Introduction—the pathway

After years of regimented medical training, graduating cardiology fellows suddenly find themselves navigating early career without a roadmap to rely on. Crossing this threshold from fellow to faculty is often met with a mix of excitement and trepidation. Yet, we must venture forth and take our first steps into uncharted territory. In this perspective piece, I will share insights from my early career journey into academic cardiology as a clinician scholar in the USA.

In the USA, academic physicians are appointed and promoted in tracks with variable emphasis on each component of the tripartite mission (research, education and clinical care).1 Although terminology varies, there is generally a ‘clinician scholar’ (or ‘clinician educator’) pathway between ‘physician scientist’ and ‘academic clinician’ pathways in the spectrum of research to patient care. The distribution of effort for clinician scholars is usually predominantly clinical with a smaller allocation for educational or other scholarly activities. Promotion on this pathway is based on demonstration of scholarship, national leadership, educational contributions and clinical excellence. Of the estimated 7%–10% US early career cardiologists in academics, 26%–40% identify with the clinician scholar track.2 3