With a rigorous academic foundation from Weill Cornell Medical College and specialized training from both the University of Pennsylvania and Stanford University, Dr. Brant Ullery has firmly established himself in the realm of vascular and endovascular surgery. His work primarily revolves around the development of innovative endovascular aortic interventions and the in-depth study of aortic and branch vessel reconstructions.
Upon joining Providence Heart and Vascular Institute in 2015, Dr. Ullery expanded his responsibilities by taking on the role of Medical Director of Vascular and Endovascular Surgery in 2019. Recognizing the intricate relationship between medicine and business, he obtained an MBA with a focus on healthcare management.
In this discussion, Dr. Ullery provides a direct and insightful look into the challenges and rewards of a career in vascular surgery. He discusses his early experiences, the importance of interdisciplinary collaboration, and the evolving business dynamics of healthcare. Join us as he offers invaluable advice for residents and fellows that is rooted in his own journey.
Shortly after you completed your residency/fellowship training, was there a therapy area or subject matter you wish you were taught or had more experience in?
I was pretty comfortable with the standard treatments when I began my career. However, I soon realized my education was far from over. New techniques and devices came out within months of starting my practice. To catch up, I worked with my colleagues in interventional cardiology and representatives from medical companies to learn about many exciting new treatment methods. In my first three years, I performed several procedures that I hadn’t learned much about during my training, including transradial access, transcarotid artery revascularization, physician-modified endografting, and in-situ laser fenestration.
Many residents and fellows leave training with a sense that they aren’t fully ready for clinical practice. Do you remember a time when you felt like you weren’t ready for “prime time”? How did you overcome this?
I can totally relate; my experience is pretty common. I was confident in my medical skills after training, but I was kind of at a loss when it came to using these skills to the fullest. I mean, how do you collaborate effectively with other specialties or lead the charge on big projects, like setting up an aortic center, or limb salvage center, or getting administrative approval and funding for something like a high-tech hybrid room. Once again, I talked to colleagues from the industry, mentors from my training days, and other peers at similar stages in their careers. They all gave me valuable insights into how to “build a brand” for myself and for the institution I was part of.
Considering you’re well-published and have extensive experience in medical research, how would you recommend a fellow get involved with clinical trials and/or establish collaborative research with other specialists?
This is a terrific question and not just for those who see themselves as career academics. One of my most rewarding experiences has been building a robust clinical research portfolio, even though I’m based in a community practice. You’d be surprised; a lot of meaningful clinical research, including clinical trials, is increasingly performed outside the traditional academic settings. If you’re planning to include research in your career, my first piece of advice would be to get to know your local Institutional Review Board (IRB) representatives and research coordinators. They’re a gold mine of knowledge. You see, there is a whole lot of behind-the-scenes work that goes into getting a research project up and running. Having an understanding and appreciation for the continuum of a research trial — from the early planning stages to budget considerations and meeting IRB requirements — gives you a clear-eyed view of what modern research looks like, whether you’re in an academic setting or not.
When it comes to treating challenging calcified plaque in the periphery, what’s your go-to algorithm?
Calcification remains the Achilles heel of peripheral vascular interventions. It can pose a major limitation for plain old balloon angioplasty, local drug (Paclitaxel) absorption, and stent expansion. Increasingly, I find that some form of debulking or plaque modification is necessary to optimize the efficacy and durability of my intervention in these select cases. Depending on the location (femoropopliteal vs. tibial), this may include atherectomy, intravascular lithotripsy, or lower threshold for a mechanical scaffold (e.g. self-expanding stent).
With a rigorous academic foundation from Weill Cornell Medical College and specialized training from both the University of Pennsylvania and Stanford University, Dr. Brant Ullery has firmly established himself in the realm of vascular and endovascular surgery. His work primarily revolves around the development of innovative endovascular aortic interventions and the in-depth study of aortic and branch vessel reconstructions.
Upon joining Providence Heart and Vascular Institute in 2015, Dr. Ullery expanded his responsibilities by taking on the role of Medical Director of Vascular and Endovascular Surgery in 2019. Recognizing the intricate relationship between medicine and business, he obtained an MBA with a focus on healthcare management.
In this discussion, Dr. Ullery provides a direct and insightful look into the challenges and rewards of a career in vascular surgery. He discusses his early experiences, the importance of interdisciplinary collaboration, and the evolving business dynamics of healthcare. Join us as he offers invaluable advice for residents and fellows that is rooted in his own journey.
