Galen Wagner was a passionate and tireless clinician-scientist and mentor, devoted father, husband, loyal friend, and colleague.

Galen Wagner was born in Connellsville, PA, on December 25, 1939. He started his professional career as an Intern-Resident in Medicine at Duke University Medical Center Durham, NC, (1965-67) and Cardiology Fellow (1967-1970). Duke University served as his place of work throughout his entire professional life where he served in a variety of leadership roles. Being active as the director of the Cardiac Care Unit of the Duke University Medical Center (1968-81), he was instrumental in leading the development of the world renowned Duke Cardiovascular Databank. He was deeply involved in research and mentoring students as the Associate in Medicine, Duke University (1970-72), Assistant Professor of Medicine, Duke University (1972-76) and the Acting Chief, Cardiovascular Division, Duke University Medical Center (1976-77), and the Associate Professor of Medicine, Duke University (1977-2016). He received an honorary Ph.D. from Lund University in Sweden honoring the extensive mentoring Galen volunteered to both students and colleagues alike in international research.

During the years (1977-82) he was Director of the Duke Cardiology Fellowship Program and Assistant Dean of Medical Education. He was a founder and Co-Director of the Duke University Cooperative Cardiovascular Society (DUCCS) (1986-97) and Director (1997-98, and 2003-08). DUCCS is a consortium of current and former Duke Cardiology Fellows, researchers from many institutions worldwide, and industry sponsors.

His remarkable ability to connect researchers in different countries working on related topics has led to two invitational Research Symposia including: the STAFF Symposia focused on myocardial ischemia and the MALT Symposia focused on cardiac imaging. Both symposia have been held every 1-2 years for the past 2 decades, bringing together physician-scientists, biomedical engineers, and researchers in industry.

Galen leaves a legacy as clinician-scientist, mentor and friend that spans many countries and numerous publications. He was an author on 701 published manuscripts, 8 books, and for the past 11 years,  has been the Editor in Chief of the Journal of Electrocardiology. He has also been on the Editorial Boards of Circulation and the American Journal of Cardiology. But the professional activity perhaps most important to him has been the mentoring of young research investigators. He has mentored 36 Ph.D. students in 8 countries (Sweden, Denmark, Spain, the Netherlands, Scotland, Germany, Slovakia, and the United States) as well as hundreds of medical students, residents, and Cardiology Fellows over the past 48 years.

The idea of the IRIS courses started during my first stay in Durham, NC, when I came to Durham, NC for a 14 days stay in the editorial office, as the newly assigned executive editor of the Journal of Electrocardiology.

In addition to the editorial experience, I had the privilege to participate in Galen’s daily mentoring of both Duke and international students. It was very different from the didactic methods I had experienced before, and very effective. I also had an opportunity to attend one of “the Research Practicum” workshops for Duke University students, developed by Galen and Dr. Eric Eisenstein.

The original course began in 2000 when clinical leaders at NorthEast Medical Center, Concord, North Carolina asked Galen to help them learn about outcomes research. Over the next few weeks Galen collaborated with Eric Eisenstein to design a core curriculum. This work was guided by Galen’s understanding of Mortimer Adler’s Paideia Proposal (1). In this book, Adler proposed that there are three types of learning: knowing what, knowing how, and knowing why, and that each type of learning is associated with a different type of teaching. Galen believed that outcomes research training should be directed to the acquisition of skills in designing and conducting outcomes research studies (knowing how) rather than the acquisition of facts about outcomes research (knowing what) as frequently occurs in traditional outcomes research training. Since skills are taught by coaching, the curriculum evolved into a series of four coaching workshops, each based upon a standard question set that was used to help participants develop specific aspects of their research projects. Given the time constraints of busy clinicians, Galen and Eric decided that each workshop should be no more than 2 hours in duration with a maximum of 20-25 participants and 4-5 project teams. The curriculum did not have formal lectures and there were no required reading materials. Rather, Galen and Eric sought to create a highly interactive environment that would tailor the curriculum to the needs of individual project teams (2).

Over the next five years, Galen and Eric gave the course in person to clinicians at several North Carolina health systems, and to faculty, fellows, residents, medical students and undergraduates at Duke University. They also conducted video sessions with faculty and students in Arkansas, Massachusetts, France and Sweden. During this time, they experimented with the curriculum by adding taped lectures, increasing the number of students and projects, and compressing the training into two workshops. Each of these experiments was unsuccessful and further convinced Galen and Eric of the validity of their original curriculum design.

