Introduction When interviewing a medical resident for a potential fellowship in Cardiovascular medicine,the majority of candidates indicate an interest in academic cardiology.However,few opt for an academic career and many decide during fellowship that private practice is best for them.I have no problem with that decision.The focus of this manuscript in on those who opt for an academic career and for several reasons decide,after a few years,to leave the academic program and often leave gaping holes in the multiple aspects of the program,that require attention of the chief of cardiology.