Shortly after you completed your residency/fellowship training, was there a therapy area or subject matter you wish you were taught or had more experience in?
I was pretty comfortable with the standard treatments when I began my career. However, I soon realized my education was far from over. New techniques and devices came out within months of starting my practice. To catch up, I worked with my colleagues in interventional cardiology and representatives from medical companies to learn about many exciting new treatment methods. In my first three years, I performed several procedures that I hadn’t learned much about during my training, including transradial access, transcarotid artery revascularization, physician-modified endografting, and in-situ laser fenestration.
Many residents and fellows leave training with a sense that they aren’t fully ready for clinical practice. Do you remember a time when you felt like you weren’t ready for “prime time”? How did you overcome this?
I can totally relate; my experience is pretty common. I was confident in my medical skills after training, but I was kind of at a loss when it came to using these skills to the fullest. I mean, how do you collaborate effectively with other specialties or lead the charge on big projects, like setting up an aortic center, or limb salvage center, or getting administrative approval and funding for something like a high-tech hybrid room. Once again, I talked to colleagues from the industry, mentors from my training days, and other peers at similar stages in their careers. They all gave me valuable insights into how to “build a brand” for myself and for the institution I was part of.
Considering you’re well-published and have extensive experience in medical research, how would you recommend a fellow get involved with clinical trials and/or establish collaborative research with other specialists?
This is a terrific question and not just for those who see themselves as career academics. One of my most rewarding experiences has been building a robust clinical research portfolio, even though I’m based in a community practice. You’d be surprised; a lot of meaningful clinical research, including clinical trials, is increasingly performed outside the traditional academic settings. If you’re planning to include research in your career, my first piece of advice would be to get to know your local Institutional Review Board (IRB) representatives and research coordinators. They’re a gold mine of knowledge. You see, there is a whole lot of behind-the-scenes work that goes into getting a research project up and running. Having an understanding and appreciation for the continuum of a research trial — from the early planning stages to budget considerations and meeting IRB requirements — gives you a clear-eyed view of what modern research looks like, whether you’re in an academic setting or not.
When it comes to treating challenging calcified plaque in the periphery, what’s your go-to algorithm?
Calcification remains the Achilles heel of peripheral vascular interventions. It can pose a major limitation for plain old balloon angioplasty, local drug (Paclitaxel) absorption, and stent expansion. Increasingly, I find that some form of debulking or plaque modification is necessary to optimize the efficacy and durability of my intervention in these select cases. Depending on the location (femoropopliteal vs. tibial), this may include atherectomy, intravascular lithotripsy, or lower threshold for a mechanical scaffold (e.g. self-expanding stent).
With a rigorous academic foundation from Weill Cornell Medical College and specialized training from both the University of Pennsylvania and Stanford University, Dr. Brant Ullery has firmly established himself in the realm of vascular and endovascular surgery. His work primarily revolves around the development of innovative endovascular aortic interventions and the in-depth study of aortic and branch vessel reconstructions.
Upon joining Providence Heart and Vascular Institute in 2015, Dr. Ullery expanded his responsibilities by taking on the role of Medical Director of Vascular and Endovascular Surgery in 2019. Recognizing the intricate relationship between medicine and business, he obtained an MBA with a focus on healthcare management.
In this discussion, Dr. Ullery provides a direct and insightful look into the challenges and rewards of a career in vascular surgery. He discusses his early experiences, the importance of interdisciplinary collaboration, and the evolving business dynamics of healthcare. Join us as he offers invaluable advice for residents and fellows that is rooted in his own journey.
Shortly after you completed your residency/fellowship training, was there a therapy area or subject matter you wish you were taught or had more experience in?
I was pretty comfortable with the standard treatments when I began my career. However, I soon realized my education was far from over. New techniques and devices came out within months of starting my practice. To catch up, I worked with my colleagues in interventional cardiology and representatives from medical companies to learn about many exciting new treatment methods. In my first three years, I performed several procedures that I hadn’t learned much about during my training, including transradial access, transcarotid artery revascularization, physician-modified endografting, and in-situ laser fenestration.
Many residents and fellows leave training with a sense that they aren’t fully ready for clinical practice. Do you remember a time when you felt like you weren’t ready for “prime time”? How did you overcome this?
