Teaching future cardiologists: insights from Dr. Philipp at RSU’s Stade Branch

Laurence Dietze, Cooperation Coordinator, medical student,
RSU International Department

PD Dr. Sebastian Philipp is the Head of the Cardiology Department and Clinical Director at Elbe Klinikum Stade (EKS). Alongside his leadership responsibilities and clinical work, he plays an active role in medical education, teaching students from Rīga Stradiņš University (RSU) during their clinical placements at the RSU Stade Branch. In this interview, he reflects on his professional journey, the evolution of cardiology, the importance of medical training, and the value of international cooperation in clinical education.

I studied medicine at the University of Berlin between 1988 and 1995. Thereafter, I began my AIP, which at the time was the first 18 months of an internship, at the University Hospital in Berlin-Buch. I started my clinical career specialising in internal medicine with a focus on cardiology. I worked there until 2003, when I became an internal medicine specialist. Thereafter I spent two years at the University of South Alabama in Mobile conducting research. Then I completed my cardiology training at the University of Essen and became an associate professor. In 2009, I applied for and was appointed the Head of the Department of Cardiology in Stade, a city where my father was raised. Since 1 October 2009, I have developed the cardiology services in Stade, Buxtehude, and Bremervörde, established an ICU to the highest standards, and for the last four years, I have also served as the Clinical Director of Elbe Klinikum Stade.

Cardiology has witnessed significant technological advancements during your career. In your view, which developments have been the most transformative, and why?

If you look back at the history of cardiology, the field barely existed until the 1980s. The development of coronary interventions and coronary stenting in the mid-80s was a major breakthrough in the treatment of acute myocardial infarction. Subsequently, the focus shifted to structural heart disease. One of the latest innovations, which we also perform in Stade, is the intervention on the mitral and tricuspid valves using an interventional clip procedure. Further advancements include pharmacological treatments for heart failure and the use of devices such as CRTs and CCM for terminal heart failure. Significant progress has also been made in electrophysiology, particularly in treating atrial fibrillation and atrial tachycardia.

Implementing new procedures in any institution can present challenges. Have there been any major obstacles in introducing targeted interventions at EKS, and how did you overcome them?

There are several challenges. Firstly, training the staff to perform these procedures is essential. For instance, we trained Oliver Marx, who leads our pacemaker programme, at the University of Kiel and other hospitals to refine his skills in device therapy. Another approach is recruiting experts who already have the necessary expertise. We hired Denise Altin to be the head of our electrophysiology department. Implementing structural heart disease interventions involved training by myself, Torsten Lauf, and Safian Anwar for device therapies, and by Tanja Melenberg and Parastoo Jalilian for echocardiographic guidance. Additionally, meeting quality standards in our echo and catheter labs and maintaining close collaboration with the University of Hamburg’s cardiac surgery department were crucial.

Training new doctors is vital to the future of cardiology. What is your approach to training residents in your department?

We follow the recommendations of the Ärztekammer Niedersachsen. Our residents spend the first two years rotating through the emergency department, gastroenterology, nephrology, and cardiology. After two to two and a half years, they complete a one-year rotation in the ICU to gain intensive care experience. In years four to six, they focus on either cardiology or continuing in internal medicine. Their training includes coronary angiograms, transthoracic and transesophageal echocardiography, pacemaker programming and implantation, as well as assisting with device therapies, structural heart disease interventions, and electrophysiological studies.

That sounds incredibly comprehensive. Looking ahead five to ten years, where do you see the field of cardiology heading, and how should students and young doctors prepare to thrive in such a rapidly evolving environment?

There will be gradual but significant technical improvements. We are currently working on scaffolds—previously known as stents but are fully resorbable—while optimizing pharmacological treatments. We aim to perform transfemoral aortic valve replacements in hospitals of our size. I don’t foresee major groundbreaking developments in the immediate future, as much of the field has already been explored. However, cardiology is increasingly taking over procedures traditionally performed by cardiac surgeons, which will spark debate on maintaining knowledge across all fields while providing quality training. Cardiology is broad; we manage not only cardiology but also intensive care and emergency medicine. It will never be boring, but it will certainly never be easy.

Beyond clinical practice, you have also organised the Elbe-Weser Health Congress, now in its fourth consecutive year. Could you elaborate on the impact of this congress and the importance of sharing scientific advancements on such a platform?

For many years, different departments in our hospital hosted their own conferences or summits. For example, our cardiology department has held an annual cardiovascular summit for eight years. However, we realized that many within the hospital were unaware of what was happening in other departments, and general practitioners often had limited knowledge of the full range of services we offer at EKS. The idea behind the Health Congress was to showcase the breadth and quality of treatments available in Stade, demonstrating that we can compete with university hospitals in Germany. It is the only congress, which I know of, that includes all departments, as well as nursing staff, to present what is possible in the treatment of various diseases.

Teaching at the RSU Stade Campus is another significant aspect of your work. What has your teaching experience been like and how do RSU students compare to other groups you have taught?

Teaching RSU students has been a time-consuming but rewarding experience. As a teaching hospital for the University of Hamburg since 2009, we were previously limited to teaching final-year medical students. Now, having the opportunity to engage with students during their clinical years is both challenging and fulfilling. The small groups, eagerness to learn, and the excellent relationship between students and physicians stand out. However, we must address concerns raised at RSU, which have led to fewer students signing up for their final-year placements in Stade. This is unfortunate, and we need to improve both our internal environment and external perceptions to encourage students to feel at home here and consider their future at Stade Hospital.

From my experience, many students feel quite at home here and often undertake their practical placements in your department. How do you and your team mentor students during these placements, and what can they expect from the educational system at Stade?

It has been a pleasure to host final-year medical students. We offer exposure to various fields, including internal medicine, surgery, ENT, and urology. While the experience is rewarding, the shorter duration of rotations—six weeks for RSU students compared to three months for University of Hamburg students—means we must compress a significant amount of learning into a short period.

Despite the shorter rotations, students often gain substantial experience. Could you outline the career pathways available at EKS for those wishing to continue here as residents? What qualities do you seek in prospective residency candidates?

Ideally, we’d love to replicate the qualities of Laurence and Paul, who are starting residency here now…if you are eager to learn medicine at Stade, you have the opportunity to rotate through 13 different fields, providing a learning experience comparable to that of a university hospital. The unique advantage here is exposure to a wide range of patients, from general cases like headaches and flu to complex interventions such as mitral valve procedures. In trauma surgery, for instance, we manage more cases than many hospitals in Hamburg due to our location close to dangerous roads and the absence of competing hospitals nearby.

Finally, what advice would you give to young doctors and medical students pursuing a career in cardiology or any demanding medical specialty?

Never give up. I recall a speech by Roger Federer, who mentioned that while he won 80% of his matches, he only won 54% of the points he scored. You must fight every day as if it is your last, but once the day is over, look forward and don’t look back.