“My main occupation is being a medical doctor, which I enjoy doing and which actually relaxes me and gives me pleasure every minute.” That is the credo of Dr. Béla Merkely, Hungarian interventional and sports cardiologist, university professor and director of Semmelweis University's Heart and Vascular Center.
Since July, 2018, he has served as the rector of Semmelweis University that recently moved up a band in the latest Times Higher Education (THE) world rankings to become the first Hungarian university to rank in the top 200-250 universities in the world.
Being the rector of a university is a major challenge: you need to improve the competitiveness of the university in an area where, understandably, there is a lot of pressure worldwide, the rector points out to Diplomacy&Trade. “There is not much of a difference between what I do as a rector and what I do at the Heart and Vascular Center. I try and match the best candidates with the right opportunities and the best positions, to build a workshop where we train young people who then continue to work on their own while attracting more young people. We have created an educational, research and healthcare workshop/center comparable with any institute in Europe or the world, one that also serves as an example for the university. Over time, I discovered more flagship areas that have been a source of new ideas in the fields of surgery, gynecology or imaging diagnostics – fields that see innovations occurring all the time,” he says.
A vocation and a passion
In oncology therapy, state-of-the-art tools and new opportunities keep emerging as well. Smaller workshops are beginning to catch up with the larger ones, especially in the field of cardiovascular surgery. That is how a large medical university develops, he adds. “We have six faculties, each of which offers something unique. The Faculty of Medicine, the Faculty of Dentistry and the Faculty of Pharmacy – where graduates are now awarded a doctorate title – are all excellent and allow one to get involved in public care immediately [after starting their studies]. Students get to do research, work alongside doctors in hospital care. It's a very dynamic field.”
He also makes mention of the András Pető Faculty known worldwide for its conductive education method for children with neurological disorders – and highlights that the work the faculty does goes beyond pure medicine.
At the Faculty of Health Sciences, popular fields include physiotherapy and dietetics. “Physiotherapy is one of the most competitive fields today. It helps to restore movement and function, but it can also be used for neurological rehabilitation. These all are daily practices. Our curriculum has disciplines that will still be relevant in medicine 50 years from now. Pursuing medicine is a vocation and a passion [for me] as it never stops changing, developing – you will never get bored. It is hard work but those who love it will find the joy in this profession.”
“What makes [teaching] medicine challenging is that we have to cope with the amount of science doubling every year or two. If someone studies medicine today, in two years' time they will have to start it all over again because by then roughly the same amount of knowledge has been accumulated. This is why it is crucial for a doctor to continue learning if he or she wants to be at the cutting edge of disease diagnosis and treatment. It is a lifelong learning process,” Merkely highlights.
Doing well in R&D internationally
Talking about the directions of research and development at Semmelweis University, the rector highlights translational medicine as one which, by default, is about bringing the results of basic and clinical research, and more broadly, all types of research (basic research, meta-analysis, cohort analysis, clinical trials) back to patient care as quickly and efficiently as possible.
The other area where Semmelweis University excels is clinical research. “Of the disciplines [we teach], cardiology stands out with endocrinology and oncology also being exceptional. These three are the most outstanding areas and perhaps we can add gastroenterology to this list. Disciplines matter as in some rankings, such as the one by US News, universities are classified based on disciplines as well. In that latest ranking, Semmelweis University is 43rd in the field of cardiovascular research.
"Imagine the number of universities and the importance of cardiovascular medicine worldwide. Yet, it is not the merit of our clinic alone but also of the institutes that teach theory including pharmacology, biophysics, cell immunobiology, physiology, pathophysiology and global research on cardiovascular disease. “Being 43rd in a global comparison is an extraordinary achievement: we exceed universities like the University of Heidelberg, which is one of the world's leading institutions in the field of medicine,” he adds.
Excelling in great competition
Semmelweis University always strives to keep up with international trends in the fields of medicine, education and research. “Some say that Semmelweis University has it easy as we teach a subject everyone is keen to learn and we receive a lot investments given that health science is one of the most rapidly growing areas. Medicine/health science is indeed a very timely discipline but it also one that faces the most competition. Similarly to sports; one aiming to become a successful football player will face tough competition while in a less popular sport, it takes less effort to get to the top. Health affects everyone and with the coronavirus, it has grown even more in importance. Everyone has an idea about medicine and health. When someone gets sick, health becomes a topic of discussion, whether within the family or at any relationship. I consider myself lucky to be able to practice this discipline. At the same time, I see the level of competition there is today in the field of medical health research.”
