Overseas Training Fellowship key step in stellar career

Following the CSANZ Annual Scientific Meeting in June, we spoke with keynote speaker Associate Professor Gerard Wilkins to learn more about his history with the Heart Foundation.

Gerry WilkinsDr Gerry Wilkins originally found his interest in cardiology through personal mentors, such as Dame Norma Restieaux, Dr Michael Ablett and Prof Pat Malloy. 

"It can be difficult for medical graduates to decide what they're going to do. I think you end up in a career based on two simple ideas – one being the whole area looks like it will be absorbing and fun, and the other is that people mostly stumble across leaders and teachers who you admire," says Dr Wilkins. 

After completing his specialist training in internal medicine and subsequently cardiology, he went on to receive a Heart Foundation Overseas Training Fellowship, where he continued his education as a research fellow at Massachusetts General Hospital in Boston, USA in 1984.

Dr Wilkins then found himself immersed alongside the pioneering people of clinical ultrasound-echocardiography and imaging, which was "the breaking thing" at the time. 

"This work being done opened the door to all sorts of new things, like diagnosis of valve disease, and ischaemic heart disease." 

It was at Massachusetts General Hospital where he created the Wilkins Score – the key decision-making step in balloon mitral valvuloplasty procedures, used to work out which valve will split easily with the balloon, and which won't. 

"It was due to me accidentally being there at the time. Balloon valvuloplasty for mitral valve started and was being pioneered strongly in the hospital where I was," says Dr Wilkins. 

The Wilkins Score is now used all over the world and has become a key decision-making step in mitral valvuoplasty. 

Giving the annual Heart Foundation Lecture at the Cardiac Society of Australia and New Zealand (CSANZ) 2021 Annual Scientific Meeting, Dr Wilkins spoke about the part he played in innovating new procedures and treatments for structural heart disease. 

"There's a whole range of interventions that large numbers of people are now undergoing. They all come out of the simplicity and accuracy of cardiac imaging, with intervention in an x-ray room. 

"You could never do these things unless you have all of the imaging tools to figure out what it is you can do technically and offer that to the patient. So, structural heart disease procedures bring together a whole range of different imaging modalities to come up with a solution. The whole area is pretty fascinating," he adds. 

Over his notable career, Dr Wilkins has continued a pioneering interest in vascular intervention and has been involved in the introduction of many new techniques and trials. His current focus is hepatic denervation and heart failure with preserved ejection fraction (HFpEF).  

He remains thankful for the benefit of that early Heart Foundation Overseas Fellowship which steered his career path. 

"The Wilkins Score only happened because the Heart Foundation put me there to learn that skill, which then became to this day, the absolute key decision-making step. 

"The Heart Foundation fund people, and now there's a tradition of everyone doing well on these fellowships and so in a way they've created their own bow wave. They basically open the door for the next generation," says Dr Wilkins. 

He encourages others to aim for Heart Foundation funding, like Overseas Fellowships, to gain vital experience and come back to New Zealand as leaders in their field. 

"There's now a tradition of these fellowships. Pretty much everybody that came before you on a fellowship hit the ball out of the park, in terms of their success. This means New Zealand fellows are welcomed with open arms all over the world, because everyone knows that they deliver. 

"We're not the only place in the world doing good work, but for a small country we tend to punch well above our weight," he adds.

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