredients in our diet to a gut microbiome that has 4 million genes. And they're processing these 20,000 ingredients at a flood of chemicals.” In this episode of Parallax, Dr Ankur Kalra speaks with Dr. Momchilo Vuyisich, co-founder and chief science officer of Viome Life Sciences. Dr Vuyisich shares his personal journey with rheumatoid arthritis and how it led him to explore the intersection of nutrition and the gut microbiome function. He explains how the complexity of nutrition and the compounds generated by the gut microbiome can impact our health. We learn more about three compounds produced by our gut microbiome that have a strong connection with heart disease. Through this conversation, Dr Vuyisich invites us to reframe our approach to nutrition and prevention as a question of food education and data-driven science. What is the effect of red meat and processed food on our gut biome? What can we learn about prevention through understanding gut biome function?

In this week’s Parallax Dr Kalra welcomes back Dr Nijjer for their annual review of the most impactful and controversial cardiovascular trials of 2022. Dr Sukh Nijjer is a Consultant Cardiologist in the UK, he is President of the Royal Society of Medicine and Honorary Senior Clinical Lecturer at Imperial College of London. The coronary physiology trial FLAVOUR was presented at ACC.22 by Dr Bon Kwon Koo. This South-Korean study compared the safety and efficacy of FFR and IVUS-guided stenting. Dr Nijjer interprets the findings and outlines the take-home messages by describing his practice. Following this, Dr Kalra and Dr Nijjer look at REVIVED-BCIS2 presented at ESC 2022 by Dr Divaka Perera. Dr Nijjer talks about the complexity of running this study that evaluated whether revascularization by PCI can improve outcomes in patients with ischemic left ventricular systolic dysfunction compared with optimal medical therapy. They distill some of the nuances for practice. Dr Nijjer summarises the all-comers PROTECTED

Parallax features a guest episode from the new podcast Neurophilia by Nupur Goel. Do you think and act with your mind or heart? How about both? Neurocardiology refers to the intersection between the fields of neurology and cardiology. The mind and heart are deeply interconnected in terms of anatomy, physiology, and various pathologic states. This episode features a vascular neurologist and an interventional cardiologist who will discuss the relationship between their two fields of medicine. Dr. Blake Buletko is a vascular neurologist at the Cleveland Clinic. He completed his residency and fellowship training at the Cleveland Clinic and was the former medical director of their mobile stroke program. In addition to his clinical responsibilities, Dr. Buletko serves as an Assistant Professor at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University and is the current Program Director of the Adult Neurology Residency program for the Cleveland Clinic. Dr. Ankur Kalra is an intervent

“Medical school cannot, and should not, feel easy—but it should feel worthwhile” – these are the opening words of Dr Kittleson’s book, Mastering the Art of Patient Care. Dr Kittleson’s book is not only a great resource for patient care, but a heartful companion to early career faculty as well. Dr Kalra’s guest on Parallax this week is Dr Michelle Kittleson, Professor of Medicine at Cedars-Sinai, Director of Education in Heart Failure and Transplantation and Director of Heart Failure Research at the Smidt Heart Institute. Coming from generations of doctors, Dr Kittleson describes herself first and foremost a dedicated clinician. With her new book, Dr Kittleson offers her mentorship and shares her advice on how to make patient care fulfilling for both clinicians and patients. In this rich and insightful discussion, Dr Kittleson talks about the origins of famous #kittlesonrules, a collection of tips for doctors shared on Twitter, and her thoughts on mentorship. We learn more about Mastering the Art of Patient

“The hospitals like things just the way they are. It gives them almost complete immunity for any peer reviews, good faith, or bad faith, that they conduct against a physician.” The Health Care Quality Improvement Act of 1986 considers accused physicians to be guilty of the charges unless and until they can prove their innocence. Over the years many hospitals abused the peer review system to extort and silence competent physicians. Dr Lawrence Huntoon, Editor-in-Chief of the Journal of the Association of American Physicians and Surgeons, returns for a deep dive into the topic of the hospital peer review system. In this second episode of our medico-legal series, Dr Kalra invites Dr Huntoon for an overview of the key terminologies and processes of the hospital peer review system. Dr Huntoon summarises some of key actions you can take as a physician to prepare and defend yourself. We learn more about different sham peer review tactics through recent cases. Dr Huntoon shares his thoughts on what we can do to

