Cardiology Program Impressions for 2012

[cathemALL]

Hi everyone,

Trying to kill time at the airport and I thought it might be helpful to share our thoughts of the programs we have interviewed at for this app season. I have a West Coast bias and so most of my contributions will be about programs in California and some from Chicago & Cleveland. Hopefully others can tell us about programs in East Coast (NYC, Boston and the Southeast).

Bare with me, I tend to be a little wordy =)

UC Davis.

Pros:

I'm a little partial to Davis because I get a sense of a strong sense of community from the IM dept down to the subspecialties. I felt the program is very supportive of its fellows and one of the fellows mentioned in particular how the PD will personally make phone calls to ensure the success of his falls. Apparently, for one of the fellows, the PD spent half the day making calls to guarantee an EP fellowship for a fellow. I found these stories to be impressive and seemed representative of the program rather than an isolated incident.

The clinical training at Davis is respectable. They test the incoming fellows up front to gauge their level of knowledge in various areas and will help to train any area that is lacking. Also they emphasize a lot of their training to board certification in cardiology as well as fulfilling a good amount of the COCATS criteria in multiple aspects so the fellows come out well-trained in general cardiology. I really admire this dedication to some sort of formal training since I do feel that many residents & fellows can go through training deficient in core skills with the PD often looking the other way when hints of this do arise.

The other major positive for Davis is great funding. They seem to have great ancillary support with a large # of RN's or NP's that can help with outpt management. They have alot of cath labs for the size of their hospital (in terms of hospital beds) - they recently added more cath labs and now totals 8 (for both EP and Interventional). One of the major benefits of the new cath lab is that it is placed right next door to the ER which will help in bringing down the door to balloon time. Needless to say, despite good overall cardiology training, interventional cardiology is heavily emphasized at Davis - likely related in part to the chief being a prominent interventionalist.

Cons.

Davis is primarily a clinically oriented program despite being affiliated with a moderate to large sized university. The PD is quite clear on this emphasis and I don't see any plans in trying to step up the research. They do have facilities for many basic science studies but they are predominantly offsite at the Davis Undergrad/Grad campus which makes it very inconvenient and inefficient (about 30 min away).

I was underwhelmed by the lack of a dedicated HF group (something I'm used to from my training) and a seeming lack of emphasis of advanced HF (again, just based on my IV day). Their new faculty member heading the HF 'program' is a jr faculty member just recently hired. She seemed very dedicated to her work and recently completed a HF fellowship at UCSF. However, I feel there is a long way to go in this regard (destination VADs only recently implemented this past summer). In addition, there is no heart transplant program at UCD and they refer these cases to outside facilities (I believe UCSF or Stanford).

Overall, I believe UCD is a strong clinical cardiology program with a heavy emphasis towards interventional cardiology. I think it is a great place for subset of fellows that fit in this category and without a doubt, they will get great support from the faculty and will be happy at Davis.


Ok, I have to board my flight. I will post reviews on U of Washington, Stanford and UCLA shortly.

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[cathemALL]

"U Dubb"

I had pretty high hopes for University of Washington. They have published alot of groundbreaking work in basic science and this appealed alot to me. However, despite their 200 page book written about their fellowship; I didn't get the clearest idea of their focus and where they were headed.

The pros for U of Washington seem to boil down to solid clinical training, heavy emphasis on training for reading echos, Dr. Otto seemed to be a very supportive PD and a three hospital based system with a moderate sized university hosp (450 bed), county hosp and VA hospital. Dr. Dichek spoke to us about the research aspect and along with Dr. Chin, they emphasized opportunities for basic science research. However, I noticed that most of the research from the cardiology faculty were primarily clinical and particularly focused on outcomes research (eg Seattle HF Model). They have actually quite a lot of funding for outcomes research, headed under the CTSA grant. I think funding of this amount is quite rare for epidemiological studies and so I found this to be a very positive aspect for those interested in clinical research.

However, there is an ongoing search for a new chief for the cardiology dept to replace the acting head, Dr. Caldwell. After speaking with some of the faculty, they made it pretty clear that they were looking for someone who would help lead them to pioneer more basic science research in the dept. Again, I can't really reconcile the discordance between the large basic science funding and large facilities dedicated to it compared to primarily clinical research from the cardiology faculty. Perhaps it may be related to Phd's and MDs from other fields that become affiliated with the cardiology dept (and listed as cardiology) - thus accounting for alot of their prominent work despite not having their clinical faculty not producing this work directly. Maybe someone from U Washington can expand on this further.

One thing I noticed was that many people did not appear enthused to be in U of Washington or Seattle on my interview day. This could just have been that particular day but that had a major impact on my impression of U Washington.

Ultimately, U of Washington is a solid program with multiple opportunities for research with changing emphasis from clinical to basic science research. The direction of the dept is still a little unfocused and unclear to myself and likely will become more evident when they choose the new chief. I hear they are close to making a decision soon on this as well.

Stanford

Great program. Very likable PD. The interview day was not very well organized compared to other interviews and in fact, may have been the least organized (perhaps part of the Californian culture). Interviews however were pretty laid back and I enjoyed talking to all the faculty.

