Wild Geese: Dr John Ryan, cardiologist, Salt Lake City, Utah

There are downsides to every job and, in the case of Tipperary-born cardiologist Dr John Ryan, it is telling people they have an incurable illness.

Ryan may have graduated first in his class at UCC, done a fellowship in cardiology at the University of Chicago and worked as chief medical resident at the teaching hospitals of Harvard Medical School and Boston University, but he was not taught how to tell someone they have a life expectancy of three years.

The upside of working in cardiology, he says, is that his job allows him to help people and do research in the area of pulmonary arterial hypertension – high blood pressure in the lungs. However, “there are no cures for this disease process,” he adds, “with current treatment being aimed at controlling symptoms.”

As for his own heart, Ryan says July 1st holds a special place. As well as being his birthday, that date also marks the Utah-based doctor’s first day working in the US, his first day as an intern, the first day of his cardiology fellowship and his first day as chief medical resident.

However, he says a downside of having a birthday on that date is that he was never able to compete in the community games in Mosney, as he always ended up being in the older age group.

Ryan studied medicine at University College Cork, finishing top of his class in 2004. He was also among the highest- ranking medical graduates in the country for which he was awarded the Stewart Medal from the National University of Ireland.

Upon graduation, he did a six-month internship at Cork University Hospital, followed by a six-month stint at the South Infirmary-Victoria Hospital in Cork. He applied for a residency position in the US and started at Boston University Medical Centre in July 2005.

“I did the US medical licence exams. There are four exams. I took the first in 2002 while still in college and did one every year after that as I always thought I wanted to go to the US.”

Ryan stayed at Boston University Medical Centre for four years, becoming chief medical resident at the hospital from 2008-2009. “I remember too well the day the programme director invited me into his office to offer me this post.”

The programme director asked Ryan if there was any project he could undertake during his year as chief, suggesting he do some form of one.

He made his disapproval quite clear when Ryan enthusiastically replied: “I was planning on perhaps writing a novel detailing my move here.”

His programme director suggested that he concentrate on making a name for himself through academia rather than literature, advice he took to heart.

To this end, Ryan then became chief medical resident at West Roxbury VA hospital, which is a teaching hospital of Harvard Medical School and Boston University.

"I then went to the University of Chicago to do a fellowship in cardiology under the guidance of Stephen Archer. He is one of the world leaders in pulmonary hypertension, which is my speciality."

While there Ryan was awarded the Cournand and Comroe Young Investigator Award from the American Heart Association for his research with Archer.

He stayed in Chicago for four years before moving to Salt Lake City with his wife. A few months after moving, they had their first child, Sabrina.

“I saw the ability to build up a novel multi-disciplinary programme at the University of Utah. I wanted to do something new.”

Ryan is the now the director of the new dyspnoea clinic at the University of Utah, the first of its kind, with heart doctors and lung doctors working together to assess patients with cryptic shortness of breath. He is also an assistant professor in the department of internal medicine at the university.

“People come into the clinic and we evaluate them and determine the cause of shortness of breath or pulmonary hypertension. We come up with a diagnosis and give them individual therapies.

"The reality is patients don't complain based on organ systems, they complain based on symptoms. Referrals come from places such as Idaho and Nevada. The referral area is over 300 miles and many of the patients are referred by their primary care doctors."

Ryan is also associate editor of Cardioexchange, a website from the New England Journal of Medicine, and is involved in organising the Grover Conference, the longest-running conference on pulmonary hypertension, which is held every two years.

As for the future, Ryan plans to develop the programme in Salt Lake City, increase awareness of pulmonary hypertension and hopes that “some day I will no longer have to tell my patients that they have an incurable condition”.