Official 2013-2014 Pulm/CCM fellowship application cycle

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jdh71 said:
Nebraska and Iowa are solid. Both of them both from a critical care and pulmonary perspective. Basic science at both spots mostly. No lung transplant at Nebraska.
Both are more "academic". Both have a VA.

Rush and Buffalo I do not know much about, though I think it would be fair to characterize them as clinical fellowships.
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Thanks! I'll be visiting them in this coming 2 weeks. Looking forward to buffalo. They seem to have a couple (or more of NIH funded faculty).
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souljah1 said:
Exposure to all areas of pulmonary and critical care from a clinical standpoint is important if you are still somewhat totipotent, which it seems that you are. Some of the bigger places mentioned above will definitely be able to do this for you.

As far as a clinical educator track is concerned - that means different things at different institutions. What do you mean by "clinical educator"? Does it include research? If so, how much?

If what you mean by that is to be a great bedside teacher who also takes part in quality improvement, curricula development, etc - then what you are really saying is that you want to be an academic clinician. The difficult part is trying to merge interests in medical education with research. The main reason why that is difficult is because it is pretty difficult (without a clear road in view) to obtain funding to pay for research that is centered on medical education. Often, you have to merge it with health services or something like that to take more of a policy angle - or seek money directly from the ABIM or intramurally. Harder to provide a clear framework for those sorts of things on an interview day. Much easier to provide a framework for successfully obtaining career development awards in epidemiology, bench work, or health policy. Feel free to PM me if you want more on that.

Best of luck.
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Thanks for your thoughts. I suppose the "clinician educator" nomenclature in my home shop is less pervasive than I realized, so thanks for asking me to clarify.

I have *much* less of an interest in research than I do in teaching. My ideal academic responsibilities would be around curriculum development, formal teaching (many clinician educators at my home pulm/cc program are involved in the MS2 pulm phys class)>>QI. With that said, I see myself very much as a clinician first ( clin. ed. attendings in my home program spend up to 32 weeks on teaching services, either in various units or on pulm consults, which sounds ideal). For the job I'm looking for, I know that I don't need to be in a huge academic program post-fellowship; I may well be content at a community program with a strong residency. So I don't need the pedigree of a Colorado-type program, though I do want a complete clinical experience, which I'm concerned that only the top few programs I'm interviewing with may provide. I also recognize that going to a less prestigious program may make me less competitive for what seems to be a bit of a rare job (my home program has 4 pure clin. ed. attendings in a fairly big department) down the road.

I can appreciate my career planning is half-baked. I came to pulm/cc late, and am riding a bunch of old basic science publications on my resume from after college, and a big name residency, to good interviews. I've been forthright about not wanting to do research down the road on interviews. Programs seems to have responded well to my enthusiasm for clinical education, though again, only UWash seems to have a mature track (though I still have interviews to attend). In their program, you can take your non-clinical time and do graduate level Ed. classes, teaching seminars, work with med students, etc., which sounds much more in line with my career interests.

Thanks again for your advice, all.
 
If Trish Kritek is involved over at UW then I would seriously consider ranking them highly and would push hard to have her be your clin ed mentor. She's a phenomenal adult education - motivated clinical educator.
 
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souljah1 said:
If Trish Kritek is involved over at UW then I would seriously consider ranking them highly and would push hard to have her be your clin ed mentor. She's a phenomenal adult education - motivated clinical educator.
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Didn't get a chance to meet her directly, unfortunately, though I was impressed with the other clin ed attendings (Park and Luks (sp?), in particular, if you're a UWash person).
 
What's the down low on Case Western? Just curious what the thought is on their program?
 
PCMMjunior said:
Any advice on how to put the rank order list?
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Put your #1 first, then your #2 second, after that should come your #3. If you need help after that...
29232811.jpg
 
Have you guys been been hearing back from everyone you email (post interview follow up)
 
ESPY said:
Didn't get a chance to meet her directly, unfortunately, though I was impressed with the other clin ed attendings (Park and Luks (sp?), in particular, if you're a UWash person).
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Nope, not a UW person. Met her when she was Brigham's program director (Partner's). As a visitor, I was very impressed with her approach to medical education. She led a fantastic conference where she would present a case and ask the attendings in the room what they would do. Fellows just sat back and watched. Great to see experienced minds share their reasoning. She provided a great rationale doing the conference that way during my interview. She's also someone who has formal training/education in adult learning theory.

Good luck with the match!
 
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Now that everything is said and done basically. Does it harm your application if you apply for 2 different specialties?
 
If I ranked program number 6, and this program ranked me number 1... Is this spot going to wait for me until I don't match in my first 5 choices? Or it will go to an applicant who ranked this program number 1?

Thank you
 
I recently visited cook county hospital. Needs a review in the forum. Largely clinical and limited program. Does not have access to lung transplant, CF, CRRT, ECMO, HFOV. Affiliate of Rush with some conferences together and a neuro icu rotation there. Fellows appear not too discontent with the training but then one said that he'd rather be a hospitalist.