Stanford's forte is basic science research and this is emphasized by their required 4 year fellowship as opposed to the standard 3 years. Their focus is giving enough time to have productive research and they strongly feel 1 yr's worth of research does not provide this. Stanford is essentially a 2 hospital based system with rotations at the university hospital and the PAVA. I can't really comment on their clinical volume since they did not give me #'s I can compare to. Their transplant program and HF group is very strong and what Stanford is known for, given the history of the first heart transplant in the US by Dr. Shumway. I believe their #'s are similar to UCSF if not greater (again, this is just a general impression). Interventional cardiology is also a strong subspecialty with IVUS having been invented here and the dept being part of the PARTNER trial for percutaneous AVR. Imaging is also very well represented at Stanford. They have their own imaging group and they share privileges for reading cardiac MRI with radiology at Stanford. Stanford is also well-known for specializing in echocardiography.

Overall, Stanford is a great program that provides strong clinical training but with heavy emphasis on producing academic clinicians. They have a great history and the fellows that I spoke with seemed genuinely happy training there.

Ok, I'll post more reviews later in the week and take a break for now. Thanks guys.

 

[cards2012]

Emory:

Briefly,

Pros:
Nice small campus
big city
Decent weather
Very strong clinically
Largest fellowship program, can go either way
a lot of stress on academic track but it seems that they dont get the residents on academic track by regular match so they give out prematch for physician scientist track. Reflects badly on the program
big on atherosclerosis research.
For IMGs, they sponsor H1B

Cons:
For EP, average, nothing great but nothing bad either
Many centers, again gives patient diversity but also adds stress as centers are pretty far apart

Overall,
a good program but at least from my perspective, academic EP, nothing to rave about..

 

[cards2012]

Emory:

Briefly,

Pros:
Nice small campus
big city
Decent weather
Very strong clinically
Largest fellowship program, can go either way
a lot of stress on academic track but it seems that they dont get the residents on academic track by regular match so they give out prematch for physician scientist track. Reflects badly on the program
big on atherosclerosis research.
For IMGs, they sponsor H1B

Cons:
For EP, average, nothing great but nothing bad either
Many centers, again gives patient diversity but also adds stress as centers are pretty far apart

Overall,
a good program but at least from my perspective, academic EP, nothing to rave about..

**A correction to my previous post**
It seems that 4 year spots are out of match at all places as UTSW and BCM also offer the 4 year track out of match.. So, sorry if I misled anyone.

Here are the reviews for UTSW

Pros:
1. They go out of the way to make your trip comfortable and memorable starting from arranging the hotel stay, reimbursing all ground transportation, almost the whole faculty coming the evening before the interview to take the applicants out for dinner etc etc. Haven't had such an experience anywhere else.
2. The program has Dr Eric Olson and Dr Hill for anyone who is interested in doing basic electrophysiology research.
3. The program directors seem very nice.
4. Rotations are not very heavy and the volumes are not bad.
5. The fellowship program funds the research for as many years as you want. contrast, Emory, where I was told the funding is from the PI you work with.

Cons:
1. EP is not as strong with 5 faculty but is also not bad. Doesnt have big name people.
2. You work mostly in Parkland hospital which is a county hospital but on the flip side you see a lot of diverse populations.
3. If anyone wants to short track, it is not possible 3rd year is only research.

Overall, a very strong academic program! Clinically, maybe good to very good but not one of the best.

************************************
I think this thread started by cathemall is extremely important. Please go ahead and add your experiences from your interviews. Also edit other posts based on your experiences.

 

[Hirachicards]

Anyone have thoughts on the Cooper program in Camden, NJ?
There is previous posts with mention of two spots not matching and fellows leaving.
Is this program in danger of being on probation or are there financial issues at the institution?

 

[KRichards62]

Great thread. Keep it coming.

 

[cards2012]

Great thread. Keep it coming.

*MAYO CLINIC*
I am not a man of many words and I prefer bullet points. So here it is.

Pros:
1) Very strong clinically. There is no weak subsepcialty except CT/MRI. They have all the big names, so although I have not been to Cleveland, it is probably, along with Cleveland Clinic, the best clinical programs in the country.
2) Faculty: Seemed very nice. Heard 'collegialty' many times from various faculty.
3) Program structure: Its a 4 year track. Looks long but its actually fast track. You can become an EP specialist in 4 years with 1 year of research under your belt.
4) Workload: Good except for EP rotation.
5) Fellows: 50% are from Mayo. All seemed very happy.
6) Research: Strong emphasis on research
7) 3 private practices for moonlighting
8) Will sponsor H1B visa if you are already on it. Seem to be IMG friendly.

Cons:
1) Not good for becoming a good general cardiologist as you can only become level 2 or more in only 2 fields.
2) Program structure: Not for people looking for 3 year programs.
3) Research: Is not as strong as some other programs in basic research but they are trying to increase it.
4) Do not pay extra to cover some calls within the system (like a few other programs)

Please add your comments to my impressions.
Good luck

 

[tgerwuds]

Okay so what did you guys think of the Cleveland Clinic?

- I was blown away. Period.

Any thoughts?

 

[cards2012]

Okay so what did you guys think of the Cleveland Clinic?