“Sham peer review or malicious peer review is defined as the abuse of a medical peer review process to attack a doctor for personal or other non-medical reasons.” “Most doctors — warns Dr Kaki — do not understand that ultimately your privileges are not dictated by your colleagues through a fair process, but hospital administration controls our destiny”. In 2018, Dr Kaki was subject to a campaign of retaliation that set out to revoke the well-respected cardiologist’s privileges. Today, Dr Kaki is Director of Mechanical Circulatory Support at Ascension and Clinical Associate Professor at Wayne State University School of Medicine. In this week’s Parallax Dr Kalra’s guests are the team that fought for justice in Dr Kaki’s case: Dr Lawrence R Huntoon, Editor-in-Chief of the Journal of the Association of American Physicians and Surgeons and Deborah Gordon, employment attorney. Dr Kaki walks us through his Kafkaesque experience and the knowledge he acquired during his battle with his former hospital. We get insig

In 2017, Rohin Francis AKA Medlife Crisis uploaded a YouTube video titled “Leonardo da Vinci's theory about the heart was right”. This first video about how the heart valves close was watched by 412K people, garnering more than 700 comments from a diverse audience who connected to the subject with fascination, curiosity and humour. This week’s guest on Parallax is Dr Rohin Francis, Consultant Interventional Cardiologist at East Suffolk and North Essex NHS Foundation Trust and prolific YouTuber. Rohin believes that authenticity is one of the keys of his videos’ success. When asked about his journey to medicine he summarises: “I was being rebellious and ended up doing the most cliché job for an Indian possible.” He turns the table and asks Ankur what he think is behind the stereotype of the Indian cardiologist. Rohin shares an advice that he received at the beginning of his career: “If you can deal with an average day, the exciting day will take care of itself.” Ankur asks Rohin about Medlife Crisis and the w

This week’s episode is dedicated to one of the biggest cardiovascular meetings, AHA’s Scientific Sessions. Dr Ankur Kalra’s guest is Dr Manesh Patel, chair of the AHA Committee on Scientific Sessions and Chief of the Division of Cardiology and Co-Director of the Heart Center at Duke University. Year on year, the organisers of the Scientific Sessions aim to give platform to cardiovascular science at its best: innovative, impactful, and collaborative. In this information-packed episode, Dr Patel takes us behind the scenes and talks about the work that goes into the curation of the programme and the considerations that shape the event. Dr Kalra asks Dr Patel about his highlights over the years and the movement and changes that he observed as vice chair and chair of the event. Dr Patel elaborates on the key late-breaking science trials in 2022. Dr Kalra and Dr Patel discuss the grading system of the award applications and share some useful information with our listeners. What does Dr Patel think about the funct

This week's Parallax is hosting a guest episode recorded for Internal Medicine & Beyond. Tune in to this new podcast from Dr Varun Aitharaju. Exploring Art & Advancement Within Medicine - A Conversation with an Interventional Cardiologist Dr. Ankur Kalra MD is an interventional cardiologist, entrepreneur, poet, and podcaster. In this episode, he discusses his journey in cardiology. He shares his non-clinical passions, including leading a non-profit organization and publishing a poetry book, and provides advice to future physicians on how to balance clinical medicine with other passions. Tune in for an extremely inspirational episode!

