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Does anyone have any insights on this program. I got the feeling the fellows weren't very happy but I don't know anyone personally at the program.
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Brown cardiology
- Thread starter Madhatter
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Does anyone have any insights on this program. I got the feeling the fellows weren't very happy but I don't know anyone personally at the program.
That program completely sucks. They give all this false info on how academic they are but its all a lie. You will get a robust clinical experience there but there's a ton of work and thoughts of suicide.
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Wow. I assume you're a fellow there?
No but I know fellows there.
Why am i not surprised? That is the usual lifecycle of an academic cardiology division.
Most Departments of medicine use cardiology ( and gastroenterology to a lesser extent) as the RVU-*****. With NIH cuts, and mounting clinical pressure faculty members (especially junior ones) get pushed more and more in to seeing more patients, doing more procedures..
I wont be surprised if the division of cardiology at Brown is paying the bill for the department of medicine.
At the fellowship level this translates in to more clinical work and less mentorship for fellows. Moreover with the recent changes in reimbursement (and loss of 'technical fees') cardiology divisions are finding it difficult to fund themselves.
As some one who is 25% protected: I barely get 1 day off in a month to do meaningful academic work.. I'd love to teach fellows, do research with them.. But where is the time????
I think there is another thread that talks of UAB's division of cardiology. It is quite instructive for me to see how they have changed in the last 5 years or so.. They have been a clinical and academic powerhouse- when I rotated there the acuity was ridiculous.. I am sure there is a lot more to what the poster has alluded to..
This is the way many divisions of cardiology are evolving.. sad but true. Many other academic medical centers have the same issues: Vanderbilt (the division of cardiology became too big to support themselves, lot of private attendings etc) , Emory etc..
At the resident and fellow-level we are 'protected' from these economic issues facing academic medicine in general.
Most Departments of medicine use cardiology ( and gastroenterology to a lesser extent) as the RVU-*****. With NIH cuts, and mounting clinical pressure faculty members (especially junior ones) get pushed more and more in to seeing more patients, doing more procedures..
I wont be surprised if the division of cardiology at Brown is paying the bill for the department of medicine.
At the fellowship level this translates in to more clinical work and less mentorship for fellows. Moreover with the recent changes in reimbursement (and loss of 'technical fees') cardiology divisions are finding it difficult to fund themselves.
As some one who is 25% protected: I barely get 1 day off in a month to do meaningful academic work.. I'd love to teach fellows, do research with them.. But where is the time????
I think there is another thread that talks of UAB's division of cardiology. It is quite instructive for me to see how they have changed in the last 5 years or so.. They have been a clinical and academic powerhouse- when I rotated there the acuity was ridiculous.. I am sure there is a lot more to what the poster has alluded to..
This is the way many divisions of cardiology are evolving.. sad but true. Many other academic medical centers have the same issues: Vanderbilt (the division of cardiology became too big to support themselves, lot of private attendings etc) , Emory etc..
At the resident and fellow-level we are 'protected' from these economic issues facing academic medicine in general.
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Why am i not surprised? That is the usual lifecycle of an academic cardiology division.
Most Departments of medicine use cardiology ( and gastroenterology to a lesser extent) as the RVU-*****. With NIH cuts, and mounting clinical pressure faculty members (especially junior ones) get pushed more and more in to seeing more patients, doing more procedures..
I wont be surprised if the division of cardiology at Brown is paying the bill for the department of medicine.
At the fellowship level this translates in to more clinical work and less mentorship for fellows. Moreover with the recent changes in reimbursement (and loss of 'technical fees') cardiology divisions are finding it difficult to fund themselves.
As some one who is 25% protected: I barely get 1 day off in a month to do meaningful academic work.. I'd love to teach fellows, do research with them.. But where is the time????