I can totally relate; my experience is pretty common. I was confident in my medical skills after training, but I was kind of at a loss when it came to using these skills to the fullest. I mean, how do you collaborate effectively with other specialties or lead the charge on big projects, like setting up an aortic center, or limb salvage center, or getting administrative approval and funding for something like a high-tech hybrid room. Once again, I talked to colleagues from the industry, mentors from my training days, and other peers at similar stages in their careers. They all gave me valuable insights into how to “build a brand” for myself and for the institution I was part of.
Considering you’re well-published and have extensive experience in medical research, how would you recommend a fellow get involved with clinical trials and/or establish collaborative research with other specialists?
This is a terrific question and not just for those who see themselves as career academics. One of my most rewarding experiences has been building a robust clinical research portfolio, even though I’m based in a community practice. You’d be surprised; a lot of meaningful clinical research, including clinical trials, is increasingly performed outside the traditional academic settings. If you’re planning to include research in your career, my first piece of advice would be to get to know your local Institutional Review Board (IRB) representatives and research coordinators. They’re a gold mine of knowledge. You see, there is a whole lot of behind-the-scenes work that goes into getting a research project up and running. Having an understanding and appreciation for the continuum of a research trial — from the early planning stages to budget considerations and meeting IRB requirements — gives you a clear-eyed view of what modern research looks like, whether you’re in an academic setting or not.
When it comes to treating challenging calcified plaque in the periphery, what’s your go-to algorithm?
Calcification remains the Achilles heel of peripheral vascular interventions. It can pose a major limitation for plain old balloon angioplasty, local drug (Paclitaxel) absorption, and stent expansion. Increasingly, I find that some form of debulking or plaque modification is necessary to optimize the efficacy and durability of my intervention in these select cases. Depending on the location (femoropopliteal vs. tibial), this may include atherectomy, intravascular lithotripsy, or lower threshold for a mechanical scaffold (e.g. self-expanding stent).
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World's Brightest Physicians
Delivered straight to your inbox. Completely free. No spam.
When thinking about the business of healthcare, what are 2-3 concepts that you wish you knew coming out of fellowship?
Healthcare has always been a business — make no mistake about it. But the financial stress brought on by the COVID-19 pandemic has simply made that fact all the more clear. Regardless of the practice setting, whether you’re hospital-employed or in private practice, it’s important to know the ins and outs of the products you use every day. While quality and safety should always guide your decisions, being mindful of product or device choices can also make you a resourceful steward for your practice. Another area that often catches new surgeons off guard is billing and coding. As reimbursement continues to decline, it’s crucial to get proper “credit” for the procedures you are performing. My advice is to get yourself and your team trained in billing and coding early on. If possible, have one or two vascular-specific coders at your institution regularly attend your provider-surgeon meetings. This ensures everyone is on the same page and keeps your billing practice up to date, especially with new techniques, such as branched TEVAR.
You have friends and colleagues across multiple healthcare disciplines and specialties. For a young clinician, how important is networking? Are there 2-3 tips that you can pass along on how to network better or effectively?
Networking is invaluable. When entering a new institution, approach work with humility and a willingness to collaborate. Gravitate toward connections among the busiest and most social specialists and build relationships that can turn into partnerships. Don’t be afraid to ask to observe or even double-scrub in procedures to learn new techniques. For example, I had barely ever spoken to an interventional cardiologist before starting to practice, but within weeks of starting, I was regularly assisting several of them on transradial interventions and transfemoral carotid stenting. Those relationships still matter, and we often refer patients to one another.
What are some red flags to consider when looking at a practice? How important is it to not be afraid to negotiate all the tangibles (e.g., starting salary, vacation time, etc.) as well as intangibles (e.g., job perks) upfront versus after your first year in practice?
Your best chance to negotiate is before you start. Once you’re in, once they “have you,” it will likely take several years of significant contributions to the practice before you can renegotiate.
Different practice settings have varying flexibility when it comes to negotiating your contract, so it is important to understand the contracts of your prospective partners. Inquire about how often their contracts are updated to accommodate factors like individual contributions to the practice, inflation, local cost of living, tax changes, or call responsibilities. A red flag to watch for is a seasoned surgeon stuck with an outdated contract. Also, if there’s ambiguity regarding the future trajectory of salary, benefits, and time off, it’s safe to assume the terms are not going to be in your favor. Ignorance is not bliss here. You owe it to yourself to get as much clarification as possible before you sign on the dotted line.
