Episode 14: From Thailand to UCSF: The Journey to Electrophysiology Fellowship

In this episode, I sit down with Dr. Jakrin “Joe” Kewcharoen, a Clinical Cardiac Electrophysiology fellow at UCSF to explore the journey of becoming a heart rhythm specialist and the important role fellows play in patient care at academic medical centers.Dr. Kewcharoen shares his unique path from Thailand to the United States and explains how international medical graduates navigate the U.S. training system while pursuing highly competitive specialties like cardiology and electrophysiology.The conversation also provides an inside look at how electrophysiology fellows work alongside attending physicians, nurse practitioners, nurses, and the broader care team in the EP lab. Fellows are already trained cardiologists who perform procedures, evaluate patients, and continue developing advanced procedural skills under expert supervision.Dr. Kewcharoen also discusses the rapidly evolving field of electrophysiology, including new technologies that are transforming arrhythmia care and the complex puzzle-solving involved in treating ventricular tachycardia.About the GuestDr. Jakrin “Joe” KewcharoenDr. Kewcharoen graduated from Chulalongkorn University in Thailand in 2017 and moved to the United States in 2018 to pursue postgraduate medical training.He completed his Internal Medicine residency at the University of Hawai‘i, followed by a Cardiovascular Disease Fellowship at Loma Linda University. He is currently completing a Clinical Cardiac Electrophysiology Fellowship at UCSF.Dr. Kewcharoen has been highly active in academic research, with over 100 peer-reviewed publications during his medical training. His research focuses on electrophysiology procedural outcomes, sudden cardiac death in the community, and inherited arrhythmia syndromes such as Brugada syndrome, a genetic disorder associated with life-threatening arrhythmias.At UCSF, he is currently involved in several research projects examining sudden cardiac death using a unique autopsy-based cohort, helping researchers better understand the cardiac and non-cardiac causes of sudden death.Outside of medicine, Dr. Kewcharoen enjoys weightlifting, basketball, playing guitar, and board games.Topics Discussed* What electrophysiology fellows actually do in the EP lab* The pathway from medical school to electrophysiology training* Differences between medical training in Thailand and the United States* Challenges and opportunities for international medical graduates* The team-based care model in electrophysiology* Pacemakers, defibrillators, and catheter ablation* The future of arrhythmia care and emerging technologies* Ventricular tachycardia ablation and complex arrhythmia managementEducational ResourcesUnderstanding ElectrophysiologyWhat is an electrophysiologist?: https://my.clevelandclinic.org/health/articles/24039-electrophysiologistPacemakers and Defibrillators ExplainedWhat is a pacemaker?: https://www.ucsfhealth.org/treatments/pacemakerWhat is an implantable cardioverter defibrillator (ICD)?: https://www.ucsfhealth.org/treatments/implantable-cardioverter-defibrillatorWhat is Brugada Syndrome?Brugada syndrome is an inherited condition that predisposes individuals to ventricular arrhythmias and sudden cardiac arrest, often diagnosed through characteristic ECG patterns.https://www.sciencedirect.com/science/article/pii/S2405500X2101080X?utm_Suggested Further Reading• Research on arrhythmia risk in Brugada syndromeWide QRS complexes have been associated with a higher risk of major arrhythmic events in patients with Brugada syndrome. https://pmc.ncbi.nlm.nih.gov/articles/PMC7011812/?utm_• Atrial fibrillation and arrhythmia risk in Brugada syndromeResearch has shown that atrial fibrillation may increase the risk of serious arrhythmic events in patients with Brugada syndrome. https://pubmed.ncbi.nlm.nih.gov/31353765/Produced by: Nadja Wlasiuk, DNP, APRN, FNP-BC, CCK Get full access to In the Loop with Nadja Wlasiuk at intheloopwithnadja.substack.com/subscribe