My Path to ACHD: Mentors and Fellowships

ACHA is continuing to share the journeys of ACHD physicians through the HeartTalk Blog. Learn more about the path taken by Tony Pastor, MD, in the post below.

College Graduation:

I graduated from Johns Hopkins University with a degree in Neuroscience in 2008. I always knew I wanted to be a doctor and was inspired at an early age by stories of my family immigrating to the United States so that my grandfather could have experimental aortic valve replacement surgery. I loved living in Baltimore! Probably one of my favorite memories is when I got a job swimming rats in a water maze while I was there to help pay for school.

Medical School Graduation:

After undergrad, I went back to my hometown of Houston, Texas, to attend Baylor College of Medicine (BCM), and graduated in 2016 with honors. As a medical student, I started the first LGBT+ organization at BCM, and helped organize health fairs for marginalized, at-risk patients in Houston. I really started figuring out what kind of doctor I wanted to be when I grew up, and it was during this time that I met a lot of Med-Peds (training in both Internal Medicine and Pediatrics) residents who I really admired for being intelligent, dedicated, and passionate about education. I remember how much they cared about our patients at the VA and our county hospital, and they really inspired me to choose Med-Peds as a residency, because I, too, wanted to dedicate my life to helping patients who really had no one else to advocate for them.

Residency:

I stayed at Baylor for Med-Peds residency. Initially I thought I wanted to go into infectious disease, but during my first year I had an existential crisis after doing a pediatric cardiology rotation. I fell so in love with the complex physiology of cardiology, and later some of those same med-peds doctors I admired so much ended up introducing me to the world of adult congenital cardiology.

I always tell trainees and students that we are all a product of our experiences and mentors, and I owe my entire career to Dr. Wilson Lam, Dr. Wayne Franklin, Dr. Peter Ermis, Dr. Stephen Greenberg, Dr. Erica Lescinskas and Dr. Frene Lacour-Chestnut. They took me as a naïve, bright-eyed young doctor and introduced me to both the amazing world of ACHD, and in the case of Drs. Lacour, Greenberg and Lescinskas, they showed me how rewarding a career in medical education and advocacy really is. In 2016-17, I was honored to spend an additional year as an internal medicine chief resident, where I had the privilege of investing in the education and future of medicine. My chief year was honestly one of my favorite years, and one of the most formative experiences, in my entire medical training.

Fellowship #1:

It was probably the hardest decision I ever had to make, but I’m incredibly grateful to Dr. Wilson Lam and Dr. Shaine Morris, who helped me decide. I remember the exact moment I found out that I had matched in Pediatric Cardiology at Boston Children’s Hospital. I screamed; I jumped up and down next to the froyo shop at MD Anderson. Fellowship, of course, had immense challenges, and imposter syndrome was very real for me at times, but learning about congenital heart disease from the faculty here in Boston was an indelible experience, and one that I don’t take for granted. They knew I was interested in ACHD, and early on I was given a clinic with mostly ACHD patients and introduced to the BACH (Boston Adult Congenital Heart Disease) faculty who took me under their wing and became lifelong mentors.

The Event of the Season:

In 2019, I married my husband Cody Bowers in Boston. Cody is an opera singer, and we met in Houston when I was a resident and he was in graduate school at Rice University—yes, they have opera grad school J. He had never dated a doctor before, and he thought I was ghosting him, in fact, when I told him I couldn’t see him for two months when I was in charge of the inpatient service at Ben Taub Hospital. He is the most supportive and loving partner, and the best decision I have ever made. I think we can both say that while we know little about the intricacies of our respective careers, it’s a great joy to be able to learn from each other every day. We really feel like we have the best of both worlds.

Fellowship #2:

The theme that mentors are key to medical training continued as I transitioned from a Pediatric to Adult Congenital Cardiology Fellow with the Harvard Adult Congenital Heart Disease Fellowship program. During my time with BACH, I was also adopted by the advanced cardiac imaging faculty to get special training in cardiac MRI and CT. The faculty here have taught me so much about not only anatomy and physiology, but also medical education and research. The biggest lesson they have taught me, though, is simply to be a good doctor. I could not have asked for better role models. They are brilliant and leaders in our field, but also have that unteachable caring touch when it comes to patient care. Dr. Anne Marie Valente, specifically, has been the most influential person in my career thus far. I will forever be grateful to her for taking me under her wing and investing in my education and career the way she has. She is the best mentor, and she is surely the most inspiring physician to me and to many of the fellows who come through the ACHD program at Harvard.

Why ACHD?:

Congenital heart disease patients have truly been my biggest teachers. I am always awed by their resilience, compassion, and sense of unity. As a gay physician, I am also acutely aware of the unique obstacles the LGBT+ community faces in medicine, and I have recently teamed up with other LGBT+ ACHD doctors and patients to address systemic inequalities, and hopefully be the catalyst of meaningful change and community research. Although I feel like I’ve accomplished so much in the last 10 years, I am even more excited about what is yet to come.

What’s Next:

To start, I will be doing three more fellowships—just kidding! Everyone has to grow up sometime, and after 10 years of training, I will be starting my career with the Yale Pediatric and Adult Congenital Cardiology Group this August. I could not be more excited to join Drs. Rob Elder, Jeremy Asnes, and Sarah Goldstein as we expand the ACHD program and, hopefully, start an ACHD fellowship in the next couple of years.

The story of my training has certainly been long and sometimes arduous, but with the tools I’ve been given, the skills I’ve developed, and the community I’ve come to love so much, I can sincerely say that the horizon for me seems brighter than ever. At long last, the real work begins, and I could not be more grateful!