Deciding on Cardiology late in residency...

[BrockDoc]

I am currently in my 3rd year of residency. I basically went into internal medicine to pursue GI. I was pretty gung-ho about GI since medical school. However, I began to have second thoughts right around the time you would normally apply during your 2nd year. I figured I would just take a year and work as a hospitalist while I let my identity crisis work itself out. I am not sure if it was the result of poor mentorship, but unfortunately my enthusiasm for GI never re-ignited. I love the idea of doing procedures, but the subject matter of GI bores me a bit. I spent my 2nd year trying to figure out what I enjoyed. Critical care definitely excited me (although not a fan of chronic trach/peg patients) and I even toyed with the idea of switching to anesthesia. What really surprised me was that I found myself drawn to cards more and more. I liked dealing with real deal heart failure patients, found myself drawn to watching caths in the cath lab, etc..

So here I am in my 3rd year of residency with plans to do a year as a hospitalist, but with no real idea what to do afterwards. I feel like I "missed the bus," so to speak, in terms of cardiology. I've done no research or anything "scholarly" because frankly I spent my time in residency trying to become a good internal medicine doctor and figure out what I really enjoy.

I guess, after all of that, my question comes down to the typical "what are my chances?" I come from a good university program in a big city. I've done no research. Is it even worth it? Frankly, I've ruined my chances to get into GI as well because of the time I wasted trying to figure out what I enjoyed. This is the problem with the way internal medicine fellowships are structured, but that is a topic for another thread...

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[dragonfly99]

If you come from a "good university program" in a big city and you are a US allopathic grad, chances are you can get spot somewhere. Your chances are way better than 50%. If you can't get it on first attempt, you'll very likely get it on a 2nd attempt if you do anything to improve your application. You can give it a shot this year, and then if you don't get in, do research for 1-2 years and you'll very likely get in. The more LOR's you can get from cardiologists, the better off you are. Also, your PD can probably help you get a spot if he is so inclined. The lack of research will hurt you, but it's not a deal breaker. It will likely keep you out of the more researchy/"prestigious" places, but that doesn't matter much unless you want to be an academic basic science researcher in the future.

 

[drdavemd]

Agreed with dragonfly. I know plenty of folks who didn't do any significant (or sometimes none at all) research, and got a spot without a problem. If cards is what you want to do, figure out your resources, line up some good letters and give it a shot.

Good Luck!

 

[BrockDoc]

Thanks...I think that's what I am going to do. I am going to schedule a meeting with my PD and see if he can point me in the right direction. I'll probably also try to meet with the cardiology fellowship director where I am doing residency and see what he says. I actually wouldn't mind getting involved in some cardiology research in the process because I find myself drawn to reading the cardiology articles when I glance over the multitude of journals that get mailed to me.

What about waiting to apply during my hospitalist year? I am actually afraid of missing the boat this year. I feel like once I am out of residency I lose some of the resources available to me, such as the cardiology department at my institution and my PD.

 

[indiamacbean]

I wouldn't wait to apply until your hospitalist year. Your PD and cards fellowship director should help you. Also, waiting a year is a year of lost opportunity cost be that financial, research, early retirement, whatever you are going for in cards. you didn't miss the boat. just apply widely and be prepared to travel on a bunch of interviews.

 

[dragonfly99]

Yeah, don't wait. You are right...you'll lose out on some resources if you wait until you are out. Also, it is unfair but there is somewhat of a stigma on applicants who apply late. People may assume you tried before and couldn't get in, and/or that there is some other problem with you. Applying during 3rd year is generally OK, though. Some programs actually might like it, in that you're likely to have a year more of either research or clinical experience, and that you may have already passed your IM boards by the time you start.

 

[Drjmd76]

I agree with whats been said. Don't focus too much on the research aspect of it. Getting several good letters from various sources and go after your passion. I've gone down the Cardiology route myself and enjoy it. In my second year after finishing at Chapel Hill and I can tell you that once you go for it, you won't regret it. Personally, the challenge of this field is what makes it so much fun. Best of luck.
If you have any questions feel free to email me at [email protected]
Dr. Baker