CT Faculty/Fellow?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
D

deleted50478

Any CT fellowships let you work as an attending 1-2 days a week? I'd like to do a CT fellowship but can't support my family on a fellow salary.
Members don't see this ad.
 
Everything is negotiable. It depends on how often the cardiac faculty are on call and so you would need to offer to participate in the faculty call roster in addition to the fellow call.
 
Cardiac is an acgme certified fellowship, so if you want to moonlight as a general attending, it wouldn't be permitted at the hospitals that host your fellowship.

Now, on your own time, and if you're credentialed, perhaps another hospital ...?
 
  • Like
Reactions: 1 user
Members don't see this ad :)
No moonlighting allowed at ACGME fellowships. No reason to do a non ACGME fellowship in this day and age. That would be a waste of time.

So, no. Cannot do that.

You can work clandestinely at another institution at your own risk (of getting caught and getting in trouble for it). I don't recommend it.

Be an attending for a few yrs and go back. Many people have done that.
 
Last edited:
  • Like
Reactions: 1 user
urge said:
No moonlighting allowed at ACGME fellowships. No reason to do a non ACGME fellowship in this day and age. That would be a waste of time.

So, no. Cannot do that.

You can work clandestinely at another institution at your own risk (of getting caught and getting in trouble for it). I don't recommend it.

Be an attending for a few yrs and go back. Many people have done that.
Click to expand...

Is that really the case? At all but one of my interviews, I was told there were opportunities to moonlight. Not necessarily within the institution, but at least the possibility to moonlight if one wanted to. I was told that by the fellows at most of the places, and by the fellowship director at one place (though he said he didn't encourage fellows to moonlight, but did not discourage it, either). The one place that did not have opportunities at the time, the fellows stated the program was trying to work something out.

I understand not allowing the current practice at a lot of non-ACGME accredited fellowships (e.g., Regional anesthesia) of being an attending at that institution for 1 day / week. But I don't think ACGME accreditation prohibits any and all moonlighting -- so long as one stays within his duty hours. Residents moonlight in a lot of different specialties, I can't imagine the ACGME being harder on fellows than residents.
 
twoliter said:
Is that really the case? At all but one of my interviews, I was told there were opportunities to moonlight. Not necessarily within the institution, but at least the possibility to moonlight if one wanted to. I was told that by the fellows at most of the places, and by the fellowship director at one place (though he said he didn't encourage fellows to moonlight, but did not discourage it, either). The one place that did not have opportunities at the time, the fellows stated the program was trying to work something out.

I understand not allowing the current practice at a lot of non-ACGME accredited fellowships (e.g., Regional anesthesia) of being an attending at that institution for 1 day / week. But I don't think ACGME accreditation prohibits any and all moonlighting -- so long as one stays within his duty hours. Residents moonlight in a lot of different specialties, I can't imagine the ACGME being harder on fellows than residents.
Click to expand...
No moonlighting as an attending. You are not credentialed as such in an ACGME fellowship.

But, you are right. It's a matter of duty hours. Your limited moonlighting is just like what residents get.

Basically getting some money here and there for staying late or covering random Saturdays.

I don't see it boosting your salary more than 30%.
 
Last edited:
You can moonlight as an attending but not in the same institution.
 
When did CT become ACGME certified?

What is the difference between those that are ACGME certified and those that have a certificate (like ICU/Pain)? (Besides the test and $2k you have to pay for the test).
 
epidural man said:
When did CT become ACGME certified?

What is the difference between those that are ACGME certified and those that have a certificate (like ICU/Pain)? (Besides the test and $2k you have to pay for the test).
Click to expand...
Long time ago. Almost 10 years.

The 3 of them are ACGME accredited fellowships. Cardiac doesn't have a board exam, yet.

Would you do a non ACGME residency? It's the same for fellowship.

Even OB fellowship is now ACGME accredited. Regional is coming soon.
 
Surely most of my time would be spent doing cases I'm perfectly capable of doing solo. It's just the higher end stuff and TEE training that would be the real benefit of a fellowship. Sure they'd rather pay $200 a day to a fellow when you would make $1000-1500 as an attending, but a compromise would be nice with 1-2 attending days a week. I'd like to make a fellows salary when doing fellow cases and an attending salary when supervision/education are not necessary.

If you do a pedi heart fellowship you get to work as an attending part time. I don't think it compromises education one bit.
 