-Identification and understanding the problem and its importance – the student’s identification with the problem and strong motivation to solve the problem

-Verbalization of the problem, critical appraisal of the topic, addressing the problem in a structured way – an excellent basis for writing a manuscript or a project proposal.

During our discussions with Galen Wagner an idea arose – to organize similar training in Central Europe.

The original Research Practicum was adapted for a four-day course to provide an interdisciplinary, international environment for training in the skills required to prepare research study protocols, scientific manuscripts and for facilitating international collaboration.  The focus of the program is to:

-Develop skills needed to carry out research projects, using a practical, problem-based approach.

-Improve communication skills, including the skills in argumentation, negotiation and critical appraisal.

-Develop skills in international research team building and networking, and establish enjoyable cross discipline/cross cultural collaboration.

-Encourage researchers to publish scientific papers.

The main differences in this international research interdisciplinary school (IRIS) arrangement from the original Research Practicum are that it includes international participants, working in (preferably interdisciplinary) groups, has a duration of four days, and encourages participants to stay onsite (to stimulate intensive interaction and development of training projects during evening discussions). The IRIS however, still maintains the core principles of the Practicum, with participants developing a hypothesis based and “doable” study protocol during the course.

The first IRIS was organized in Slovakia in 2006.  We were not sure how this different way of training would work in a very different environment. The results and feedback from the participants exceeded our expectations, so we decided to continue. Thus the second IRIS was organized in Turkey. The faculty of the first Summer School 2006 in Liptovsky Jan, Slovakia, was represented by the editors of two involved journals: the Journal of Electrocardiology (Galen S. Wagner and Ljuba Bacharova), and the Croatian Medical Journal (Aleksandra Misak). During the second Summer School 2007 in Silivri, Turkey, the faculty was completed by the editors of the Anatolian Journal of Cardiology: Bilgin Timuralp and Gulmira Kudaiberdieva, with a generous support of Bulent Gorenek, MD, PhD.

Already during the first IRIS, the participants were invited and encouraged to moderate plenary discussions, and consequently two trainees from the 2006 IRIS in Slovakia (Nina Hakacova and Jana Kirchnerova) served as moderators / junior faculty at the 2007 IRIS in Turkey. This became the natural way to prepare the faculty for the following IRIS: selected participants were invited to serve first as moderators of discussions during workshops and then to subsequently to serve as faculty. Up to date (July 2016) the total number of faculty members is 47, comprising 9 editors of scientific journals and 24 former participants. This number ensures sufficient flexibility and supply of well-trained faculty for different locations and cultures, considering their experience, scientific background and nationality.

During the first IRIS courses, the faculty members were included into the groups. Thus, they not only moderated the plenary discussions but also contributed to the discussions in the group with the aim to stimulate discussion. Paradoxically, the presence of the faculty in the groups was found to be a limitation. The groups’ behavior followed the classical behavior of students – to “please” the faculty, to bring the “right’ / “correct” answers/solutions, and the students’ spontaneity and creativity were to some extend suppressed or blocked.

From June 1999 through July 2000 I had the good fortune to work as a clinical research coordinator in Galen Wagner’s ECG Lab at the Duke University Medical Center. Over the next thirteen months, I worked with medical professionals and students from different parts of the world on clinical research projects. Galen’s ECG Lab also served as the home to undergraduates during the summers and recent graduates (of which I was one) with an interest in medicine, and more specifically, an interest in learning how to effectively develop outcomes based research projects.

In working with Galen, I learned many life-long and research related skills I continue to apply in my work to this day assisting communities in developing flood emergency response and hazard mitigation plans.  Galen served as an important guide for me at a critical time in my life. Near the middle of this experience, I thought I might actually want to pursue a career in public health or even clinical research. Up to this point, Galen had been instrumental in teaching me how to design and successfully lead projects to completion through the myriad of factors a researcher must consider such as how to apply for and receive Institutional Review Board (IRB) approval for a study design to meet all IRB eligibility criteria. While learning how to develop the critical thinking skills needed to conduct research from Galen was valuable, what I will always remember most is that spring day when I went into Galen’s office to clarify a few questions for a draft manuscript we were close to submitting for review. Before I could ask a question, Galen asked me what it was I really wanted to do with my life. No one had ever really asked me that question before, and it provided me with an invaluable opportunity to realize that it is okay to decide for yourself what it is you want to do with your life, and pursue your own path.

