Dr. Mirvat Alasnag is a vanguard in interventional cardiology. As the first female interventional cardiologist in the Gulf region and the Director of the Catheterization Laboratory at King Fahd Armed Forces Hospital, she is a practitioner who has broken significant barriers. Her expertise is recognized across various prestigious cardiology societies, including the Saudi Arabian Cardiac Interventional Society and the European Association of Percutaneous Cardiovascular Interventions. In this interview, Dr. Alasnag shares her experiences in the transition from fellowship to clinical practice, the complexities of treating calcific plaque, and the nuances of networking and professional development.
Shortly after completing your fellowship, was there a therapy area or subject matter you wish you were taught or had more experience in?
Intracoronary imaging was something I had to pick up in the field. I wish I had more structured training to identify arterial morphologies and appropriate stent sizing. However, interventional cardiology is a field where lifelong learning is a prerequisite, and for me, learning through proctored sessions and workshops was paramount.
Many residents and fellows leave training with a sense that they aren’t fully ready for clinical practice. Did you ever feel unprepared for clinical practice after your training? How did you overcome this?
Collaborating with an experienced operator on complex cases is crucial. I advise newcomers to plan and strategize well before procedures — procure the necessary equipment and prepare for potential complications before taking patients to the cath lab for a procedure.
It's key to establish a reputation as a safe, proficient, and independent interventional cardiologist early in one’s career. Complications and failures will negatively impact the trust of referral sources and the hospital administration. This is a field that requires consistency in volume and outcomes to maintain or even expand the skill set.
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?
Conferences and mentors are vital for refining hypotheses and nurturing collaboration. You can find collaborators who can help you form cohesive teams that are willing to share data and co-author projects. Again, the biggest factor in your ability to find strong collaborators is maintaining your reputation for meeting deadlines and fulfilling commitments.
When it comes to treating challenging calcific plaque from an interventional perspective, what’s your go-to algorithm?
Intracoronary imaging allows me to assess the arc, degree, and depth of calcium to determine the need for atherectomy and debulking. For crossable lesions, if the calcium burden is large, I usually start with intravascular lithotripsy. For uncrossable lesions, I consider laser, orbital, or rotational atherectomy. Orbital atherectomy is particularly useful in ostial disease. Laser atherectomy creates a track but often requires additional atherectomy and debulking therapies. Rotational atherectomy has proven successful in modifying calcified disease, permitting lumen gain, delivery, and appropriate expansion of contemporary stents.
Regarding the business of healthcare, what are 2-3 concepts that you wish you knew coming out of fellowship?
I work in a public facility where coding and billing are not central to what we do. However, I recognize the value of understanding these processes. I'm aware that current fellowship programs are starting to offer training in coding/billing and medico-legal training sessions, which can be critical in certain settings.
Dr. Mirvat Alasnag is a vanguard in interventional cardiology. As the first female interventional cardiologist in the Gulf region and the Director of the Catheterization Laboratory at King Fahd Armed Forces Hospital, she is a practitioner who has broken significant barriers. Her expertise is recognized across various prestigious cardiology societies, including the Saudi Arabian Cardiac Interventional Society and the European Association of Percutaneous Cardiovascular Interventions. In this interview, Dr. Alasnag shares her experiences in the transition from fellowship to clinical practice, the complexities of treating calcific plaque, and the nuances of networking and professional development.
Shortly after completing your fellowship, was there a therapy area or subject matter you wish you were taught or had more experience in?
Intracoronary imaging was something I had to pick up in the field. I wish I had more structured training to identify arterial morphologies and appropriate stent sizing. However, interventional cardiology is a field where lifelong learning is a prerequisite, and for me, learning through proctored sessions and workshops was paramount.
Many residents and fellows leave training with a sense that they aren’t fully ready for clinical practice. Did you ever feel unprepared for clinical practice after your training? How did you overcome this?
Collaborating with an experienced operator on complex cases is crucial. I advise newcomers to plan and strategize well before procedures — procure the necessary equipment and prepare for potential complications before taking patients to the cath lab for a procedure.
It's key to establish a reputation as a safe, proficient, and independent interventional cardiologist early in one’s career. Complications and failures will negatively impact the trust of referral sources and the hospital administration. This is a field that requires consistency in volume and outcomes to maintain or even expand the skill set.
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?
Conferences and mentors are vital for refining hypotheses and nurturing collaboration. You can find collaborators who can help you form cohesive teams that are willing to share data and co-author projects. Again, the biggest factor in your ability to find strong collaborators is maintaining your reputation for meeting deadlines and fulfilling commitments.
