Cardiac Fellowship advice needed...

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bkell101

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Hi everybody,

Hoping you all could weigh in and give me some advice....

My wife and I currently live on the East Coast. We are from Cincinnati and would like to eventually move back to be around family. My wife's company has moved her current role from the East Coast back to the Cincinnati beginning July 2016 (Same time I would start fellowship). That being said, she is willing to look for work elsewhere and there are no guarantees for me to eventually find work in Cincinnati.

Would you pursue "top fellowships" away from home and then look back into Cincinnati after fellowship? If so, what programs would make you consider giving up your wife's current job?..... Or, would you keep your wife's guaranteed income, look more regionally (Cincinnati/OhioState), and rely on local connections to land a job in the Cincinnati market?

Any input and or similar prior experiences would be much appreciated!

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I'd go with fellowship in Cincinnati if you want to live and stay there after. Local connections would be very helpful.
 
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Agree with Wiscoblue, local connections go a long way and I've heard that Cincinatti has solid peds and cardiac fellowships. If your goal is to remain in OH, then I don't see any reason why you shouldn't train at Cincinnati. Other solid regional programs include OSU and CCF.
 
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Current CA-1 in the Northeast, originally from midwest/southeast and could easily see myself in a very similar situation if I choose fellowship route.

I've talked to a few of my cardiac attendings and their very general advice has been to try and land a fellowship in the region I'd like to eventually end up (Nashville/Louisville/Lexington/Cincy). However my program's very strong connections are in the Northeast, so it'll be interesting this time next year if/when I'm applying. .
 
anybody out there have any personal experience at Cincinnati or Ohio State for Cardiac fellowship? feel free to pm me.

....so if you were in charge of hiring for your group in Cincinnati and you had an applicant from Cincinnati/Ohio State with recommendations from another attending in the area vs a guy/gal from a place like Duke of BIDMC you would hire the local person with good personal recommendations?

anybody have any recent experience searching for a job in the Cincinnati/Northern KY market?
 
A lot of hiring decisions come down to fit, and sometimes it's not obvious what they're looking for. Every applicant here has board certification and a fellowship, some have several years of experience.
The decision about who they interview often comes down to where they trained (because of good experience with past grads) and what their letters say and don't say. Not passing the boards will sink your application.
Wherever you end up, bust your ass and be memorable. Help others, stay late, read, be better than your colleagues. That way your letters will have all the right buzz words to get you the interview. The difference between an average letter and a great one is obvious. Knowing the letter writer is probably a plus as well as it will lead to a phone call. Local programs may help with this. Once you're in the door, turn on the charm.
Local ties help also as you want to hire people that will be happy and will potentially stay a long time. We have moved applicants up the rank list just because of strong local ties.
 
A lot of hiring decisions come down to fit, and sometimes it's not obvious what they're looking for. Every applicant here has board certification and a fellowship, some have several years of experience.
The decision about who they interview often comes down to where they trained (because of good experience with past grads) and what their letters say and don't say. Not passing the boards will sink your application.
Wherever you end up, bust your ass and be memorable. Help others, stay late, read, be better than your colleagues. That way your letters will have all the right buzz words to get you the interview. The difference between an average letter and a great one is obvious. Knowing the letter writer is probably a plus as well as it will lead to a phone call. Local programs may help with this. Once you're in the door, turn on the charm.
Local ties help also as you want to hire people that will be happy and will potentially stay a long time. We have moved applicants up the rank list just because of strong local ties.
What is this, if not the definition of a rat race? Welcome to the future of anesthesia.
 
How is working hard, and being a helpful and flexible resident a rat race? If you want to be a superstar you have to work for it. Competitive jobs in desirable locations are always hard to get, now more than ever, you don't just send a resume and start house hunting. You're sounding a bit entitled, like the residents from the home program whining about not matching here or fellows not getting a job offer. You weren't the best applicant.
 
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How is working hard, and being a helpful and flexible resident a rat race? If you want to be a superstar you have to work for it. Competitive jobs in desirable locations are always hard to get, now more than ever, you don't just send a resume and start house hunting. You're sounding a bit entitled, like the residents from the home program whining about not matching here or fellows not getting a job offer. You weren't the best applicant.
You read too much into my post (although we could exchange a few cheap shots about who's more entitled, given the fact that you probably make much more per hour than I do - partner vs employee). I should have posted it on the thread about the future of anesthesia.

Funny thing is I tend to tell residents the same thing: be careful not to piss anybody during residency, not even one of your colleagues, because it will come back to bite you. This is a career where professional competency is among the last on the checklist, and character is dead last (except when one confuses being a worker bee with having a spine). It's mostly smoke and mirrors, especially in a specialty where nobody knows how good one really is (since USMLE, board scores, complication rates etc. are not public).

I quoted your post as an example of how anesthesia job hunt will look in the future. This is nothing about being a superstar; this is about a pretty regular job (especially coming from a cardiac fellowship). Who in their right mind would pursue a career where it's enough to just sneeze the wrong way for one to become virtually unemployable (except for crappy jobs)? That is the definition of rat race: busting one's bottom one's entire life, so that one can stand out somehow and continue to just have a job. I don't think anybody dreamt about this when committing to a medical career. It has nothing to do with taking excellent care of patients anymore; it's about good enough medical care, but excellent theatricals and brown-nosing (excuse me, "diplomacy") towards the higher-ups (the latter are much more important in today's corporate medical world).

Apologies to the OP for the off-topic.
 
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You read too much into my post (although we could exchange a few cheap shots about who's more entitled, given the fact that you probably make much more per hour than I do - partner vs employee). I should have posted it on the thread about the future of anesthesia.