Members don't see this ad :)
So you can't get a fair wage in an ACGME fellowship
and you can't get TEE certified in a non-ACGME fellowship.
There's a cheap labor conspiracy it seems, what a racket!
 
l
nolagas said:
So you can't get a fair wage in an ACGME fellowship
and you can't get TEE certified in a non-ACGME fellowship.
There's a cheap labor conspiracy it seems, what a racket!
Click to expand...
Oh, it IS a racket, no doubt about it.

Not only you cannot get TEE-certified without a 12-month fellowship, they removed the combined CT+CCM fellowships that lasted only 18 months, and now you have to do 12+12, but with 3 months of "electives" in each. WTF?

Why does one need 12 months for regional? So they can have cheap labor.
Why does one need 12 months for OB? For the same reason.
Why do ambulatory, neuro and other male bovine excrement fellowships need 12 months? For the same reason.

Now go back 30 years, and see how long medical education took at that time. Somehow a bunch of people were able to practice cardiac anesthesia for decades without a fellowship or echo certificacation. Somehow they were able to place single-shot regional blocks, take care of healthy kids, take care of most women in labor, or most brain surgeries, with less technology than we have today. And we are surprised that CRNAs have zero respect for the current generations?

The lazy academics want residents and fellows to do most of the grunt work for peanuts. That's the reason for this entire educational industry. Let's not forget that Medicare pays 140K or more for every resident, and probably also for fellows. We are a better deal than even the royalty of suckers, the medical students.

The difference between a true academic place and an cheap labor camp is that, in the former, the system would easily continue to function if all trainees suddenly stopped showing up at work. That's exactly how my previous foreign residency was. Even my American medical internship had harder working attendings than 90% of the anesthesiologists who taught me. Many of the latter would have trouble to do the same cases they supervise solo. Plus supervision is not the same as teaching!
 
Last edited by a moderator:
  • Like
Reactions: 1 users
G-Man82 said:
Cardiac is an acgme certified fellowship, so if you want to moonlight as a general attending, it wouldn't be permitted at the hospitals that host your fellowship.

Now, on your own time, and if you're credentialed, perhaps another hospital ...?
Click to expand...

Not sure where you get this. CT fellows regularly took faculty call where I trained.
 
FFP said:
l
Oh, it IS a racket, no doubt about it.

Not only you cannot get TEE-certified without a 12-month fellowship, they removed the combined CT+cardiac fellowships that lasted only 18 months, and now you have to do 12+12, but with 3 months of "electives" in each. WTF?

Why does one need 12 months for regional? So they can have cheap labor.
Why does one need 12 months for OB? For the same reason.
Why do ambulatory, neuro and other male bovine excrement fellowships need 12 months? For the same reason.

Now go back 30 years, and see how long medical education took at that time. Somehow a bunch of people were able to practice cardiac anesthesia for decades without a fellowship or echo certificacation. Somehow they were able to place single-shot regional blocks, take care of healthy kids, take care of most women in labor, or most brain surgeries, with less technology than we have today. And we are surprised that CRNAs have zero respect for the current generations?

The lazy academics want residents and fellows to do most of the grunt work for peanuts. That's the reason for this entire educational industry. Let's not forget that Medicare pays 140K or more for every resident, and probably also for fellows. We are a better deal than even the royalty of suckers, the medical students.

The difference between a true academic place and an cheap labor camp is that, in the former, the system would easily continue to function if all trainees suddenly stopped showing up at work. That's exactly how my previous foreign residency was. Even my American medical internship had harder working attendings than 90% of the anesthesiologists who taught me. Many of the latter would have trouble to do the same cases they supervise solo. Plus supervision is not the same as teaching!
Click to expand...

Personally, I think TEE certification in general is a racket. You can bill for it which means Medicare pays you peanuts to spend a year of your life away from a bigger paycheck.
 
Ignatius J said:
Not sure where you get this. CT fellows regularly took faculty call where I trained.
Click to expand...
One can do that as long as one does not go above the 80 hour limit. Good luck with that in any good CT fellowship.
 
FFP said:
One can do that as long as one does not go above the 80 hour limit. Good luck with that in any good CT fellowship.
Click to expand...

Funny thing, our surgery residents never seemed to leave the hospital but alas, never a duty hour violation reported. Weird how that works.
 
It's more complicated in anesthesia, where the OR time and schedules are easy to check. If you are supposed to be in the OR from 6 am to 9 pm 5 days a week, you get 5 more hours to moonlight weekly, not enough for even one call monthly.