- I was blown away. Period.

Any thoughts?

Didnt make the cut but I have received the same impression from my friends. The only con is little basic science research and that it is taken a little lightly by academic university programs but overall a superb program.

 

[intcards]

I agree that the clinical training is superb, maybe the best around. However, unless things have changed since I interviewed, it is basically a cardiology residency, not a cardiology fellowship. I recall that they have several services in which the cardiology fellow is the primary service, i.e. must write admissions orders, daily progress notes, replete electrolytes, discharge planning, social work, etc...all the things I was thankful to leave behind after completing residency. Also, the cardiology department is by far the strongest division and dominates the hospital. So, cardiology is consulted for EVERYTHING. Of course, poorly thought-out, noneducational consults happen everywhere, but it seemed that they are commonplace there. That was just my impression. Oh and don't forget, the Cleveland Clinic is in, well, Cleveland.

 

[tibor75]

I agree that the clinical training is superb, maybe the best around. However, unless things have changed since I interviewed, it is basically a cardiology residency, not a cardiology fellowship. I recall that they have several services in which the cardiology fellow is the primary service, i.e. must write admissions orders, daily progress notes, replete electrolytes, discharge planning, social work, etc...all the things I was thankful to leave behind after completing residency. Also, the cardiology department is by far the strongest division and dominates the hospital. So, cardiology is consulted for EVERYTHING. Of course, poorly thought-out, noneducational consults happen everywhere, but it seemed that they are commonplace there. That was just my impression. Oh and don't forget, the Cleveland Clinic is in, well, Cleveland.

Also, unless things have changed over the years, the IM residency program is mediocre, at least for a high profile institution. There are good residents, but many that are weak. In the CCU half of your job may be hand holding the weaker residents.

 

[BlackNDecker]

*MAYO CLINIC*
Cons:
1) Not good for becoming a good general cardiologist as you can only become level 2 or more in only 2 fields.

Please add your comments to my impressions.
Good luck

The rationale for not offering level 2 in more than 2 areas is because when you complete your training you will be an ambassador for Mayo and the expectation is that you will be the local expert in your area of training. Either be good at many things...or great at a few things.

The training/education in Echo is second to none. I know a fellow that recently moved on to what is widely considered a "top tier" program and he/she readily admits that the echo training at Mayo trumps the new program.

 

[BlackNDecker]

The interview season is almost over and I'm surprised more people aren't contributing program impressions. The cardiology subforum is on life-support...people only seem to want to post (flaunt) which interview invites they've gotten.

 

[Commotio Cordis]

** JOHNS HOPKINS **

These are my impressions. Overall, good program. Steve Schulman, their program director is a great guy, very laid back, and seems like he really fights for the fellows.

Like any superb IM program, the hospital is essentially resident run, so fellows take a backseat and let residents do most of the procedures (residents even float swans, temp wires -- if they want to). A bit lacking in clinical volumes, although they really try to de-emphasize it since they are an academic program. Cath volumes are pretty low and are made up for by the fact that Bayview is affiliated with them, HF is pretty bad (<20 txplants last year), and EP is their jewel in the crown -- a very enviable program.

They're really trying to boost their basic science -- and with people like David Kass and Gordon Tomaselli they have much to tout. Also have recently hired new faculty in basic science -- so my impression is that they are setting themselves up well for the future.

Again, a 4 yr mandatory program. 2 yr clinical + 2 yr research. I did talk to one fellow who apparently managed to dodge the 2 research years, in anticipation of going into PP, but he said it doesn't happen often and is actively looked down upon.

Bottom line -- if you can love Baltimore, it is a good cards fellowship program that will set you up for an academic career.

 

[Commotio Cordis]

Did anyone interview at PENN? What were your thoughts, with respect to interventional/EP or preparing for a career in private practice?

 

[BlackNDecker]

@Commotio Cordis

May I ask why you're interviewing at programs widely known to brow beat residents into research when your apparent career goals are private practice? It would make more sense to interview at programs known for their strong clinical training rather than NIH funding or USNWR rankings. Just saying...

 

[BlackNDecker]

Texas Methodist Hospital (Houston TX):

Pro's
- Methodist seems to have benefitted greatly from the recent falling out with Baylor. The Cardiology group demanded separation from Radiology for all imaging including cardiac CT and MRI during contract negotiations.
- There is no Internal Medicine program to answer to. Cards is a separate entity.
- There are big names in the program...past and future presidents of AHA and most are on all the guidelines...including the recent guidelines for advanced imaging.
- Methodist is a private hospital.

Con's
- Currently, Methodist is not ACGME approved for all subspecialty tracks...including advanced imaging and I believe EP. This is expected to come soon.
- This is a "new" old program and there is some uncertainty still how the dust will settle.
- Methodist is a private hospital.

I think in several years Methodist will be one of the premier advanced imaging fellowships.