When it comes to treating challenging calcific plaque from an interventional perspective, what’s your go-to algorithm?
Intracoronary imaging allows me to assess the arc, degree, and depth of calcium to determine the need for atherectomy and debulking. For crossable lesions, if the calcium burden is large, I usually start with intravascular lithotripsy. For uncrossable lesions, I consider laser, orbital, or rotational atherectomy. Orbital atherectomy is particularly useful in ostial disease. Laser atherectomy creates a track but often requires additional atherectomy and debulking therapies. Rotational atherectomy has proven successful in modifying calcified disease, permitting lumen gain, delivery, and appropriate expansion of contemporary stents.
Regarding the business of healthcare, what are 2-3 concepts that you wish you knew coming out of fellowship?
I work in a public facility where coding and billing are not central to what we do. However, I recognize the value of understanding these processes. I'm aware that current fellowship programs are starting to offer training in coding/billing and medico-legal training sessions, which can be critical in certain settings.
Dr. Mirvat Alasnag is a vanguard in interventional cardiology. As the first female interventional cardiologist in the Gulf region and the Director of the Catheterization Laboratory at King Fahd Armed Forces Hospital, she is a practitioner who has broken significant barriers. Her expertise is recognized across various prestigious cardiology societies, including the Saudi Arabian Cardiac Interventional Society and the European Association of Percutaneous Cardiovascular Interventions. In this interview, Dr. Alasnag shares her experiences in the transition from fellowship to clinical practice, the complexities of treating calcific plaque, and the nuances of networking and professional development.
Shortly after completing your fellowship, was there a therapy area or subject matter you wish you were taught or had more experience in?
Intracoronary imaging was something I had to pick up in the field. I wish I had more structured training to identify arterial morphologies and appropriate stent sizing. However, interventional cardiology is a field where lifelong learning is a prerequisite, and for me, learning through proctored sessions and workshops was paramount.
Many residents and fellows leave training with a sense that they aren’t fully ready for clinical practice. Did you ever feel unprepared for clinical practice after your training? How did you overcome this?
Collaborating with an experienced operator on complex cases is crucial. I advise newcomers to plan and strategize well before procedures — procure the necessary equipment and prepare for potential complications before taking patients to the cath lab for a procedure.
It's key to establish a reputation as a safe, proficient, and independent interventional cardiologist early in one’s career. Complications and failures will negatively impact the trust of referral sources and the hospital administration. This is a field that requires consistency in volume and outcomes to maintain or even expand the skill set.
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?
Conferences and mentors are vital for refining hypotheses and nurturing collaboration. You can find collaborators who can help you form cohesive teams that are willing to share data and co-author projects. Again, the biggest factor in your ability to find strong collaborators is maintaining your reputation for meeting deadlines and fulfilling commitments.
When it comes to treating challenging calcific plaque from an interventional perspective, what’s your go-to algorithm?
Intracoronary imaging allows me to assess the arc, degree, and depth of calcium to determine the need for atherectomy and debulking. For crossable lesions, if the calcium burden is large, I usually start with intravascular lithotripsy. For uncrossable lesions, I consider laser, orbital, or rotational atherectomy. Orbital atherectomy is particularly useful in ostial disease. Laser atherectomy creates a track but often requires additional atherectomy and debulking therapies. Rotational atherectomy has proven successful in modifying calcified disease, permitting lumen gain, delivery, and appropriate expansion of contemporary stents.
Regarding the business of healthcare, what are 2-3 concepts that you wish you knew coming out of fellowship?
I work in a public facility where coding and billing are not central to what we do. However, I recognize the value of understanding these processes. I'm aware that current fellowship programs are starting to offer training in coding/billing and medico-legal training sessions, which can be critical in certain settings.
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World's Brightest Physicians
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Fun, Insightful Interviews with the
World's Brightest Physicians
Delivered straight to your inbox. Completely free. No spam.
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?
Medicine, and interventional cardiology specifically, is a team sport. A lot of what we do requires multidisciplinary input. For example, structural interventions involve a team of proceduralists, anesthesiologists, heart failure experts, and echocardiographers to select the appropriate patient and procedure, conduct the procedure safely, and continue to optimize the patient’s wellbeing after the procedure is complete. As such, keeping the communication lines open, showing humility, and attending educational activities or reading published data in other disciplines are imperative for a successful practice nowadays.
With the acceleration of virtual learning and digital technology in healthcare, particularly due to COVID-19, what are your thoughts on the impact for medical trainees?
The pandemic has opened doors to global learning opportunities. Trainees can now have remote mentoring from international faculty, observe a broader range of procedures, and engage with different patient demographics they wouldn’t have had access to learn from before.
