Are you saying don't go to Iowa, or are you saying go to San Francisco? So help us, can you parse out what you mean by that phrase? Absolutely. So, first of all, I'd like to say it's just what that particular study showed, so it's not my opinion, but what that showed was that people that left within the first five years had chosen location as the first priority. That doesn't mean that they stayed where they wanted to stay. They went to a location, I mean, going to a particular location was the first priority for their job. And those people tend to leave within the first five years after their first job. That's what that data showed, and that particular study, again, is not, it's just an interview of 500 physicians, so it's just something to figure out, to think about. But what was also interesting was that the people that ended up staying more than 10 years in their first job decided on that job based on the quality of the practice, as opposed to wanting to go to that location. So, what it is, I'm not sure what that means, how you interpret that. I think that what I was trying to say was it's just something you want to think about. You know, you may want to think about location, location may be an important thing, don't use that as a priority, but if that's your only reason to go to that job, perhaps it's not the best option. Yeah, I just want to mention a couple of case examples. I have more coming home to his wife's hometown of L.A. after, what, 20 years at St. Louis. We have Jim Blankenship following his grandkids to New Mexico. And I hear all these examples, and you came back to your wife after years away, and so, you know, seeing your examples, it seems to me that people eventually come home to family. And so I guess maybe you can put some of that into perspective for us. Yeah, I think you sort of have to really figure out what's important to you. You know, when I went to Charlotte in 1993, the most important thing in my life was getting clinical research going. That was my passion, Gary Rubin training. And, you know, whether it was in Iowa or Florida or Charlotte. And then when the bottom fell out of that, you've got to be willing to make a change. My wife and I have been married for 40 years. Very happy. But I basically, Jill had gotten a great job in Charlotte, so I saw her on weekends. And airplane pilots do it, CEOs do it, a lot of people do it. You know, we work harder, right? What time do you guys get home, 5 o'clock? No. Right? So my wife told me, don't kick the dog when you come home on those bad nights. So I think you've got to find out what works for you. I think moving your kids around is a challenge. It is a challenge. You want to try and avoid that. I think it's important to think about the impact on your kids. But when you do a good job, if you also find that impact, it's a good job. If it's a good job, quite frankly, it's a good job. And that's the thing you want to discover in your career. When you have to decide which path you've chosen to go down. And if there's one you want to go down, that's the key. And that's the where you want to end up. And that you want to end up with a supportive environment for your family. Be serious. Because if you fall off the bus at the end of that time, you're not going to want to get run over by all these other people. You're not going to want to get run over by all these other people. So you have to actually stop and adapt. But nevertheless, I think there's these days when you try to follow your career. I think that's the best advice I can give you. So please, if you're an elder, don't be too early. And a little bit less of a wait. In the middle, you might be able to do something. And then you got Dr. Cohn, who actually got the best of both worlds. He was at University of Miami for 20 years. And then things sort of fell apart. And he could live in the same house and drive. Just a little extra miles from each other. Yeah, so in North Carolina, Chuck, you'll be surprised to hear this, the non-competes are supposedly going to go away. Just like the state of Alabama got rid of all non-competes. So I think that would be, for early career people, an incredible game changer. I'm surprised you quoted the Jackson-Coker. There's another article out. And George knows this better than anybody. 50% of the fellows that George fed to back trained changed jobs after two years. That was true when I was a fellow in 193, and it's true now. So it's not just residents. You know, it was a... Great. Well, that's a great... Any last thoughts on that? No, I just want to say, like, I tell my fellows that, you know, the statistics that you quoted, and we sort of see that anecdotally in our programs as well, I think it's just a matter of trying to find the right home. You don't know these groups or practices that you're joining. And one of the themes was you want to be working with people who you share, you know, a same vision with or a similar vision with or who you complement very well so that you're contributing to a group that you want to see to grow and things like that. You don't always know that when you first come out of training. If you know the place, that's wonderful. I mean, for me, location is New York. Yeah, all over New York. Iowa is a great place to practice, by the way. All right. It's my honor and pleasure to ask my good friend, Chuck Simon, to come up and talk about setting yourself up for a transition to industry. If none