A profession that lasts a lifetime
When asked why he recommends students to choose the health sector, Dr. Béla Merkely says that it is a subject, a profession that lasts a lifetime and one that one cannot get bored of. "There are always new challenges, and we always see unresolved issues get resolved at some point. If you compare what I learned in cardiology as a medical doctor with what I am doing now, the difference is profound. The evolution that takes place in this field is hard to keep track of. There used to be conditions we could not cure and now we are able to cure them. Today, we are able to perform a heart transplant or place a motor or a valve in the heart. We have just finished a transcatheter aortic valve implantation on a patient who was awake – inserting a valve through the blood vessels with millimeter precision. A procedure like that would earlier have required us to open the chest. Going even further back in time when heart motors did not exist, there was no way for us to cure these people. They were incurable patients. Today, a practiced professional can do it with high precision with an operation that takes 10 to 20 minutes,” the cardiologist proudly says.
"I have a vision and I know where we are headed to”
Swimming taught Merkely that achieving excellence requires one to have a clear goal. “The road to get there can feel long and tiring so it takes strength and perseverance. To develop the institution, I draw strength from patient care, and the motivation comes from having a vision and being aware of where we are headed to," he said in an interview published on the university’s website when he was awarded the Széchenyi Prize in 2021. The state award, named after 19th-century politician István Széchenyi, dubbed as "the Greatest Hungarian," is given in recognition of those who have made an outstanding contribution to academic life in Hungary.
Following in the footsteps of great predecessors
"Two key figures in my career – Dr. Zoltán Szabó, the designer and performer of the first Hungarian heart transplantation, and Dr. Sándor Juhász-Nagy, the leading circulatory researcher of his time – were also Széchenyi Prize-winning professors here at the Városmajor Heart and Vascular Clinic. It is a fantastic and uplifting feeling to become one of them", Merkely said. He was awarded the prize in recognition of his exceptionally valuable scientific career, his internationally acclaimed cardiology research achievements, his devotion to teaching, his institutional management skills and public activities.
Merkely was recruited to the clinic three decades ago by Dr. Zoltán Szabó, the director of the institution at the time who oversaw his career until he passed away in 2016. "I respected him as if he were my father and, from the beginning, we had a close relationship of trust. He saw that I was keen and if set my mind to something, I did it. He saw the potential in me and gave me the chance to grow," he recalls. In addition to his clinical approach, Dr. Zoltán Szabó taught him a lot about being a good leader. "He was a man with great management skills who focused on the essentials rather than the details. He had a vision, he always had a goal in mind and he never stopped creating," the rector pointed out.
“Guarantee for good quality”
As a young doctor, Merkely developed pacemakers, implantable defibrillators and radiofrequency ablation devices at the clinic’s research lab, headed at the time by Dr. Sándor Juhász-Nagy. "He was a thorough, structured thinker, full of ideas, a unique personality who not only taught me how to build a research project with integrity, but also prepared me to endure successes and failures. Under his leadership, the laboratory – which by now has grown several times in volume – was able to produce true translational research," he recalls another important mentor.
In 2006, Merkely was recommended by Dr. Sándor Juhász-Nagy to be appointed as head of the Department of Cardiology while retaining the management of the Heart and Vascular Center, as he saw him as a guarantee for good-quality cardiology education. He based his decision not only on Merkely’s research results, but also on the "extraordinary intensity and efficiency of his therapeutic activities, his exemplary commitment to his patients, his excellent organizational skills and his inspirational power over his young staff," Dr. Sándor Juhász-Nagy said in the letter of recommendation he wrote to Dr. Tivadar Tulassay, the rector of the university at the time.
Professor József Tenczer was another mentor who had an impact on Merkely’s career. He was a professor of cardiology and the head of internal medicine at the Department of Internal Medicine III where Merkely worked as a cardiac care nurse for one and a half years. On how he later chose the Városmajor Heart and Vascular Clinic as a graduate doctor, Merkely recalls it was during his fellowship in Heidelberg that it became clear to him that interventional cardiology would define this area in the future, and within the university. It was clear that the Városmajor Heart and Vascular Clinic could become the cradle of this specialty, which is why he asked Dr. Attila Fonyó, the then dean, to allow him to work here.
As he pointed out on the university’s website, medicine is a 24-hour job, but is one of the most beautiful professions. Two of his three children – his grown-up son and daughter – chose this career, and now his youngest child is also convinced that there is no other profession but medicine. “It feels great to see that our children find that the profession we chose gives us an uplifting, lifelong job,” Dr. Béla Merkely said.