 

[BlackNDecker]

UT Houston:

This was the worst interview I've ever been on. About 20 of us were led into the basement of the UT Houston medical school and stuffed into a room from 7:30 am until around 1:30 pm (when the hospital tour began). The room itself consisted of 4 computer stations and a giant plasma TV that was never turned on. There was a large table in the center of the room and we were all encouraged to sit. I knew I was in for a long day when one of the chief fellows broke out the checkers and a deck of cards.
We were interviewed 2 at a time and asked to recite the "research/publication" portion of our CV aloud in front of the interviewer as well as the other applicant. A strange interview experience that foreshadowed a malignant fellowship experience.

The fellows stated over and over again, "we have to look out for each other cause noone else is gonna look out for you." I believe the intent was to show camaraderie (which seemed genuine throughout the day), however, I got the sense that the faculty took little interest in the well being of the fellows.

I don't recall much about the structure of the fellowship itself because it was presented as a chaotic scribble on a dry erase board (why not use that fancy plasma TV for a proper presentation?).

Overall, I get the sense that you will be well trained but your education is mostly self-driven. I didn't get the sense that any particular area shined, but that the program provides great care nonetheless for the residents of Houston.

I realize this comes off a bit scathing, but I felt like I deserved a comp on my hotel/flight considering the lack of effort on my interview day.

 

[AntonioMontana]

UT Houston:

This was the worst interview I've ever been on. About 20 of us were led into the basement of the UT Houston medical school and stuffed into a room from 7:30 am until around 1:30 pm (when the hospital tour began). The room itself consisted of 4 computer stations and a giant plasma TV that was never turned on. There was a large table in the center of the room and we were all encouraged to sit. I knew I was in for a long day when one of the chief fellows broke out the checkers and a deck of cards.
We were interviewed 2 at a time and asked to recite the "research/publication" portion of our CV aloud in front of the interviewer as well as the other applicant. A strange interview experience that foreshadowed a malignant fellowship experience.

The fellows stated over and over again, "we have to look out for each other cause noone else is gonna look out for you." I believe the intent was to show camaraderie (which seemed genuine throughout the day), however, I got the sense that the faculty took little interest in the well being of the fellows.

I don't recall much about the structure of the fellowship itself because it was presented as a chaotic scribble on a dry erase board (why not use that fancy plasma TV for a proper presentation?).

Overall, I get the sense that you will be well trained but your education is mostly self-driven. I didn't get the sense that any particular area shined, but that the program provides great care nonetheless for the residents of Houston.

I realize this comes off a bit scathing, but I felt like I deserved a comp on my hotel/flight considering the lack of effort on my interview day.

Good thing I turned down that invitation.

 

[AntonioMontana]

Washington University

My expectations were exceeded after visiting Wash U. They seem to have a great balance between basic science and clinical research. The interview day itself began with a great (powerpoint) introduction of the program by Drs. Mann (chair) and Kates (PD). I appreciate programs that have their Division Chiefs speak to the applicants at some point. It makes the division look caring towards the fellows and applicants. The presentation was very organized and detailed regarding all of the different clinical and research pathways available for training at Wash U., including funding sources. They have 10 spots per year, and take 4-5 internal candidates. The interview process was somewhat unique to me, as you were interviewed by two persons at the same time, one basic science and one more clinical.
Despite its great academic environment, I think 30% of the fellows eventually end up in private practice, which is similar to other, highly ranked institutions.
In summary a great program. Perhaps, the only cons, would be the location. Many people don't like St. Louis.

 

[AntonioMontana]

*MAYO CLINIC*
I am not a man of many words and I prefer bullet points. So here it is.

Pros:
1) Very strong clinically. There is no weak subsepcialty except CT/MRI. They have all the big names, so although I have not been to Cleveland, it is probably, along with Cleveland Clinic, the best clinical programs in the country.
2) Faculty: Seemed very nice. Heard 'collegialty' many times from various faculty.
3) Program structure: Its a 4 year track. Looks long but its actually fast track. You can become an EP specialist in 4 years with 1 year of research under your belt.
4) Workload: Good except for EP rotation.
5) Fellows: 50% are from Mayo. All seemed very happy.
6) Research: Strong emphasis on research
7) 3 private practices for moonlighting
8) Will sponsor H1B visa if you are already on it. Seem to be IMG friendly.

Cons:
1) Not good for becoming a good general cardiologist as you can only become level 2 or more in only 2 fields.
2) Program structure: Not for people looking for 3 year programs.
3) Research: Is not as strong as some other programs in basic research but they are trying to increase it.
4) Do not pay extra to cover some calls within the system (like a few other programs)

Please add your comments to my impressions.
Good luck

You forgot to list the biggest con: The location. Rochester is in the middle of no where. Rochester, kind of reminded me of Las Vegas, in the sense, that there is nothing else around, only that instead of casinos, you have Mayo. Otherwise, I thought it was a great place to get outstanding clinical training as you pointed out.