I think there is another thread that talks of UAB's division of cardiology. It is quite instructive for me to see how they have changed in the last 5 years or so.. They have been a clinical and academic powerhouse- when I rotated there the acuity was ridiculous.. I am sure there is a lot more to what the poster has alluded to..
This is the way many divisions of cardiology are evolving.. sad but true. Many other academic medical centers have the same issues: Vanderbilt (the division of cardiology became too big to support themselves, lot of private attendings etc) , Emory etc..
At the resident and fellow-level we are 'protected' from these economic issues facing academic medicine in general.
Well said. I couldnt agree more. UAB is definitely in a similar situation. When you interview at many of these places, they obviously cant tell you the real story. In fact, they will paint a picture of what the program used to be. You have to be self-informed which many applicants dont do and then they find out the hard way.
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Very smart post by Epadha.
I believe that when I was a fellow, the cardiology division was holding up the medicine dept., financially speaking, and I know we/they were subsidizing other academic divisions, essentially. But now with cuts to imaging reimbursement (and cath soon?) not sure that will work out in the future. It's becoming like private practice where people have to work more and more to approximately their same billing/profit that they had in the past.
It's not just cardiology.
I have an MD/PhD friend who is an oncologist and trying to do basic research...the research funding just isn't there, any more.
Ditto for my accomplished PhD friend with many publications and 2 post docs, one of them at Harvard, and who cannot find a faculty job and not even one in private industry easily.
It makes me afraid about what we are going to do to find innovative therapies in the future. You can only get so much work out of one physician, and you can't expect people to go into "academia" with zero job security or if they are going to have to try to do what we do in private practice (or pseudo private practice in an academic affiliated clinic like I'm in) and see patients all day and still be doing research on the side.
I believe that when I was a fellow, the cardiology division was holding up the medicine dept., financially speaking, and I know we/they were subsidizing other academic divisions, essentially. But now with cuts to imaging reimbursement (and cath soon?) not sure that will work out in the future. It's becoming like private practice where people have to work more and more to approximately their same billing/profit that they had in the past.
It's not just cardiology.
I have an MD/PhD friend who is an oncologist and trying to do basic research...the research funding just isn't there, any more.
Ditto for my accomplished PhD friend with many publications and 2 post docs, one of them at Harvard, and who cannot find a faculty job and not even one in private industry easily.
It makes me afraid about what we are going to do to find innovative therapies in the future. You can only get so much work out of one physician, and you can't expect people to go into "academia" with zero job security or if they are going to have to try to do what we do in private practice (or pseudo private practice in an academic affiliated clinic like I'm in) and see patients all day and still be doing research on the side.
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I can weigh in on this as I am a current second year fellow at Brown.
The cardiology program has traditionally been very clinically heavy, until recently, we had approximately 14 clinical months (consults, etc), where the requirement was only nine. Additionally, the first year class, had a very difficult call schedule. Not only were the calls clinically very demanding, but they required in house presence (we were not allowed to go home). This obviously led to great clinical training (although in my opinion -- diminishing returns), and some unhappy fellows. For the past few years, we also had an interim chairmen of cardiology (our prior chair went to BID) which lead to a temporary stagnation of the program. I can honestly say that there were times during my first year where I had wondered if Brown was the right program for me.
However, recently, there have been a lot of changes in the program (groundbreaking considering how quickly/how many there were). In March, we got a new chairmen, Sam Dudley from UIC. With the new chairmen, came a lot of changes to the program. Some of the significant one's included:
1. Cutting the total amount of call down.
- First year call was cut in half (A large amount of the call was replaced by moonlighters). They do about 50 calls for the whole year (was about 80 prior to this)
- In term's of weekends, first years work approximately 20 weekends/yr (this is either Friday night, Saturday Night, or Sunday Night at the main hospital), second years work 8 weekends/yr (this is Fri 5pm-Monday 7am -- but only covers emergencies at the community hospital/VA), and Third years have 0 weekends (0 calls total)