I chose to pursue a career outside of medicine thanks to that simple yet profound question Galen asked me in 2000, and feel privileged to have worked with and become dear friends with someone who truly cared about the work not only he was doing, but just as much in what it was you were doing. Since my time working in Galen’s ECG Lab, I continued to collaborate with Galen on a variety of projects including most recently the Scientific Summer Schools in Trilj, Croatia in 2009 and Gebze, Turkey in 2010. Both experiences continue to serve as highlights in my professional career having gotten the chance to collaborate and work with interdisciplinary professionals and students from throughout the world. The four-day outcomes based research practicum has since progressed under the leadership Ljuba Bacharova and Galen into the International Research Interdisciplinary School (IRIS).  Galen always had an incredible and selfless ability to envision and facilitate the development of effective research based educational programs; and then in finding the leaders who could take the initial vision to new heights into the future, which may be his greatest legacy of all.  

Galen accepted me for a research elective without knowing who I was and what my capabilities were. He personally picked me up from the Durham airport where I arrived in 1999 as a young medical student from the Netherlands with no research experience. On the ride back he started asking me questions “Why did you come here?” “What do you want to do?” “How are you going to do this?”. Before I knew it I was coordinating a prehospital ECG transmission project, feeling very much out of my comfort zone and learning more than I ever had during my previous studies. This research elective formed a pivotal point in my own career. Galen taught me how to approach complex problems/projects and find ways to achieve the goal, while never to losing sight of that goal. I learned how to use these skills to approach goals in research, clinical work, career and personal life.

The initial experience led me to pursue a career in cardiology in Rotterdam, obtain a PhD including spending a year for research in West Virginia and subsequently a clinical fellowship in electrophysiology in Sydney and Melbourne. He was always available in person at conferences or via Skype to discuss career decisions and/or research ideas.

I clearly remember my first contact with Galen Wagner. It was in July 1995 and I had just finished the first half of medical school in Sweden. I´d been offered an American Heart Association scholarship for a year at Duke University to collect data for a study, got permission for a one year leave from medical school and had this initial telephone call with a man that would come to make a significant difference in my life.

That telephone call was the start of a long and fruitful learning experience for me in many ways, not only in cardiology research. I immediately noticed his very unique personality in general and as a research mentor in particular. His enthusiasm in mentoring a young, inexperienced medical student in the research field of cardiology was striking. His never-ending energy to come up with new ideas, new ways to look at things, new suggestions of collaborations, new possibilities of collecting data, using other, already existing databases etc was impressive. His office was always open for any medical student who was interested and curious about learning cardiology research.  In a conversation with Galen Wagner you never knew where it would lead. Our countless discussions over the years always opened my mind and boosted it with energy and several new inputs that I later could digest and use to form new directions in solving specific problems, push forward ongoing as well as planning new projects.    

During my year in the US we collected a database (STAFF III) that has later come to play an important role both to me and numerous younger as well as more experienced medical and engineering researchers, as Galen built an invitational Symposium initially based on it. This  ”STAFF Symposium” has since then been held every to every other year in several different countries for two decades.

Galen had an outstanding sense of networking. Not only for himself, since one of his signum was to be unusually modest in focusing on his own success and accomplishments. Rather, he played a role as a facilitator, using his great network connecting other people. In his very informal way, he thereby easily introduced me as well as all other students he mentored to a vast variety of experienced researches around the world. In every sort of discussion he always took the opportunity to include you to get you involved, being just a telephone conference, informal chat in the corridor or a larger discussion at a meeting.

Galen’s involvement in the research education in Turkey and Kyrgyzstan has been especially valuable.

It is very painful but also a chance to write about a mentor and colleague we lost recently, and acknowledge his significant influence on education of young researchers and me personally. I met Prof. Galen Wagner in 2008 during the IRIS at Pezinok, Slovakia. During those 5 days in a beautiful forest in Slovakia my education on the method of workshop training (as described previously) started (2, 3). It was a wonderful time fully filled with various activities for faculty and participants from different countries. It was remarkable to learn from observing Galen’s interaction with students, mentoring them, teaching how to work in a team, how to compete and to carry out scientific debate, and encouraging those who were less fluent in English or simply shy, to participate in discussions, to speak out.  Later, we met in Gebze, Turkey, when we organized a second research school in Turkey. We were actually in constant contact via email and conference calls, something that would become our routine during the organization of each IRIS, and again we learned from Galen how to organize a research school, step by step. As with the other IRIS with Galen, our school was characterized by diversity of participants and faculty, being a true ``university without walls”(4). This time, faculty from Turkey had a chance to meet Galen and learn through personal interactions, faculty meetings and workshops, now all of them remember Galen as their outstanding mentor. As our participants were mostly residents in cardiology, cardiovascular surgery and internal medicine, it was a question at that time, whether the research education was necessary for them (as now the scholarly activity requirements are included in the residency training programs elsewhere) and what the best way was to provide such a training (5).