Funny thing is I tend to tell residents the same thing: be careful not to piss anybody during residency, not even one of your colleagues, because it will come back to bite you. This is a career where professional competency is among the last on the checklist, and character is dead last (except when one confuses being a worker bee with having a spine). It's mostly smoke and mirrors, especially in a specialty where nobody knows how good one really is (since USMLE, board scores, complication rates etc. are not public).

I quoted your post as an example of how anesthesia job hunt will look in the future. This is nothing about being a superstar; this is about a pretty regular job (especially coming from a cardiac fellowship). Who in their right mind would pursue a career where it's enough to just sneeze the wrong way for one to become virtually unemployable (except for crappy jobs)? That is the definition of rat race: busting one's bottom one's entire life, so that one can stand out somehow and continue to just have a job. I don't think anybody dreamt about this when committing to a medical career. It has nothing to do with taking excellent care of patients anymore; it's about good enough medical care, but excellent theatricals and brown-nosing (excuse me, "diplomacy") towards the higher-ups (the latter are much more important in today's corporate medical world).

Apologies to the OP for the off-topic.

This is as accurate of a post as one will find in this thread going back years. Of course there has been several "On the money posts" over the years but this ranks among the tops...
 
That is the definition of rat race: busting one's bottom one's entire life, so that one can stand out somehow and continue to just have a job. I don't think anybody dreamt about this when committing to a medical career.
Well, pre-med dreams are about an inch away from high school dreams. The typical wide-eyed, optimistic, and naive pre-med dream (I had it too) starts and ends with an acceptance to medical school. It was supposed to be all easy and downhill, with riches and respect after that, right? Because getting in the door was the hard part. Nope.

Let's be honest, unless you're born into wealth (and I mean REAL wealth, i.e. never ever have to work at all) life is a rat race whether you're a subsistence farmer in the 3rd world or a doctor in the 1st. If you want to be more successful than your peers, you need to work harder than them. It helps to be smarter than them. It helps if you start off on a socioeconomic 2nd or 3rd base. It helps if you have help, and help comes from being sufficiently social and likeable that other people want to help you.

We can gripe about this "rat race" and pretend it's some kind of modern invention, but it's been the human existence for thousands of years. Why on earth would anyone other than a naive premed think that medicine would be any different?

Or maybe it's now time to rehash the MBA and i-banker fantasies ... it's been a couple weeks. :)
 
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Well, pre-med dreams are about an inch away from high school dreams. The typical wide-eyed, optimistic, and naive pre-med dream (I had it too) starts and ends with an acceptance to medical school. It was supposed to be all easy and downhill, with riches and respect after that, right? Because getting in the door was the hard part. Nope.

Let's be honest, unless you're born into wealth (and I mean REAL wealth, i.e. never ever have to work at all) life is a rat race whether you're a subsistence farmer in the 3rd world or a doctor in the 1st. If you want to be more successful than your peers, you need to work harder than them. It helps to be smarter than them. It helps if you start off on a socioeconomic 2nd or 3rd base. It helps if you have help, and help comes from being sufficiently social and likeable that other people want to help you.

We can gripe about this "rat race" and pretend it's some kind of modern invention, but it's been the human existence for thousands of years. Why on earth would anyone other than a naive premed think that medicine would be any different?

Or maybe it's now time to rehash the MBA and i-banker fantasies ... it's been a couple weeks. :)
The only difference is that in a patient based practice you have to appeal to patients whereas we have to appeal to the suits. It's all about marketing your value.
 
Well, pre-med dreams are about an inch away from high school dreams. The typical wide-eyed, optimistic, and naive pre-med dream (I had it too) starts and ends with an acceptance to medical school. It was supposed to be all easy and downhill, with riches and respect after that, right? Because getting in the door was the hard part. Nope.

Let's be honest, unless you're born into wealth (and I mean REAL wealth, i.e. never ever have to work at all) life is a rat race whether you're a subsistence farmer in the 3rd world or a doctor in the 1st. If you want to be more successful than your peers, you need to work harder than them. It helps to be smarter than them. It helps if you start off on a socioeconomic 2nd or 3rd base. It helps if you have help, and help comes from being sufficiently social and likeable that other people want to help you.

We can gripe about this "rat race" and pretend it's some kind of modern invention, but it's been the human existence for thousands of years. Why on earth would anyone other than a naive premed think that medicine would be any different?

Or maybe it's now time to rehash the MBA and i-banker fantasies ... it's been a couple weeks. :)
It has never been this bad in medicine. And the outlook hasn't been this bad either. Before Obamacare, being a doctor in America was better by degrees of magnitude (and I am not talking only about financials).

It's all related to the destruction of the private independent medical professional. It's a walmartization.
 
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It has never been this bad in medicine. And the outlook hasn't been this bad either. Before Obamacare, being a doctor in America was better by degrees of magnitude (and I am not talking only about financials).

It's all related to the destruction of the private independent medical professional. It's a walmartization.

Strange. I haven't noticed ANY difference pre and post Obamacare. Not in terms of volume or reimbursements. Still marching along.
 
Strange. I haven't noticed ANY difference pre and post Obamacare. Not in terms of volume or reimbursements. Still marching along.
It's the boiling frog syndrome. Things are changed slowly, a few at a time, so that they become the new normal unconsciously. It's been a known technique since Machiavelli.

One cannot avoid to notice the significant decrease in private physicians, the metastasis of big corporate hospitals into outpatient medicine, with all their ills and shortcomings, the disappearance of a healthy healthcare market, the decrease in insurance benefits, the decline in reimbursements (also by not adjusting their value to inflation) etc. Just look back 20 years, and then do the same 20 years from now.
 
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