 

[AntonioMontana]

Brigham and Womens Hospital, Boston

Similar to Wash U., Dr. Libby (chair) followed by Dr. Beckman (PD) started the day giving an excellent introduction of the program. Dr. Beckman's initial statement was: "if you're interested in private practice, this is not the place". However, despite these nice words, around 10-20% switch to private practice at the end of training. Brigham also provides a fine balance between basic science, translational, and clinical research opportunities and clinical expertise. Cardiology fellows rotate 6 months out of the 24 clinical months at MGH (MGH fellows do the same at BWH). They also have a VA system, like many other places, and I think their continuity clinic is every other week at BWH, and the VA. Don't ask me about numbers, because I don't pay much attention to it, but it seems that BWH have a good volume on interventional, EP, and imaging. I think there are about 20 heart transplantation per year at BWH, which is good, if you take into account the large number of tertiary hospitals in the Boston Area. Regarding the interview itself, you get to interview with either Dr. Libby or Beckman, two additional faculty (common research interests), and one fellow (which I, personally, dislike). I didn't get to interview at MGH, so I'm not so sure how different/similar these two programs are. Hopefully, somebody else will.

 

[AntonioMontana]

**A correction to my previous post**
It seems that 4 year spots are out of match at all places as UTSW and BCM also offer the 4 year track out of match.. So, sorry if I misled anyone.

Here are the reviews for UTSW

Pros:
1. They go out of the way to make your trip comfortable and memorable starting from arranging the hotel stay, reimbursing all ground transportation, almost the whole faculty coming the evening before the interview to take the applicants out for dinner etc etc. Haven't had such an experience anywhere else.
2. The program has Dr Eric Olson and Dr Hill for anyone who is interested in doing basic electrophysiology research.
3. The program directors seem very nice.
4. Rotations are not very heavy and the volumes are not bad.
5. The fellowship program funds the research for as many years as you want. contrast, Emory, where I was told the funding is from the PI you work with.

Cons:
1. EP is not as strong with 5 faculty but is also not bad. Doesnt have big name people.
2. You work mostly in Parkland hospital which is a county hospital but on the flip side you see a lot of diverse populations.
3. If anyone wants to short track, it is not possible 3rd year is only research.

Overall, a very strong academic program! Clinically, maybe good to very good but not one of the best.

************************************
I think this thread started by cathemall is extremely important. Please go ahead and add your experiences from your interviews. Also edit other posts based on your experiences.

University of Washington, in Seattle, also offer two research positions (first-2-years of training) outside the match.

 

[AntonioMontana]

@Commotio Cordis

May I ask why you're interviewing at programs widely known to brow beat residents into research when your apparent career goals are private practice? It would make more sense to interview at programs known for their strong clinical training rather than NIH funding or USNWR rankings. Just saying...

Fortunately for him, this is a safe place to ask these type of questions (obviously not during your interview). I haven't seen any program yet, and don't think there's such a program, where everyone stays in the academia.

 

[BlackNDecker]

Fortunately for him, this is a safe place to ask these type of questions (obviously not during your interview).

Agreed.

I haven't seen any program yet, and don't think there's such a program, where everyone stays in the academia.

That isn't the point. I was questioning the rationale of pursuing heavy academic & research focused training if you ALREADY know that you want to work private practice. It should be quite obvious that MGH, BWH, and JHU are prepping you for an academic career...why would you subject yourself to 2 years of research (and rob yourself of the 1-2 years of clinical training?).










<BTW this is a rhetorical question...I think we all know the answer. It just doesn't make sense from a practical standpoint IMHO>

BTW, I'm not hating or flaming the OP. I'm sure Commotio is a stellar resident.

 

[intcards]

Regarding the Brigham, the interventional volume is actually quite low. They perform just over 1000 interventions per year and recently had to decrease the number of interventional fellows from 5 to 3. They do offer a second year option for 2/3 of those fellows which is dedicated to structural/peripheral training. Although, whereas they advertise that they are a PARTNER site, they have only enrolled 2 patients. I realize that this is a little off topic since you are applying for a general fellowship position and although these numbers should be fine for your purposes, they also have a ton of PA's in the lab who do most of the panning.

You mentioned that you don't pay attention numbers. I guess my point is that unless you are sure that you are not going into practice, I think its time to start looking at numbers. Its tedious and annoying, but its actually pretty important. At least on the private interventional side of things, most employers won't give a crap about the name of your program but they will ask about the numbers you did as a fellow. The interventional community is a small world and it is not a mystery which are the low volume centers. Just something to keep in mind.

 

[AntonioMontana]

Regarding the Brigham, the interventional volume is actually quite low. They perform just over 1000 interventions per year and recently had to decrease the number of interventional fellows from 5 to 3. They do offer a second year option for 2/3 of those fellows which is dedicated to structural/peripheral training. Although, whereas they advertise that they are a PARTNER site, they have only enrolled 2 patients. I realize that this is a little off topic since you are applying for a general fellowship position and although these numbers should be fine for your purposes, they also have a ton of PA's in the lab who do most of the panning.

You mentioned that you don't pay attention numbers. I guess my point is that unless you are sure that you are not going into practice, I think its time to start looking at numbers. Its tedious and annoying, but its actually pretty important. At least on the private interventional side of things, most employers won't give a crap about the name of your program but they will ask about the numbers you did as a fellow. The interventional community is a small world and it is not a mystery which are the low volume centers. Just something to keep in mind.