Theoretically, a motivated RRC could catch you. And they won't be friendly if they catch you lying in order to make more money.
 
Last edited by a moderator:
FFP said:
It's more complicated in anesthesia, where the OR time and schedules are easy to check. If you are supposed to be in the OR from 6 am to 9 pm 5 days a week, you get 5 more hours to moonlight weekly, not enough for even one call monthly.

So, theoretically, a motivated RRC could catch you. And they won't be friendly if they catch you lying in order to make more money.
Click to expand...

That's fine. All I am saying to the OP is that there are opportunities to do a fellowship and also moonlight as an attending. The opportunities are there.

Fellowships and cases aren't as straightforward as being in the OR from X time to Y time either. Especially in CT.
 
OP -

If you can stomach doing it, consider an ICU fellowship. There are a few that will provide you the opportunity to "get your numbers" doing perioperative TEE, so you can sit for the advanced exam. Moreover, some ICU fellowships have a work-hard/play-hard schedule, so that you work a bunch of days in a row, then have a bunch of days off. You could potentially supplement your income with that extra time off.
 
You must be kidding. Why do that for a year, instead of a real ACGME-accredited CT anesthesia fellowship?
 
Last edited by a moderator:
bigdan said:
OP -

If you can stomach doing it, consider an ICU fellowship. There are a few that will provide you the opportunity to "get your numbers" doing perioperative TEE, so you can sit for the advanced exam. Moreover, some ICU fellowships have a work-hard/play-hard schedule, so that you work a bunch of days in a row, then have a bunch of days off. You could potentially supplement your income with that extra time off.
Click to expand...
I am reading the Advanced PTE application for certification, and I am not sure how CCM can qualify anymore. I think they have closed that door.
Applicants that finished their core residency training after June 30, 2009, can ONLY qualify for certification by completing cardiothoracic or cardiovascular anesthesiology fellowship training at an ACGME accredited fellowship program.
Click to expand...
http://www.echoboards.org/sites/default/files/AdvPTE Cert App.pdf
 
FFP said:
You must be kidding. Why do that for a year, instead of a real ACGME-accredited CT anesthesia fellowship?
Click to expand...

Because what is MOST valuable (it seems to me) during a CT fellowship is the use of echo - and very few CT fellowships really focus on TTE and most probably get okay with TEE.
 
The problem is that I don't see the echo fellowship being ACGME accredited. Hence it's worthless for echo certification.
 
FFP said:
You must be kidding.
Click to expand...

Nope. Not at all. Why would I kid about this?

How nice would it be to call out a collegue in the ANESTHESIA dpt and ask for a bed side TTE?
Echo lab run by gas?

Or just covering your own ass and doing MORE than what is traditionally thought?

No. I'm NOT kidding. :p
 
  • Like
Reactions: 1 user
Why are we thinking about perioperative home when the answer is right in front of us.

How about we refer to... ummmm... OURSELVES! :p and I raise you a :hungry:...

Although self referrel is looked down upon, it makes sense in the perioperative seetting.
 
I love the idea of an echo fellowship, I am just not sure about that program specifically (I look at the fellows' educational histories and I am under unimpressed). Plus I don't see any ACGME accreditation.

If I'm going to slave for a year, it'd better be for a board certification.
 
FFP said:
I love the idea of an echo fellowship, I am just not sure about that program specifically (I look at the fellows' educational history and I am under unimpressed). Plus I don't see any ACGME accreditation.

If I'm going to slave for a year, it'd better be for a board certification.
Click to expand...

Ask yourself how many CT anesthesiologist have gone through board certification...?
 
I would happily do an unaccredited one year-long echo fellowship at Duke, MGH etc. , especially if extended to all kinds of echo investigations, including FAST, thoracic, abdominal.

Utah? You should be kidding.
 
FFP said:
I would happily do an unaccredited one year-long echo fellowship at Duke, MGH etc. , especially if extended to all kinds of echo investigations, including FAST, thoracic, abdominal.

Utah? You should be kidding.
Click to expand...

Wait a minute... Your changing your tune? So you would do an echo fellowship?

Well then we agree.

You ever been to Utah?
 
I would, if it's either accredited, or if it's done at a such a fantastic place that my non-certified ass would be more valuable than most other certified ones. :p

I have been to Southern Utah. It's breathtakingly beautiful. I am not going there for the nature.
 