So-called “turf wars” are inevitable in almost any workplace setting, including healthcare. How do you approach this challenge and what’s your advice for graduating residents and fellows?
It's essential to understand the local dynamics, including any "turf wars," before you settle into a job. Make sure to talk with key players in other specialties like cardiology, cardiac surgery, interventional radiology, and vascular medicine during your interviews. Ask them the tough questions, understand how well these people work together, and what the opportunities and challenges are in the institution. Additionally, find a mentor within your own vascular surgery group to help you navigate through the tricky dynamics.
When operating, if you had to choose 3 songs to play on repeat, what would they be?
I’d go with anything by Creedence Clearwater Revival, Chris Stapleton, and yes, I'll admit it — Lady Gaga.
How about movies – what are your top 3 favorites of all time?
Top Gun, Charlie and the Chocolate Factory, and Forrest Gump.
If you could go back to your late 20s or early 30s, what would you tell your younger self from a professional standpoint?
Do not let your job become your whole identity. At the end of the day, what matters most is being there for your family. Strive to keep the challenges of your professional life from slipping into your life at home. Especially given the increasing pressures of modern healthcare, the odds are ever more against us on this issue.
When thinking about the business of healthcare, what are 2-3 concepts that you wish you knew coming out of fellowship?
Healthcare has always been a business — make no mistake about it. But the financial stress brought on by the COVID-19 pandemic has simply made that fact all the more clear. Regardless of the practice setting, whether you’re hospital-employed or in private practice, it’s important to know the ins and outs of the products you use every day. While quality and safety should always guide your decisions, being mindful of product or device choices can also make you a resourceful steward for your practice. Another area that often catches new surgeons off guard is billing and coding. As reimbursement continues to decline, it’s crucial to get proper “credit” for the procedures you are performing. My advice is to get yourself and your team trained in billing and coding early on. If possible, have one or two vascular-specific coders at your institution regularly attend your provider-surgeon meetings. This ensures everyone is on the same page and keeps your billing practice up to date, especially with new techniques, such as branched TEVAR.
You have friends and colleagues across multiple healthcare disciplines and specialties. For a young clinician, how important is networking? Are there 2-3 tips that you can pass along on how to network better or effectively?
Networking is invaluable. When entering a new institution, approach work with humility and a willingness to collaborate. Gravitate toward connections among the busiest and most social specialists and build relationships that can turn into partnerships. Don’t be afraid to ask to observe or even double-scrub in procedures to learn new techniques. For example, I had barely ever spoken to an interventional cardiologist before starting to practice, but within weeks of starting, I was regularly assisting several of them on transradial interventions and transfemoral carotid stenting. Those relationships still matter, and we often refer patients to one another.
What are some red flags to consider when looking at a practice? How important is it to not be afraid to negotiate all the tangibles (e.g., starting salary, vacation time, etc.) as well as intangibles (e.g., job perks) upfront versus after your first year in practice?
Your best chance to negotiate is before you start. Once you’re in, once they “have you,” it will likely take several years of significant contributions to the practice before you can renegotiate.
Different practice settings have varying flexibility when it comes to negotiating your contract, so it is important to understand the contracts of your prospective partners. Inquire about how often their contracts are updated to accommodate factors like individual contributions to the practice, inflation, local cost of living, tax changes, or call responsibilities. A red flag to watch for is a seasoned surgeon stuck with an outdated contract. Also, if there’s ambiguity regarding the future trajectory of salary, benefits, and time off, it’s safe to assume the terms are not going to be in your favor. Ignorance is not bliss here. You owe it to yourself to get as much clarification as possible before you sign on the dotted line.
So-called “turf wars” are inevitable in almost any workplace setting, including healthcare. How do you approach this challenge and what’s your advice for graduating residents and fellows?
It's essential to understand the local dynamics, including any "turf wars," before you settle into a job. Make sure to talk with key players in other specialties like cardiology, cardiac surgery, interventional radiology, and vascular medicine during your interviews. Ask them the tough questions, understand how well these people work together, and what the opportunities and challenges are in the institution. Additionally, find a mentor within your own vascular surgery group to help you navigate through the tricky dynamics.