This week’s Parallax episode is focusing on the latest science and questions surrounding one of the conundrums of cardiovascular science: Lipoprotein(a). Dr. Ankur Kalra invites Dr Salim S Virani to help simplify the concept of Lp(a) with answering key questions about its measurement and its place in practice and prevention. Dr Virani is a Professor at Baylor College of Medicine, Director of the Cardiovascular Disease Fellowship Program and Vice Provost of Research at Aga Khan University from early next year. Lp(a) was first described in 1963. Since then, many epidemiologic studies have noted association of high Lp(a) levels with elevated risk of cardiovascular disease, however, the role of this particle remained a conundrum (Kamstrup, 2017). New data from the development of novel drugs are offering strong evidence on the causality between Lp(a) and ASCVD and AVS (Kronenber et al. 2022). Dr Virani, one of the authors of the new European Atherosclerosis Society consensus statement on Lipoprotein(a) in athero

Back by popular demand, Dr Ankur Kalra's guest is Dr Purvi Parwani, Director of Women’s Cardiovascular Disease Clinic and Assistant Professor at Loma Linda University Medical Center, US. In this ESC 2022 edition of Parallax, Ankur asks Purvi to review her highlights of the congress. Purvi details the study design and key findings of each trial and provides her insights after attending the event in Barcelona. Ankur and Purvi discuss how each trial will inform their practice. Trials covered in detail include: - REVIVED: Study of Efficacy and Safety of Percutaneous Coronary Intervention to Improve Survival in Heart Failure (NCT01920048) - DANCAVAS: Danish Cardiovascular Screening Trial II (NCT03946410) - DELIVER: Dapagliflozin Evaluation to Improve the LIVEs of Patients With PReserved Ejection Fraction Heart Failure (NCT03619213) - SECURE: Secondary Prevention of Cardiovascular Disease in the Elderly Trial (NCT02596126) - INVICTUS: INVestIgation of rheumatiC AF Treatment Using Vitamin K Antagonists, Rivaroxab

Dr Sohail Khan was working as an interventional cardiologist in Salt Lake City, but he was growing more and more skeptical of the corporate aspects of his job. He had a dream about moving back to Pakistan and building a hospital there. Following the death of a colleague, he decided to take a leap. In this inspiring episode, Dr Ankur Kalra’s guest is Dr Sohail Khan, Chief Operating Officer at the National Institute of Cardiovascular Diseases in Karāchi. Dr Khan talks about education in the US and his decision to move back to Pakistan. Ankur asks Sohail about his new professional home: NICVD, a free clinic providing primary heartcare for Pakistanis. They discuss some of the innovations Dr Khan works on to improve patient care that utilise simple but effective interventions. We learn more about free screening clinics and about Dr Khan’s work on the largest ever study in Pakistan on association of Lpa and CV disease in South Asians. What were the considerations for Dr Khan when he decided to move to Pakistan?

Dr Dipti Itchhaporia, 70th President of American College of Cardiology (ACC), always met her fears with actions. One of her motivations to become a cardiologist was to be able to act in the face of acute situations. When Dr Itchhaporia, the fifth woman and the first of South Asian descent to fill in this position, was asked to summarise her presidential year, she answered: flourishing in opposition of languishing. Dr Ankur Kalra’s guest in this episode of Parallax is Dr Dipti Itchhaporia, ACC Immediate-Past President, an interventional cardiologist and the Eric and Sheila Samson Endowed Chair in Cardiovascular Health, director of disease management for Hoag Heart and Vascular Institute, and associate professor at the University of California, School of Medicine. In this personal interview, Dr Itchhaporia recalls her early years and the influences and decisions that led her to medicine and cardiology. She talks about her connection to ACC and the importance of choosing a professional home where one can find

“Seek refuge in the attitude of detachment and you will amass the wealth of spiritual awareness. The one who is motivated only by the desire for the fruits of their action, and anxious about the results, is miserable indeed.” Bhagavad Gita In medical school, Dr Chinnaiyan was fascinated with embryology. The question that used to hunt her was how does once cell know to differentiate into so many different organs: what is that knowledge? In this week’s Parallax, Dr Ankur Kalra welcomes back Dr. Kavitha Chinnaiyan cardiologist, Professor of Medicine at Oakland University William Beaumont School of Medicine and accomplished author. This nurturing episode focuses on questions that touch on what it is that we seek as human beings and how can we cultivate awareness and authenticity while practicing modern medicine. Ankur asks Kavitha about what it means to be spiritual as a cardiologist. Kavitha talks about the experiences made possible by mindfulness. They discuss the difference between conditioning and growth.