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?
Finding the balance between being able to accommodate colleagues while standing your ground to ensure you are not devalued is not easy. My advice would be: to prioritize patient welfare. Don’t let the patient fall victim to any turf war!
When operating, if you had to choose 3 songs to play on repeat, what would they be?
It changes regularly. These days I’m into the cello and violin remixes of modern songs.
How about movies – what are your top 3 favorites of all time?
Shawshank Redemption
Cleopatra
Dumbo
If you could go back to your late 20s, what would you tell your younger self from a professional standpoint?
Find work-life balance early on. Chasing a career can rob you of precious moments and can burn you out down the line.
Are there any events, congresses, clinical research, etc., you’d like to raise awareness for?
I would encourage physicians to responsibly engage on social media. It can be a valuable source for late-breaking trials and recent publications that can direct you to contemporary medical research and discussion. But make sure it’s a gateway and not a destination in and of itself. Bite-sized abbreviated discussions of science are not sufficient in the long term.
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?
Medicine, and interventional cardiology specifically, is a team sport. A lot of what we do requires multidisciplinary input. For example, structural interventions involve a team of proceduralists, anesthesiologists, heart failure experts, and echocardiographers to select the appropriate patient and procedure, conduct the procedure safely, and continue to optimize the patient’s wellbeing after the procedure is complete. As such, keeping the communication lines open, showing humility, and attending educational activities or reading published data in other disciplines are imperative for a successful practice nowadays.
With the acceleration of virtual learning and digital technology in healthcare, particularly due to COVID-19, what are your thoughts on the impact for medical trainees?
The pandemic has opened doors to global learning opportunities. Trainees can now have remote mentoring from international faculty, observe a broader range of procedures, and engage with different patient demographics they wouldn’t have had access to learn from before.
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?
Finding the balance between being able to accommodate colleagues while standing your ground to ensure you are not devalued is not easy. My advice would be: to prioritize patient welfare. Don’t let the patient fall victim to any turf war!
When operating, if you had to choose 3 songs to play on repeat, what would they be?
It changes regularly. These days I’m into the cello and violin remixes of modern songs.
How about movies – what are your top 3 favorites of all time?
Shawshank Redemption
Cleopatra
Dumbo
If you could go back to your late 20s, what would you tell your younger self from a professional standpoint?
Find work-life balance early on. Chasing a career can rob you of precious moments and can burn you out down the line.
Are there any events, congresses, clinical research, etc., you’d like to raise awareness for?
I would encourage physicians to responsibly engage on social media. It can be a valuable source for late-breaking trials and recent publications that can direct you to contemporary medical research and discussion. But make sure it’s a gateway and not a destination in and of itself. Bite-sized abbreviated discussions of science are not sufficient in the long term.
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?
Medicine, and interventional cardiology specifically, is a team sport. A lot of what we do requires multidisciplinary input. For example, structural interventions involve a team of proceduralists, anesthesiologists, heart failure experts, and echocardiographers to select the appropriate patient and procedure, conduct the procedure safely, and continue to optimize the patient’s wellbeing after the procedure is complete. As such, keeping the communication lines open, showing humility, and attending educational activities or reading published data in other disciplines are imperative for a successful practice nowadays.
With the acceleration of virtual learning and digital technology in healthcare, particularly due to COVID-19, what are your thoughts on the impact for medical trainees?
The pandemic has opened doors to global learning opportunities. Trainees can now have remote mentoring from international faculty, observe a broader range of procedures, and engage with different patient demographics they wouldn’t have had access to learn from before.
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?
Finding the balance between being able to accommodate colleagues while standing your ground to ensure you are not devalued is not easy. My advice would be: to prioritize patient welfare. Don’t let the patient fall victim to any turf war!
When operating, if you had to choose 3 songs to play on repeat, what would they be?
It changes regularly. These days I’m into the cello and violin remixes of modern songs.
How about movies – what are your top 3 favorites of all time?
Shawshank Redemption
Cleopatra
Dumbo
If you could go back to your late 20s, what would you tell your younger self from a professional standpoint?
Find work-life balance early on. Chasing a career can rob you of precious moments and can burn you out down the line.
Are there any events, congresses, clinical research, etc., you’d like to raise awareness for?
I would encourage physicians to responsibly engage on social media. It can be a valuable source for late-breaking trials and recent publications that can direct you to contemporary medical research and discussion. But make sure it’s a gateway and not a destination in and of itself. Bite-sized abbreviated discussions of science are not sufficient in the long term.