- A large amount of call was replaced by moonlighters
2. Elimination of fellow involvement except for CCU admissions at the community hospital (Miriam).
- This was one of the biggest changes to the program. In the past, first years did approximately 30 days/yr at the community hospital, where we involved with low risk chest pain, all elevated troponins, etc. The involvement in the fellow in this setting was one of the largest reasons for fellow unhappiness
3. Increasing of elective time
- First years have one month of elective, second years have two months of elective, third years have 12 months of elective
4. Decreasing of required clinical months to 9
5. Institution of 2+2 programs, Research Pathways
- Allows people to fast track into EP or interventional
Looking back on my first year -- it was extremely difficult. Number wise I did over 300 echos, 60 TEE, 212 Diagnostic Cath's (as primary operator), 18 Temp wires, 30 swans, and 1 balloon pump -- figures that some fellows don't see in three years.
In response to Cardio4Life's post (I'm surprised someone who didn't match would make such harsh comments towards a program -- Maybe a bit bitter eh?) about claiming to be academic, I don't think we claim to be that. We are pretty straight forward about what we have to offer. We don't do much research outside of EP (although 8/18 fellows presented at AHA/ACC), however we are trying to expand this with Dudley's lab coming here from Chicago, the research track, and having 12 months of elective.
Since the change's have been implemented -- I feel that the first year fellows are extremely happy. Additionally, there are some more changes that will be happening (VAD starting in January). I think this program is clearly on the rise.
As a word of advice for applicants, when looking at a program -- be honest with what your career goals are and find a program that matches them. Most programs tend to be either clinical or academic, there are VERY FEW that are a SUCCESSFUL hybrid. If you goal is to have NIH funding, K awards etc, a program like Brown isn't for you. However if you want to be clinically strong, and be COCATS2 in multiple modalities (I'll be in echo, cath, nuc, RPVI, and MRI), and work at a place with friendly fellows and attendings -- I'd highly consider Brown
If anyone has any further questions, feel free to respond or PM me. Hopefully this was helpful. Good luck on the trail.
The cardiology program has traditionally been very clinically heavy, until recently, we had approximately 14 clinical months (consults, etc), where the requirement was only nine. Additionally, the first year class, had a very difficult call schedule. Not only were the calls clinically very demanding, but they required in house presence (we were not allowed to go home). This obviously led to great clinical training (although in my opinion -- diminishing returns), and some unhappy fellows. For the past few years, we also had an interim chairmen of cardiology (our prior chair went to BID) which lead to a temporary stagnation of the program. I can honestly say that there were times during my first year where I had wondered if Brown was the right program for me.
However, recently, there have been a lot of changes in the program (groundbreaking considering how quickly/how many there were). In March, we got a new chairmen, Sam Dudley from UIC. With the new chairmen, came a lot of changes to the program. Some of the significant one's included:
1. Cutting the total amount of call down.
- First year call was cut in half (A large amount of the call was replaced by moonlighters). They do about 50 calls for the whole year (was about 80 prior to this)
- In term's of weekends, first years work approximately 20 weekends/yr (this is either Friday night, Saturday Night, or Sunday Night at the main hospital), second years work 8 weekends/yr (this is Fri 5pm-Monday 7am -- but only covers emergencies at the community hospital/VA), and Third years have 0 weekends (0 calls total)
- A large amount of call was replaced by moonlighters
2. Elimination of fellow involvement except for CCU admissions at the community hospital (Miriam).
- This was one of the biggest changes to the program. In the past, first years did approximately 30 days/yr at the community hospital, where we involved with low risk chest pain, all elevated troponins, etc. The involvement in the fellow in this setting was one of the largest reasons for fellow unhappiness
3. Increasing of elective time
- First years have one month of elective, second years have two months of elective, third years have 12 months of elective
4. Decreasing of required clinical months to 9
5. Institution of 2+2 programs, Research Pathways
- Allows people to fast track into EP or interventional
Looking back on my first year -- it was extremely difficult. Number wise I did over 300 echos, 60 TEE, 212 Diagnostic Cath's (as primary operator), 18 Temp wires, 30 swans, and 1 balloon pump -- figures that some fellows don't see in three years.