You're probably right in many ways, however, I have no genuine interest in interventional or EP, (in fact, I don't really enjoy doing procedures) so I don't really care about volumes. Moreover, it seems to me that the intervention numbers are trending down in most places, with very few exceptions, in part because there's more data backing-up medical therapy, and perhaps because of the use of FFR to assess hemodynamically significant lesions. On the other hand, EP numbers are still up in most places, but hopefully that will also change eventually, once we do a better job in risk stratification for ICD placements.
Again, this is the opinion of someone with absolute no interest in IC or EP.

 

[cards2012]

.

 

[chikaficarika]

Here are some pros and cons about IUPUI Cardiology fellowship program

IUPUI is one of the busy cardiology fellowship program. they have four different hospitals to cover.
(1)IUPUI--university hospital
(2)Wisherd--county hospital
(3)VA
(4) Methodist--Private hospital.

Pros :
(1) Excellent teaching and very dedicated faculty.
(2) Has very high voulmes, so if you want to do general cardiology you will be level 3 in any field by end of 2 years
(3) Has Dr Feigenbaum (father of echocardio)
(4) very top named EP faculty (Doughlas Zipes)
(5) Teaching is excellent and program is very supportive to fellow. one of 3 year fellow decided to do Interventional instead of EP just few weeks ago and they offer him Interventional spot and start interview for EP,He already signed for EP before. that was very nice and supportive according to me.
(6) Indianapolis very nice town and not that costly
(7) All fellows were from top tired program like Duke, Mayo Clinic, John Hopkins
(8) Plenty of Moonlightling Oppourtunity.

Cons:
(1) Very busy first year but then second year only 12 calls per year and almost no call in third year.

Dont think so has any other cons.


Let me know if you know more about IUPUI Cardiology program. Any thoughts are welcome.

 

[horserider74]

Agreed.

That isn't the point. I was questioning the rationale of pursuing heavy academic & research focused training if you ALREADY know that you want to work private practice. It should be quite obvious that MGH, BWH, and JHU are prepping you for an academic career...why would you subject yourself to 2 years of research (and rob yourself of the 1-2 years of clinical training?).
<BTW this is a rhetorical question...I think we all know the answer. It just doesn't make sense from a practical standpoint IMHO>

BTW, I'm not hating or flaming the OP. I'm sure Commotio is a stellar resident.

I totally agree with you guys.I mean why should you subject yourself to 2 years of research torture especially in basic science if you really wanna go to private practise and all of this on the expense of your clinical training .For example a place like UTSW ( I actually didnt apply there since i wanna go into private practice )where they force you to do a 1-2 year of basic science research and you graduate with a COCATS level 1 in cardiology which is only suffient for you to pass to boards and thats all.
I actually know a friend who did his fellowship there whom indicated that he didnt feel clinically competent when he left.
if you wanna be a researcher ,then that another story and i do recommend going to such heavy research places

 

[horserider74]

UT Houston:

This was the worst interview I've ever been on. About 20 of us were led into the basement of the UT Houston medical school and stuffed into a room from 7:30 am until around 1:30 pm (when the hospital tour began). The room itself consisted of 4 computer stations and a giant plasma TV that was never turned on. There was a large table in the center of the room and we were all encouraged to sit. I knew I was in for a long day when one of the chief fellows broke out the checkers and a deck of cards.
We were interviewed 2 at a time and asked to recite the "research/publication" portion of our CV aloud in front of the interviewer as well as the other applicant. A strange interview experience that foreshadowed a malignant fellowship experience.

The fellows stated over and over again, "we have to look out for each other cause noone else is gonna look out for you." I believe the intent was to show camaraderie (which seemed genuine throughout the day), however, I got the sense that the faculty took little interest in the well being of the fellows.

I don't recall much about the structure of the fellowship itself because it was presented as a chaotic scribble on a dry erase board (why not use that fancy plasma TV for a proper presentation?).

Overall, I get the sense that you will be well trained but your education is mostly self-driven. I didn't get the sense that any particular area shined, but that the program provides great care nonetheless for the residents of Houston.

I realize this comes off a bit scathing, but I felt like I deserved a comp on my hotel/flight considering the lack of effort on my interview day.

It was my worst interview too.feels like your like a rat trapped in that room.
I also felt that dont care about your training ,and also it seems like your repeating your intership again with their frequent in-house call.
Also I heard that their IM resident are not that good so apparently this will put extra burden on us esp at the CCU rotation.
it is not that good at research either

 

[Commotio Cordis]

I totally agree with you guys.I mean why should you subject yourself to 2 years of research torture especially in basic science if you really wanna go to private practise and all of this on the expense of your clinical training .For example a place like UTSW ( I actually didnt apply there since i wanna go into private practice )where they force you to do a 1-2 year of basic science research and you graduate with a COCATS level 1 in cardiology which is only suffient for you to pass to boards and thats all.
I actually know a friend who did his fellowship there whom indicated that he didnt feel clinically competent when he left.
if you wanna be a researcher ,then that another story and i do recommend going to such heavy research places

WOW!
I am truly impressed at the amount of press my single posting drew. OK to be clear, I am not even that interested in Private Practice. I may consider it down the road, but my primary motivations are to build a career in basic science.