of you know it, Chuck was the best interventionist in the state of North Carolina before he left Sanger Clinic. So this will be a fascinating talk. Wow, you were in North Carolina then. What are you doing? You're giving it over now. I was in Davis. This is great. So I didn't do a slide about myself. It's more about the tips. But just so folks that are in here that don't know me as well, I kind of went through some of the transitions that the mid-careers have already talked about. When I went to Charlotte, I did all my cardiology training at Duke. I grew up in the state of North Carolina. When I left Duke, my main objective was to stay academic, to have trials, to enroll in trials, to stay connected to the faculty that I had learned so much from at Duke and all the faculty I knew around the world. So I started out actually starting a research group. I hired our first research coordinator at the Sanger Clinic in 1989, I think it was, and then gradually built from there and stayed very much involved with industry. I was doing technical guys, probably one of the last guys that people thought would go to industry because I wasn't sitting behind a desk writing papers. I was doing over 500 coronary interventions a year. After 20 years of that, what is that, almost 10,000 coronary interventions by the time I left to go to industry. And so I was doing a lot of testing with R&D engineers but also clinical trials. So technical stuff, clinical trial, enrollment, and then eventually made the transition to industry. So that's why I'm standing up here to give you this talk. So I'm an employee of Abumad. Oh, let's get the rest of my personal history. So after 20 years at the Sanger Clinic in Charlotte, in 2008 I left and went to Abbott Vascular. In July of Abbott Vascular we launched a stint called the Zion Stint that John Capek convinced me was going to be much better than Cipher in Texas. It turned out that was right, and it was good timing for me, and I can talk about the reasons why. I was having a great time in Charlotte. This was an opportunity to sort of change the world maybe in a different way. And then we bought MicroClip, which was e-valved. We got into a fully bioresorbable scapula called Absorb. And I did the CREST trial panel for carotid stents, which the FDA approved for both symptomatic and asymptomatic carotid stenosis, but CMS never reimbursed. So I had three FDA panels. It was three for three, so I thought that was pretty good. And then I left Abbott in 2019, right before COVID, and then Mike Minogue, who was running AbbeyMed, asked me to come in and help AbbeyMed become a bigger company and do bigger things. So that's, I'm in my third year at AbbeyMed. So that's my background, and that's my disclosure. So here, it's like this is kind of a Jim Hermiller thing to show a slide like this, but it's because I love Jim's talks. But it's, you hit this point sometimes as you get through. It can be early career, it can be mid or late, where you really are starting to ask yourself, does my life stay the same as what I do now, or do I change? Do I change, you don't necessarily have to move, but you may change your emphasis in practice. Some of the things that you do, practice versus academics. So do I do a private practice career, do I do academics, or do I maybe even think about going to industry? And for me, that was the one that hit me. So the three Cs, I found that I thought was pretty good. The three Cs of life are choices, chances, and changing. So you have to make a choice to take a chance, or your life will never change. And I bet you everybody sitting up here at some point has the choice they had to make to reach out, to take a chance, to ask for support from a colleague, or a mentor, actually, that maybe you were almost too humble or too nervous to go in and even talk to, to help you make a change. Or for me, it was taking a chance to make a change, to try to change patient care instead of day-to-day in the lab and the clinic, and more across the world by bringing new technologies to patients. So here's how I think you set yourself up for a successful transition to industry, if you're really thinking about doing it. First, you've got to be really good at what you do. So you've got to have a reputation as being technically really good in the cath lab, if that's your thing, and clinical expertise in interventional cardiology. Strong peer relationships, clear respect by your colleagues in the field, as being talented. So you just have to be good at what you do. The second thing is, take on some leadership roles, whether it's in your practice, your hospital, your academic institution, clinical trials, or professional society. And if you look at the Sanger Clinic, where I came from, when I left, Hadley Wilson, who joined the Sanger Clinic the same time I did, said, God, Chuck, this is really cool. He was following my career as I was going through this in industry. But for him, he was getting more and more involved in American College of Cardiology. And it was proud times for Sanger Clinic, Charlotte, North Carolina, and the state of North Carolina. I'm the first president of ACC from North Carolina to come in. Hadley is one of my best colleagues and friends in life. So he made a career change, but it was for society. He took on a leadership role in society. And that goes very important to industry as well, when industry is looking at you as a leader. Develop meaningful