FFP said:
I would happily do an unaccredited one year-long echo fellowship at Duke, MGH etc. , especially if extended to all kinds of echo investigations, including FAST, thoracic, abdominal.

Utah? You should be kidding.
Click to expand...
Totally agree.

Please tell all you know that Utah is horrible - and add Idaho too and lets stop people from going there and moving there. Why you are at it, please also tell all those Californians that have decided to move to Utah already how horrible it is and get them to leave pronto. Let's spread the word.
 
Sweetie, I love Utah. It's one of the most beautiful states I have visited. I plan to go back many times in my life. I am not prejudiced against the place in any other way than academically.

I honestly think there are very few states (if any) in the union that are not worth visiting.
 
Last edited by a moderator:
FFP said:
Sweetie, I love Utah. It's one of the most beautiful states I have visited. I plan to go back many times in my life. I am not prejudiced against the place in any other way than academically.
Click to expand...

What's your beef with Utah anesthesia? I interviewed there and have attended several CMEs. The fact that they have an echo fellowship is far beyond most programs in the US... and you have prime outdoor recreation opportunities. Really? Sorry bro. I'm not following.
 
My problem is with a one-year non-accredited, hence non board-certifiable, unknown fellowship in a not-so-famous place. Yeah, I would enjoy it, especially if I could practice anesthesia and CCM in the meanwhile. But I really need to be convinced that it's worth another 200-300 in lost wages.

If I see their graduates kicking butt in some good programs or PP groups, I might be all over it in the future.
 
How many anesthesiologists do YOU know that can comfortably do TTE or echo lab?
 
It's not about the $$$. It's about you as a provider and the specialty.
 
If you know TEE, I would expect that TTE is not such a big jump (same organ different views), at least not for anesthesia purposes. Plus most recent CCM grads will have at least basic proficiency in TTE (and other echo exams).

I doubt that an anesthesiologist could do echo lab. That's cardiac territory and they will defend it the same way we defend the cardiac OR.
 
sevoflurane said:
It's not about the $$$. It's about you as a provider and the specialty.
Click to expand...
Listen, I love improving my skills, but it has to be within reason. I could do another five fellowships and become anesthesia Superman... and single (because my wife would definitely divorce me during the third).

They lost me when they created all these cotton field year-long fellowships. I would do half-year without thinking twice.
 
Last edited by a moderator:
Shouldn't improving your skills be life long? We are talking about 1 year and really cornering a part of anesthesia we should have had a long time ago.

Why refer when we can do it in house?
 
Lifelong skills improvement does not equal lifelong servitude. There are other ways that don't pay 60k/year for 3-4000 hours of work.

I bet I will know enough TTE after CCM to do preop clearance for 90+% of my patients, if needed. If the anesthesia department will bother to actually invest in a TTE for the preadmission center, which I strongly doubt will ever happen.
 
Echo is like doing a 1 month old.

It's different.
 
I've never visited Utah's program but I've been to some of their faculty TEE lectures at conferences and I've heard their program teaches a lot of echo at the resident level. Reportedly many of their residents take the advanced exam/testamur. I can't comment on the echo fellowship, but they seem to have a decent number of faculty that are proficient in echo and enjoy teaching it.
 
The Utah echo course is on par with the SCA/ASE course (I've attended both multiple times.) and Desjardins is double boarded cardiologist/anesthesiologist who lives and breathes echo and is a fantastic dynamic teacher. I would do that fellowship in a second if I could spare the time off. That program is on par with Duke, Brigham, etc. Can't imagine you could spend a year there without becoming an echo badass.
 
Last edited:
How are the clones? Because one master-teacher a fellowship does not make, says Yoda.

I still believe it's way too long, unless proven to be as valuable as a cardiac one. Again, I am looking at his fellows and I am unimpressed.
 
You must log in or register to reply here.
Next unread thread

Similar threads

P
SF Match for CT anesthesia fellowship
Replies
27
Views
3K
Pablo94
P
A
Applying late to CT fellowship vs applying in CA-3 year?
Replies
5
Views
912
DrN2O
D
J
Anesthesia fellow moonlighting
Replies
21
Views
1K
deleted875186
D
Nivens
AMA: Graduating CT/ICU fellow
2
Replies
70
Views
7K
Hork Bajir
Hork Bajir
S
CT anesthesia fellowship for international candidate?
Replies
4
Views
1K
rvcsummer
R
Top