This episode of JACC This Week, hosted by Harlan M. Krumholz, MD, SM, highlights key research and perspectives from the October 14, 2025 issue of JACC. It opens with a call to modernize physician certification by distinguishing core knowledge from clinical reasoning, emphasizing continuous, engaging learning over rote memorization. Featured studies in this week's issue include the cardiovascular risks linked to clonal hematopoiesis in older women, improved clotting outcomes with third-generation LVADs despite ongoing bleeding risks, and how dapagliflozin reduces heart failure events post-TAVI without improving perceived quality of life. The episode also explores inflammation as a target after myocardial infarction, the evolving role of drug-coated balloons in PCI, and cardiac CT's expanding use in prosthetic valve assessment—signaling a shift toward more precise, less invasive cardiovascular care. We also feature an article from JACC: Asia this week on cardiovascular Implications of lipoprotein(a) and its genetic variants in patients from the Middle East.