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Jagmeet P. Singh, MD, DPhil, discusses challenges, rewards of clinical cardiology
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In this issue, Jagmeet P. Singh, MD, DPhil, FACC, FHRS, associate chief of the cardiology division at Massachusetts General Hospital and Roman W. DeSanctis Endowed Chair in Cardiology and professor of medicine at Harvard Medical School, discusses with Cardiology Today ongoing research efforts to help patients with atrial fibrillation and HF and the path that led him to specialize in these areas.
Singh, who is also the founding director of the Resynchronization and Advanced Cardiac Therapeutics Program at Massachusetts General Hospital and a member of the Cardiology Today Editorial Board, received his medical degree from BJ Medical College, Pune University, India, and completed his internal medicine residency and cardiology and cardiac electrophysiology fellowships at Massachusetts General Hospital. He also received a doctorate in cardiac electrophysiology from Oxford University, an Master of Science in clinical investigation from Massachusetts Institute of Technology and a research fellowship from the Framingham Heart Study.
Singh has become a prominent researcher in cardiac electrophysiology, with interests in device therapy for patients with HF and catheter ablation for patients with AF. Some of his research has focused on improving patient selection strategies, multimodality imaging, lead implantation techniques and follow-up protocols for patients who have received an implantable cardiac device. He is serving as national principal investigator on five multicenter trials and has been a member of the steering committee for more than 15 other studies.
He also serves as deputy editor of the Journal of the American College of Cardiology: Clinical Electrophysiology and as editor-in-chief of Current Treatment Options in Cardiovascular Medicine. He has published more than 200 articles in scientific and medical journals and textbooks.
Who has had the greatest influence on your career?
Dr. Singh: It’s important for me to emphasize that I’ve had an interesting journey across three continents. I’ve had mentors along the way that have been pivotal to my personal growth, either by serving as examples to emulate or providing me with the opportunities that have helped me evolve as a clinician scientist. Starting off in India, a senior colleague of mine, Bharat Dalvi, MBBS, MD, DM, FACC, at KEM Hospital in Mumbai, continuously challenged me through ideas that forced me to examine the field of medicine through a more critical lens. Then in Oxford, Peter Sleight, MD, DM, FRCP, FACC, created the opportunity for me to undertake a doctorate. His mentorship and unselfish support set me on the next leg of my journey to the United States, where I worked at the Framingham Heart Study with Daniel Levy, MD, who reinforced my desire to pursue a career as a clinician investigator.
Subsequently, at Massachusetts General Hospital, where I did my residency in cardiology and electrophysiology fellowship, I’ve had many colleagues who were important in supporting and guiding me along the journey. Over the years, on the investigative front, I have always looked at Arthur Moss, MD, from the University of Rochester Medical Center, New York, as a role model and tried to emulate him, probably oftentimes unsuccessfully, as a clinical trialist. More recently, a significant change in my role as a clinician transpired a couple of years ago when Anthony Rosenzweig, MD, chief of cardiology, asked me to join him as the associate chief of cardiology division. This is a step in my life that introduced me full-throttle into the world of administration. It is a role that I’ve greatly enjoyed, as it has allowed me to touch the life of many of my colleagues while at the same time instituting changes in the division that will help us adapt to the turbulent health care environment which is coming down the pike.
Photo credit: Courtesy of Massachusetts General Hospital; printed with permission.
What area(s) of research in cardiology interests you the most right now?
Dr. Singh: I’ve had the good fortune of research training in basic science, clinical epidemiology and clinical trials. Over the last few years, my primary interest has been in clinical research and trials, much of which has been focused on device therapy for HF and AF. The field of cardiac resynchronization therapy has been particularly gratifying. Currently, my primary electrophysiology research interests are figuring out strategies to better individualize care for this frail group of patients. Developing better lead implantation strategies for subsets of patients that don’t respond to conventional approaches has been my area of focus. I am fortunate to currently be the international or national principal investigator on five such separate clinical trials. More recently, my academic efforts in cardiology have been directed toward health care- and payment reform-related issues.
What advice would you offer a student in medical school?
Dr. Singh: I would tell the student that if given a second chance to start over, I would still pursue a career in medicine. I would say enjoy the ride and be true to yourself and those around you. Being a doctor is an immensely fulfilling profession, and the opportunities are many and diverse. It sometimes takes a while to find your niche and area of expertise, but it’s good to keep an open mind and be ready to evolve with the times, being flexible and taking advantage of any situation at hand. It may not be the opportunity you were looking for at the outset, but if you do well at it, it will enhance your prospects for further good work. It’s a great journey for friendships; there is enough work out there for everyone to do, and the more friends you make along the way, the more successful you will be. Balance, however, is very important. I sometimes still find this difficult but I think it’s important to set boundaries at the outset so that you have enough time for your family and others that are central to your life.
What was the defining moment that led you to your field?
Dr. Singh: There were several defining moments that helped me get where I am. I think one of the key ones that led to this journey across three countries was winning a competitive scholarship to go to Oxford in 1994. Not only was that the start of a phenomenal journey, but it led me to get a doctorate in the field of cardiac electrophysiology. Even though I did not know it at that time, I had become wedded to a field of ion channels, repolarization dynamics, autonomic tone and arrhythmias.
What’s up next for you?
Dr. Singh: This one I haven’t figured out yet. I love my administrative role, as well as being a clinician-scientist. I’m not exactly sure where I would go from here, but I would certainly like to be a significant part of the transformative change in medicine that is happening at the national and international level. Meanwhile, I greatly enjoy looking after my patients, performing procedures, teaching the younger generation, contributing to science and doing my best to better the work lives of my colleagues. – by Erik Swain