That being said, this board is not to post comments for myself. So I thought I should post my impressions of my interviews, both from the perspective of a scientific researcher as well as clinical person going into PP. And whenever I interview at a place, I investigate both aspect - i.e., how many folks go into PP and how many go into academic careers.

One of the things I quickly came to realize (something that has been reiterated over and over again on these boards) is that for the "private" world, and more so for your clinical academic appointments your exposure volume matters. So just because I investigate the volumes in each subspecialty of cardiology at the places I interview at, does not mean that I am doing so with the interest of going into PP. I do that so that I know what I am getting myself into.

This is perhaps why I would stay away from a place like Brigham, MGH or UCSF where impressive research overshadows any clinical volume. Clearly, people who emerge from such places are less suited for private practice than someone who graduated from, say, Cleveland Clinic (who inversely, will be ill-prepared for an academic career).

I think that since we are posting our thoughts on a place (and since this board caters to people with both types of aspirations) it is important to give my honest opinion about both sides of the coin.

The reason that commentor may have gotten the impression that I am a hypocrite bound for PP sucking up interviews at research-oriented places, maybe from that comment I made about the fellow I met who managed to "dodge" the research years. I stated that as a warning to anyone hoping to do the same thing, since it clearly is attempted every year by a few people who change their minds mid-fellowship.

And frankly I don't even think that there's anything wrong with changing your mind. After all, how many people who come into fellowship vowing to become heart failure specialists end up becoming interventionalists? Similarly, why is it so bad if someone comes into fellowship hoping to do science and finds out half way that that is not what they want to do. Maybe the particular fellow in question changed tracks because of personal or family reasons.

So to set the record straight, getting back to the original question -- why did I interview at places that are clearly academic when my hope is to really go into PP?... well, it's because I want to go into an academic career, but have the training to go into a clinical career own the line if things don't work out.

 

[BlackNDecker]

WOW!

Relax...nobody called you a hippocrite. I only asked what made you apply to (and accept invitations from) staunchly academic programs based on the following statement:

Did anyone interview at PENN? What were your thoughts, with respect to interventional/EP or preparing for a career in private practice?

My question was reasonable....and the ensuing conversation (very informative BTW particularly with respect to cath volumes) might help a clueless applicant save the $10 application fee and $400 airfare to Boston or Baltimore.



Sincerely, thanks again for the program reviews and congrats on the awesome interview invites.

 

[cards2012]

Here are some pros and cons about IUPUI Cardiology fellowship program

IUPUI is one of the busy cardiology fellowship program. they have four different hospitals to cover.
(1)IUPUI--university hospital
(2)Wisherd--county hospital
(3)VA
(4) Methodist--Private hospital.

Pros :
(1) Excellent teaching and very dedicated faculty.
(2) Has very high voulmes, so if you want to do general cardiology you will be level 3 in any field by end of 2 years
(3) Has Dr Faisumbum (father of echocardio)
(4) very top named EP faculty
(5) Teaching is excellent and program is very supportive to fellow. one of 3 year fellow decided to do Interventional instead of EP just few weeks ago and they offer him Interventional spot and start interview for EP,He already signed for EP before. that was very nice and supportive according to me.
(6) Indianapolis very nice town and not that costly
(7) All fellows were from top tired program like Duke, Mayo Clinic, John Hopkins

Cons :
(1) you have to cover 4 hospitals at the same time while you on call. I dont know how you can do that.
(2) First year cardiology fellowship is so busy, fellow spent most of the time in hospital. according to fellow the earliest they left while on call was 3.00 AM.
(3) its take 20 minutes to go from one hospital to other .They have their on trail to travel from one hospital to other.
(4) compare to 4 hospital they have only 15 fellows total which according to me is quite low
(5) Interventional is not that strong.
(6) No jobs in IN now according to fellows so you have move after 3 years.
(7) you dont have resident support most of the time

Let me know if you know more about IUPUI Cardiology program. Any thoughts are welcome.

Hey chicafarika, you meant Feigenbaum, right. I bought my first feigenbaum in 2003. nice book. You made him sound like a faisumBUM

 

[dragonfly99]

Regarding the Brigham, the interventional volume is actually quite low. They perform just over 1000 interventions per year and recently had to decrease the number of interventional fellows from 5 to 3. They do offer a second year option for 2/3 of those fellows which is dedicated to structural/peripheral training. Although, whereas they advertise that they are a PARTNER site, they have only enrolled 2 patients. I realize that this is a little off topic since you are applying for a general fellowship position and although these numbers should be fine for your purposes, they also have a ton of PA's in the lab who do most of the panning.

You mentioned that you don't pay attention numbers. I guess my point is that unless you are sure that you are not going into practice, I think its time to start looking at numbers. Its tedious and annoying, but its actually pretty important. At least on the private interventional side of things, most employers won't give a crap about the name of your program but they will ask about the numbers you did as a fellow. The interventional community is a small world and it is not a mystery which are the low volume centers. Just something to keep in mind.

I don't know jack about the training @Brigham, but what you say about the volume of procedures (for private practice) is pretty much true, at least as far as I know (2nd year cards fellow perspective).

 

[BlackNDecker]

Agree x Infiniti.

I believe this is part of the reason the perennial "Top 25 best programs for Cardiology" threads and the nonsensical "tier rankings" died off....