Galen explained why it is important and advantageous to include such a 5-day workshop in the training of residents in cardiology, who are usually fully involved and overloaded in their clinical work (cathlab, echo and nightshifts duties) and simply do not have time for any scholarly activity. Taking them out of their routine and immersing them in intense workshop research training is the most realistic and efficient way of training that provides them also armamentarium and directions for self-learning after school.  I was then surprised how Galen was right, because indeed almost all participants acknowledged that. The Pezinok 2008 and Gebze 2010 schools participants’ research performance outweighed all our expectations as they had the highest number of publications and citations received after summer school (6), due to the team of participants, faculty and all training activities were led by Galen.

The most important thing about the research schools that we are proud is, under Galen’s guidance, bringing the IRIS to Kyrgyzstan, after years of efforts. Galen’s leading role at each level of planning and organization of Cholpon-Ata Issyk-Kul school should be emphasized. His presence via Skype faculty meetings and a live connection during the IRIS from Issyk-Kul to Galen in Durham, NC provided a unique opportunity for young researchers of Central Asia, thirsty for such education and information they needed. We should refer for their published reflections and opinions on what they have gained during training (7).  Galen was interested in and kept an eye on research activity of Cholpon-Ata participants after school as well and promoting their activities, sharing satisfaction with their achievements in gaining international projects, grants, becoming reviewers in international journals,  presentation of their research work at different meetings and submitting publications. 

Now, we are in preparation of the IRIS in Kazakhstan, and Galen as always was in close contact on progress of organization, continuing to guide us even during his illness. The team trained by Galen now successfully moves forward.

Galen Wagner is an example of an Editor-in-Chief who implements unbiased peer-review process,  works together with authors on proper revision and improvement of the content of the manuscript, educating both authors and reviewers. That I actually learned from Galen and have carried out through my 10-year career as an editor of a cardiology journal. The education of participants and faculty by Galen continued after research schools, as he involved them in reviewing articles and inspired editors of other journals  (8, 9).

We can weigh and analyze the outcomes of research training by the number of publications, citations and international projects participants have gained after their participation. However more than that Galen`s legacy, his mentorship and dedication to education of young researchers in every aspect of their life’s will always live in hearts and minds of hundreds of participants and faculty members.

Gulmira Kudaiberdieva

Editor-in-Chief,  Heart Vessels and Transplantation

Faculty of International Research Interdisciplinary School

Alina Altymysheva, Kyrgyzstan

Oben Baysan, Turkey

Berik Bolatbekov, Kazakhstan

Joao-Batista Destro-Filho, Brazil

Nina Hakacova, Sweden

Cigdem Koca, Turkey

Taalaibek Kudaiberdiev, Kyrgyzstan

Rodrigo Penha Almeida, Brazil

Katarzina Piotrowicz, Poland

Ruslan Sadabaev, Kyrgyzstan

Alexei Savelev, Russia

Peter Skrak, Slovakia

Adam Stanczyk, Poland

Editors of  International Research Interdisciplinary School journals and supporting journals

Beverly Perkins – Journal of Electrocardiology (USA)

Sasa Misak – for Croatian Journal of Medicine (Croatia)

Marian Bernadic and Peter Kristufek, Slovak Monitor of Medicine (Slovakia)

Leonas Valius – Family physician  (Lithuania)

Aynagul Dzhumagulova – Central Asian Medical Journal (Kyrgyzstan)

Mykhaylo Sorokivskyy- for Ukranian Journal of Cardiology (Ukraine)

Bulent Gorenek for JECG editorial board , Turkey

Egle Kaleniuskaine, for JECG editorial board Lithuania

Seitkhan Djoshibayev – Journal of Cardiovascular Research (Kazakhstan)

Nurlan Brimkulov – Bulletin of Kyrgyz Medical Academy (Kyrgyzstan)