When operating, if you had to choose 3 songs to play on repeat, what would they be?
I’d go with anything by Creedence Clearwater Revival, Chris Stapleton, and yes, I'll admit it — Lady Gaga.
How about movies – what are your top 3 favorites of all time?
Top Gun, Charlie and the Chocolate Factory, and Forrest Gump.
If you could go back to your late 20s or early 30s, what would you tell your younger self from a professional standpoint?
Do not let your job become your whole identity. At the end of the day, what matters most is being there for your family. Strive to keep the challenges of your professional life from slipping into your life at home. Especially given the increasing pressures of modern healthcare, the odds are ever more against us on this issue.
When thinking about the business of healthcare, what are 2-3 concepts that you wish you knew coming out of fellowship?
Healthcare has always been a business — make no mistake about it. But the financial stress brought on by the COVID-19 pandemic has simply made that fact all the more clear. Regardless of the practice setting, whether you’re hospital-employed or in private practice, it’s important to know the ins and outs of the products you use every day. While quality and safety should always guide your decisions, being mindful of product or device choices can also make you a resourceful steward for your practice. Another area that often catches new surgeons off guard is billing and coding. As reimbursement continues to decline, it’s crucial to get proper “credit” for the procedures you are performing. My advice is to get yourself and your team trained in billing and coding early on. If possible, have one or two vascular-specific coders at your institution regularly attend your provider-surgeon meetings. This ensures everyone is on the same page and keeps your billing practice up to date, especially with new techniques, such as branched TEVAR.
You have friends and colleagues across multiple healthcare disciplines and specialties. For a young clinician, how important is networking? Are there 2-3 tips that you can pass along on how to network better or effectively?
Networking is invaluable. When entering a new institution, approach work with humility and a willingness to collaborate. Gravitate toward connections among the busiest and most social specialists and build relationships that can turn into partnerships. Don’t be afraid to ask to observe or even double-scrub in procedures to learn new techniques. For example, I had barely ever spoken to an interventional cardiologist before starting to practice, but within weeks of starting, I was regularly assisting several of them on transradial interventions and transfemoral carotid stenting. Those relationships still matter, and we often refer patients to one another.
What are some red flags to consider when looking at a practice? How important is it to not be afraid to negotiate all the tangibles (e.g., starting salary, vacation time, etc.) as well as intangibles (e.g., job perks) upfront versus after your first year in practice?
Your best chance to negotiate is before you start. Once you’re in, once they “have you,” it will likely take several years of significant contributions to the practice before you can renegotiate.
Different practice settings have varying flexibility when it comes to negotiating your contract, so it is important to understand the contracts of your prospective partners. Inquire about how often their contracts are updated to accommodate factors like individual contributions to the practice, inflation, local cost of living, tax changes, or call responsibilities. A red flag to watch for is a seasoned surgeon stuck with an outdated contract. Also, if there’s ambiguity regarding the future trajectory of salary, benefits, and time off, it’s safe to assume the terms are not going to be in your favor. Ignorance is not bliss here. You owe it to yourself to get as much clarification as possible before you sign on the dotted line.
So-called “turf wars” are inevitable in almost any workplace setting, including healthcare. How do you approach this challenge and what’s your advice for graduating residents and fellows?
It's essential to understand the local dynamics, including any "turf wars," before you settle into a job. Make sure to talk with key players in other specialties like cardiology, cardiac surgery, interventional radiology, and vascular medicine during your interviews. Ask them the tough questions, understand how well these people work together, and what the opportunities and challenges are in the institution. Additionally, find a mentor within your own vascular surgery group to help you navigate through the tricky dynamics.
When operating, if you had to choose 3 songs to play on repeat, what would they be?
I’d go with anything by Creedence Clearwater Revival, Chris Stapleton, and yes, I'll admit it — Lady Gaga.
How about movies – what are your top 3 favorites of all time?
Top Gun, Charlie and the Chocolate Factory, and Forrest Gump.
If you could go back to your late 20s or early 30s, what would you tell your younger self from a professional standpoint?
Do not let your job become your whole identity. At the end of the day, what matters most is being there for your family. Strive to keep the challenges of your professional life from slipping into your life at home. Especially given the increasing pressures of modern healthcare, the odds are ever more against us on this issue.