What we (SDN community) should have done over the years is rate programs according to sub categories, like:

1) Best Echo program (i.e. Level 2 or 3 training, combined nuc, etc)

2) Highest procedural volume for fellows (coronaries, peripherals, carotids, etc)

3) Best EP (highest volume, outcomes studies, etc)

4) Heart failure, transplant, etc etc etc

5) advanced imaging, relationship with Radiology, etc etc etc



^This type of info might have actually helped stratify programs in a logical way.

 

[modband]

Hey All,

any thoughts on UPMC fellowship? Sounds amazing but what do you all think--i'm thinking in terms of clinical skills, teaching, and what fellows do once they leave there?

Hope the season is treating you well.

Thanks

 

[cards2012]

Hey All,

any thoughts on UPMC fellowship? Sounds amazing but what do you all think--i'm thinking in terms of clinical skills, teaching, and what fellows do once they leave there?

Hope the season is treating you well.

Thanks

I have not gone there yet but I am very excited about that program. btw, what are your thoughts?

 

[cardsforever]

Hi Guys
How is the program at CaseWestern reserve/University Hospital?Any thoughts?it seems like a decent program with a lot of changes after the new chair appointment.

 

[tibor75]

** JOHNS HOPKINS **

HF is pretty bad (<20 txplants last year), and EP is their jewel in the crown -- a very enviable program.

The number of transplants isn't the problem (very few programs consistently do > 20 per year)...it's the survival. It stinks (survival stats for every program in the country is public info and can be found on the internet). Not sure why their transplant program is a mess, but it is.

 

[indiamacbean]

I liked the Hopkins program but you certainly speak the truth about survival:

http://www.srtr.org/csr/current/Centers/centerdetail201012x.aspx?facility=MDJHTX1HR

 

[tibor75]

I liked the Hopkins program but you certainly speak the truth about survival:

http://www.srtr.org/csr/current/Centers/centerdetail201012x.aspx?facility=MDJHTX1HR

Wow, did not even realize myself it was that bad. 1 year graft survival of 58%, when expected should be 85%!!

Of course, this doesn't really matter in terms of picking the right fellowship, unless your interest is in heart failure.

This link shows the 3 year survival which is still good:
http://www.srtr.org/csr/current/Centers/centerdetail201012x.aspx?facility=MDJHTX1HR

Remains to be seen if the recent dip in survival is just a blip, or a sign of serious problems in the program.

 

[whodatMD]

Did anyone interview at the following programs (not top-10 programs):
1) U of Missouri
2) U of Arizona
3) University of Kansas
4) University of Florida
5) Jackson Memorial (FL)
6) North Carolina
7) Wake Forest
8) U of Virginia

Thanks!

 

[DKUS]

Yes, I Ived at U of AZ. Could you plz tell me ur experience? Can any one share thoughts abt U Of Az?

 

[Dyssrhythmia]

Does anyone have any thoughts on the strengths / weaknesses of Mayo Clinic in Jacksonville, FL?

 

[Dyssrhythmia]

With reference to Mayo Clinic, Rochester (and the comment about Rochester being in the middle of nowhere): You're there for excellent training, not for entertainment.

 

[RickyBobby23]

I put some of my impressions after my interviews last year, you can probably search for them. I stopped because nobody else was contributing. I think the real benefit of this forum would be to put up people's impressions. I know there are plenty of people posting what interviews they get so it shouldn't be that much harder to write a few simple sentences about each program. Just my opinion fwiw

 

[cards2012]

I am killing time till the match results so I thought i will put in my impressions about some other programs for future applicants..

Pitts:

I ranked this program very high in my list and here are the reasons:

1. Loved the faculty. Mike Mathier is a very easy going person. Some people thought teh chair Barry London was kind of abrupt and asked uncomfortable questions but I liked my interview with him.

2. Research: It seems that Pitts many years back was a very clinical program but over the last ?5-6 years the focus has been on research. They still dont have the track record but as per Dr Mathier if you have an idea they will back it up full time. He told me that many places wont guarantee you but at Pitts even if you dont get a postdoc award or K08/K23, Pitts will put in their own money into your research and will give you protected time as a young faculty. Sounds good right..

3. Many programs are currently facing a financial crunch. Pitts it seems is flush with money. Was told about this by people outside Pitts and was told couple of times by the faculty during interview too.

4. EP: is 2 years. Have a decent training program. Maybe not in the top 10 but by no means you will be undertrained. I think they have 6-8 EP faculty there.

5. Structural heart disease/HF: Now this is their strength. If you are interested in it, then there is no place like Pitts.

6. Fellows: Were very happy with their training. One thing that came up was in house call which was VERY busy. I forget the frequency but its like 1-2 per month. please correct me if I am wrong. So, seems doable. also they have addressed by putting another fellow on call at teh same time.

7. Location: very beautiful. cold but not minnesota. 2 people who were FMGs told me that it lacks diversity and they felt out of place while working there.

Overall, excellent program and seems to be on the rise!

 

[RickyBobby23]

since everyone has now matched..bump

 

[eeasy363]

Anyone have any thoughts on MGH?