Paul Grayburn did his general cardiology fellowship under the tutelage of Dr. Anthony N. DeMaria at the University of Kentucky from 1984 to 1986, followed by a year of interventional cardiology training with Dr. David C. Booth. In 1988, he was recruited to the University of Texas Southwestern Medical School by Dr. James T. Willerson, where he served on the faculty for 15 years. During that time, he was director of the echocardiography laboratories at the University of Texas Southwestern and chief of cardiology at the Dallas Veterans Affairs Medical Center, where he also practiced interventional cardiology.