hello

i'm a third year med student who is completely undecided. I have been thinking of ENT, Family Med, IM subspecialty, etc. I want to do something broad based, that's why i am undecided about ENT, but then again, I want something with a good lifestyle, so i'm more unsure about IM and Family Med (b/c of how much you have to work, etc). At this point, i'm looking towards possibly cardiology as an IM subspecialty. Any of you guys know how hard it is to get a cardiology fellowship? what is involved? how long is it for?


can anyone tell me what are some of the top IM residency programs and what kind of scores/grades/extracurricular stuff you would need to match with them?



thanks!!!

NT

A very short answer-
Cardiology is one of the top two most competetive IM fellowships (along with GI) right now. It is three years long.

Since you are in med school now, the best advice I can give you is to find an advisor in internal medicine and talk to him or her about your questions regarding making yourself competetive for residency and fellowship.

Good Luck
MC

I was under the impression that lifestyle not so good for cardiology...

Wow. No offense, but for a third year, you seem remarkably uninformed about residency training. I would first encourage you to talk with as many residents and attendings about your career goals. Having a mentor would be an excellent idea, I have one and even though I don't get that much in terms of advise from him, he was very helpful in motivating me to finish my application stuff early for fourth year. You can read my FAQ posted on the top of this page for basic answers to many of your questions, but I will tell you here that IM residency is 3 yrs. You apply for fellowships at the beginning of second year, so it's pretty important that you have some idea of which IM fellowship you want to do fairly early in the game. For cardiology, the best extracurrular activity you can do is research. Cardiology and GI are the most competive fellowships right now and for many of those programs, research is almost considered a pre-requisite. For top IM programs, you should aim to be AOA or be ranked in the top quartile of your class and have step I scores of 235+. That's not to say that you won't be considered at a lot of them if your scores are any less impressive, but as my PD likes to say, it's where applicants who have received interviews have been scoring in the past. A cardiology fellowship is 3 yrs, and it is definitely one of the more rigourous fellowships in terms of work-load. Many fellows feel that their workload and hours are actually greater then intern's, which can be frustrating as you are working long hours for a low salary while you see your classmates go out into private practice working far fewer hours making 3-4X your salary. Right now, it's one of the more higher reimbursed specialties, but many of my professors predict that this may change in the next 20 yrs. Besides all of the rumbling in Washington about decreasing reimbursement for things like cath's, there are a lot of turf wars that are going to be happening soon with diagnostic cath's in terms of radiologists being able to do gated-CT scans and give you the same information with a much less invasive procedure. And then the better they get at making those stents and the more medical therapy improves, the less people will need angioplasties. That being said, with the current high rates of medical non-compliance and rising age and obesity of our population, I don' tthink cardiologist have anything to worry about in the near future. There is currently a shortage of cardiologist because now, everybody who has an MI should ideally be cathed and get an angioplasty. That's a lot of patients who need to see a cardiologist right away.

Not every cardiologist does angioplasties and stents... there are always non-invasive cards and EPS.

But I agree, residency and fellowship are not known to be easy. ENT isn't quick and easy either, though.

Looking back just 10-15 years ago there were medical economists and the like who predicted the market would be inundated with subspecialists by now. As it turns out, there is in fact a shortage of specialists in many fields including cardiology.
Just goes to show, predicitions of any sort, may they be medical, political, or about the weather- should always be taken with a good deal of healthy skepticism.

It seems to me quite clear that the reason cardiology and gastroenterology enjoy so much popularity at the moment is because of the "lifestlye," i.e. salaries these specialists earn. Medical school graduates today are keenly attentive to lifestyle issues and compensation, as perhaps they should be, and so more and more of those who pursue internal medicine training feel compelled to go into cards or gi so as to be earning higher end medical salaries...Doctors in all specialties, like everyone else in this society, are creatures of capitalism.

I've been plagued by worries about my future earning potential and I think the thing that keeps me most sane and human is remembering the admonition to do what you love doing...the fellowship, money etc etc...will fall in place if you stick to that one rule...

I agree that things will fall into place (unless you plan to make your career in a free clinic). If all you do is worry about "future earning potential" then you will not get anywhere.