In a broad sense, one might think of John Ikonomidis as a prized, "five-star" recruit, an uncommonly gifted athlete pursued by colleges throughout the land.

Indeed, the Charleston transplant was a nationally ranked tennis player in his native Canada.

But instead of fretting about him being 'one and done,' starring for one season before beating a quick exit, the Medical University of South Carolina can content itself with having landed, and retained, one of the most sought-after surgeons in North America.

As the new chief of cardiothoracic surgery at MUSC, the 44-year-old physician, scientist and academic has hit the court running, focusing on growing the program and its reputation, not burnishing his star.

Ikonomidis came to MUSC from Stanford University in July 2000 as an assistant professor and attending CT surgeon. After a steady progression through the ranks, his new post as CT chief finds him succeeding Dr. Fred Crawford, who held the position for 30 years and is remaining on staff as a surgeon, a rather daunting act to follow.

"It goes beyond that," says Ikonomidis, whose scholarly papers, awards, fellowships and other honors require a book-length resume. "In addition to not just being the division chief of cardiothoracic, Dr. Crawford was also chair of the entire department of surgery for a very long period of time. On top of that, in our subspecialty of cardiothoracic surgery, he's really achieved all of the important and desirable milestones within our profession.

"I have benefited greatly from my association with Dr. Crawford because he has tremendous experience, and his mentorship has been about as good as it could possibly be. So, yes, it's kind of daunting, but at the same time an experience that is extremely valuable."

Seizing opportunity

Ikonomidis is enjoying an unusual interlude of quiet in his office-on-high in MUSC's Ashley River Tower, an expansive view of the city at his back. Ptolemy or Caesar would appreciate the lordly panorama, but the landscape is not on his mind, at least not entirely. Rather, he muses on why he came to the university and the area in the first place.

"I was very fortunate personally in that I had no bias as to where I wanted to be. Having said that, I was sort of leaning toward going back to Toronto (in 2000), but there really wasn't a satisfactory position available there. I was also very open-minded with regard to what was available. When I was invited to MUSC to look at the job, it was pretty obvious that this is where I needed to be."

Apart from his responsibilities as a surgeon and administrator, Ikonomidis has several key initiatives in the works: the establishment of the S.C. Heart Valve Institute, a joint endeavor between CT surgery and cardiology; the HeartMate II left-ventricular assist device program headed by Dr. Matt Toole; a lung (cardiopulmonary) transplant program; and the hiring of new surgeons, a process already under way.

Currently vice chairman, Ikonomidis will become chairman of the American Heart Association's Council for Cardiovascular Surgery and Anesthesia next year.

"It's an administrative position having to do with programs and concepts within the AHA as they apply to surgeons. It also involves guiding the direction of the council, which has a membership right now of about 4,000 surgeons and scientists."

Steady as he goes

With all this piled on his plate, efficiency is almost as vital as planning and precision of execution. Ikonomidis suggests that while he relishes a many-faceted challenge, he is not changing his fundamental approach.

"I tend to side toward the analytical," says Ikonomidis, guest editor of the American Heart Association Surgical Supplement to the periodical Circulation.

"Given a task, I tend to jump on it immediately and assess what's required, then plan, execute and review before it's actually time to open it up and bring it forward," he says. "I've never historically been all that good at doing things on an impromptu basis. I obviously will if I need to, but I prefer not to be putting things off till the last minute, mushing around.

"Clearly, it's different sometimes in the operating room when you have to think on the spot. That's fine, and I'm very comfortable with that."

At present, Ikonomidis remains a Canadian citizen, though he enjoys permanent resident status in the United States. Dual citizenship is on the horizon, he says, probably within two years. Meanwhile, he navigates the familiar task of balancing the professional and personal.

"My days are very busy and very concentrated, but I must say I enjoy what I am doing so much that despite how busy I may be or what my day may look like, I wake up every day extremely excited and ready to come to work. I am excited about all these challenges. This is what I want to do. I love being a doctor. I love being a surgeon. I love being an academic. And I am enjoying the administrative side very much as well."

Ikonomidis says he is fortunate to have an extremely supportive spouse.

"My wife, Shari, has put up with a lot through my residency and through the many hours I work here. I try very hard to structure it so that when I'm home at night, I'm at home. I leave my work here. When I'm not on call, I try to make a point of (being incommunicado)," he says. "We have three children, and I really try to spend time with them, understand their interests and participate in them, help with things like their homework and so forth. I think it is extremely important. I'm as dedicated to my family, I believe, as I am to my job.

"It is a balancing act, no question, something you have to work at. And it doesn't come easily."