relationships with industry, the tool makers, product testing, clinical trial leadership and enrollment, physician advisory boards, education, product and clinical testing. And then the most important thing, and I think everybody up here on this panel has somehow done this, is discover your superpower. Everybody, you have your own superpower. And it is going to be different than the man or woman sitting next to you who came out of your fellowship. You're each going to have a different superpower. Is it technical, like a Bill Lombardi? Is it clinical trials, like a Greg Stone? Is it publications like, you know, Sri Paul Bangalore or Benita Shah? Is it education? Is it professional societies? And then once you discover it, and I love Benita, you said something really good, go deep in that. Because you said don't multitask. The other thing is don't try to be a jack of all trades. If you just do everything really well, you'll be somebody that everybody says, and that may be fine. That may be what you want to do in your career, is be really good at a lot of different things. Could you like that? But if you want to take on leadership or be attractive to industry, if you want to maybe get on the industry side, you've got to be the expert in something. You have to know more about something than anybody else. They go, well, go talk to her, because she knows more about this than anybody else. And if you're one of those, industry is going to be very interested in you. And then timing is everything. Decide when you should consider the transition, early versus later in career. I was 53 when I left. Mid-career, later career maybe. This will impact the level at which you may enter a company. Do you want to come in at the director level and run clinical trials and then try to maybe grow in your leadership within the company? Or do you want to come in as a CMO or a vice president? If you want to come in as a CMO or a vice president, you've kind of got to do the timing like I did and not try to come in in your 30s or maybe early 40s when you're really good, but come in as a director. And it's harder to get to that VP status or to get to the CMO position if you come into a company at the director level. But if you come in with all the stuff I talked about as being strong, you can come in as a VP or CMO. Then look at the company's technology and make sure it matches up with your expertise. If they're strong and structural, make sure that's your thing. If it's vascular, that's your thing. And also look at the size of the company, whether it's a start-up, mid-size, or large, and what you think the longevity of that company is going to be. When I made the shift, I told John Capek, who hired me at Guidant, running Guidant, I said, John, I don't know. These companies have got to come and go. How long will I have a job if I go to industry? Sanger Clinic, I'm running the Cat Black program. All's good. I know I'll have a job until I decide I want to retire. He said, Chuck, Avid is a 135-year-old company and you've been paying dividends for 75 consecutive years. I think you're going to be all right. And so you do, if that's what you want is stability. But on the other hand, you may not. If you're scrappy and you're young and you want to get involved in a start-up, that's okay too. You've just got to know what you're getting into. Then carefully assess the culture of the company because companies really have different cultures. They have different fundamental philosophies. If you sit down and you find that when you talk to people from a company that they start the conversation off with finance, stock price, and sales, or do they start out the conversation with they put patients first? And that was the thing that really impressed me about Avid. Mike said, Chuck, patients first in everything we do. And there's pictures of patients who have been impacted by technology all over the office building. If they do that and the leadership stays on patients, the rest is going to be fine. So that's kind of my bias is away from the financial side. And then finally, try to get a feel for the working environment. How much cross-functional consultation? How much did the R&D people talk to the clinical people in regulatory sales and marketing? And you can kind of tell when you talk around to people in the company whether that's happening or not and find out about their leadership philosophy. Do they do leadership training? Are they going to help you become a leader? Because most positions are kind of one-off. I can tell you I was not a very good leader when I went to Avid Vascular. I'd never managed a team before, a big research team, and I had to learn how to do that. And then make sure you know how they would define success for your role. So whatever role you're coming in at, make sure you're really clear about how success is defined. So you don't have to change your life, but if you're going to, I think you can either make a binary decision at some point or you can put your toe in the water, do some consulting, get more involved with industry, see if it feels right to you to be on the other side. We used to call it the dark side before you do it. But I think you'll hit this point, whether it's industry or another transition like we've heard already, but industry is a good thing. I've really enjoyed it. Thanks.

transitioning to industry

successful transition

area of expertise

leadership roles

industry relationships