In response to Cardio4Life's post (I'm surprised someone who didn't match would make such harsh comments towards a program -- Maybe a bit bitter eh?) about claiming to be academic, I don't think we claim to be that. We are pretty straight forward about what we have to offer. We don't do much research outside of EP (although 8/18 fellows presented at AHA/ACC), however we are trying to expand this with Dudley's lab coming here from Chicago, the research track, and having 12 months of elective.
Since the change's have been implemented -- I feel that the first year fellows are extremely happy. Additionally, there are some more changes that will be happening (VAD starting in January). I think this program is clearly on the rise.
As a word of advice for applicants, when looking at a program -- be honest with what your career goals are and find a program that matches them. Most programs tend to be either clinical or academic, there are VERY FEW that are a SUCCESSFUL hybrid. If you goal is to have NIH funding, K awards etc, a program like Brown isn't for you. However if you want to be clinically strong, and be COCATS2 in multiple modalities (I'll be in echo, cath, nuc, RPVI, and MRI), and work at a place with friendly fellows and attendings -- I'd highly consider Brown
If anyone has any further questions, feel free to respond or PM me. Hopefully this was helpful. Good luck on the trail.
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Completely agree with BOYZ OF 4D!
This program is on the up and up (not that it was truly ever down anyway). The statement by CARDIO4LIFE, is completely outrageous and self biased from what is likely an unmatch bitterness...and now outdated.
I interviewed here and know the one of the fellows there. Let me say, I am completely jealous of not being there.
It should be considered a top-tier program, as it is one of the few successful hybrid programs.
With the impact of the new Chief of Cards bringing in high-level research and (what is most important to be a great cardiologist) high-level of experience and exposure you obtain from rotations, it is a great training program. PERIOD.
The fellows are all very happy, from word of mouth and through seeing it first hand. The PD is great and very personable with sets the tone for the fellowship, a nice place to work while achieving all that was stated above.
Seems they made some drastic changes recently, which only improved the program (see BOYZ comment) and truthfully, the program was better than others I interviewed at (Tufts, Yale, BU to name a few), and would only become best in the region if it were to solidify the VAD and start a transplant program.
I sound like I'm trying to sell the program, but as a non-fellow there (with nothing to lose) who knows the fellows and has interviewed first hand, I can say that Brown is TOP TIER and should not be overlooked as a hidden player in the New England area and applicants should not be miss led by inaccurate comments as CARDIO4LIFE had stated.
This program is on the up and up (not that it was truly ever down anyway). The statement by CARDIO4LIFE, is completely outrageous and self biased from what is likely an unmatch bitterness...and now outdated.
I interviewed here and know the one of the fellows there. Let me say, I am completely jealous of not being there.
It should be considered a top-tier program, as it is one of the few successful hybrid programs.
With the impact of the new Chief of Cards bringing in high-level research and (what is most important to be a great cardiologist) high-level of experience and exposure you obtain from rotations, it is a great training program. PERIOD.
The fellows are all very happy, from word of mouth and through seeing it first hand. The PD is great and very personable with sets the tone for the fellowship, a nice place to work while achieving all that was stated above.
Seems they made some drastic changes recently, which only improved the program (see BOYZ comment) and truthfully, the program was better than others I interviewed at (Tufts, Yale, BU to name a few), and would only become best in the region if it were to solidify the VAD and start a transplant program.
I sound like I'm trying to sell the program, but as a non-fellow there (with nothing to lose) who knows the fellows and has interviewed first hand, I can say that Brown is TOP TIER and should not be overlooked as a hidden player in the New England area and applicants should not be miss led by inaccurate comments as CARDIO4LIFE had stated.
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