The PD is the "jewel" of this program. To me he appeared pompous and openly categorized some of his fellows and the local residency program as "deficient". Apparently another PD will step up this year and he will be dedicated to research. Wich is pretty non existent however, 6 months in 3 years and clinical only if anything, can elect Toured the ICU: 2 teams of 12 more or less. The unit was half empty and there were only 3 patients on vents.

To me it appears as if the old reputation of "you'll see everything at county" is long gone. The acuity appears low. The PD gave me a terrible impression and will not rank this program mostly due to that reason.

More on the PD.
BTW clinical questions in fellowship interviews? He trained under Tobin in Loyola and frequently mentioned that in the interview. No mentorship program. Best thing of the $400 dollars spent to come to Chicago was spending a weekend with long lost friends.
 
PCMMjunior said:
If I ranked program number 6, and this program ranked me number 1... Is this spot going to wait for me until I don't match in my first 5 choices? Or it will go to an applicant who ranked this program number 1?

Thank you
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The advantage in the match is to the applicant. If a program ranks you number one, it will "wait" through the algorithm of the NRMP until you match. If you don't match at your top 5 and you have them 6, then you'll match. If you match at one of your top 5, then your name leaves their list and the process is repeated with their number 2 and so on.
 
Super Turrican said:
I recently visited cook county hospital. Needs a review in the forum. Largely clinical and limited program. Does not have access to lung transplant, CF, CRRT, ECMO, HFOV. Affiliate of Rush with some conferences together and a neuro icu rotation there. Fellows appear not too discontent with the training but then one said that he'd rather be a hospitalist.

The PD is the "jewel" of this program. To me he appeared pompous and openly categorized some of his fellows and the local residency program as "deficient". Apparently another PD will step up this year and he will be dedicated to research. Wich is pretty non existent however, 6 months in 3 years and clinical only if anything, can elect Toured the ICU: 2 teams of 12 more or less. The unit was half empty and there were only 3 patients on vents.

To me it appears as if the old reputation of "you'll see everything at county" is long gone. The acuity appears low. The PD gave me a terrible impression and will not rank this program mostly due to that reason.

More on the PD.
BTW clinical questions in fellowship interviews? He trained under Tobin in Loyola and frequently mentioned that in the interview. No mentorship program. Best thing of the $400 dollars spent to come to Chicago was spending a weekend with long lost friends.
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Glad they were trying to impress you.
 
I was really mad at that guy. Mentioned Martin Tobin like he was beettlejuice and could be summoned by saying his name multiple times. Giving out his pimp questions.
5 causes of hypoxemia with clear lungs
Ecg findings in copd
5 causes of multiple infiltrates and goof heart
 
Super Turrican said:
I was really mad at that guy. Mentioned Martin Tobin like he was beettlejuice and could be summoned by saying his name multiple times. Giving out his pimp questions.
5 causes of hypoxemia with clear lungs
Ecg findings in copd
5 causes of multiple infiltrates and goof heart
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That's garbage. I wouldn't rank anywhere that pimped me either.

Who cares about the ECG in COPD anyway?

"goof heart"?
 
5 CAUSES OF HYPOXEMIA WITH CLEAR LUNGS.
PE
CO POSONING
RT--> LT Shunt
Acute MI
septic shock
 
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What is your opinion about Mayo Florida, Wake Forest, U of Florida? Thanks in advance. Almost done with long season.
 
Mayo Florida
- Very interesting program, i wasn't sure what to make out of it
- Great location, Nice hospital, Mayo brand, Good resources, database research scope and funding
- Limited but strong faculty, limited pt population, mainly undiagnosed/extensively worked up quarternary referrals,lots of transplant, more than basic pulm i guess.
- Open ICU mainly surgical i feel. How many sick ots will u have in a 250 bed hosp? mostly referrals i guess.
Feels good in some ways not so much in others.... Definitely worth thinking abt though
 
patusmle said:
What is your opinion about Mayo Florida, Wake Forest, U of Florida? Thanks in advance. Almost done with long season.
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You want to see Wake. It's a really, really nice, but not perfect (No VA or Transplant for instance) program.

Florida is program I know more by reputation from working with a few people from there, seems solid, with a very healthy interventional component to their program including pleuroscopy.

Skip Mayo-Jax.
 
I recently visited Mayo-FL. As said before, it ain't mayo, maybe miracle whip.
The unit was half empty. appears to be a nice place, with a lot of seasonality. A lot of surgical intensive care, as PCCM takes care of all of SICU. No trauma, which you do in Shands-JAX. No CF. No real research, trying to build an focused clinic like a PH, ILD, thing. Still on the works though. Jacksonville is OK.

UF: visited Gatorland earlier in the season. Sounds like a nice well rounded place. Has a large/very large CF component (can be either good or bad depends on your liking). Gainesville is a college town (again either good or bad). No in house call. Most of the fellows were from Florida (either UF, UMiami, or Nova Southeastern). Nice place. I liked it. The PD appears to play a secondary role and the Assoc. PD seems to run the show.
 
Anyone has any opinions on Washington hospital center?
 
Has anyone got any post interview/near ranking emails from programs?
 
patusmle said:
Oh I guess it from west coast? :)
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Why does it imply West Coast? But since you asked, yes it was :)

Got one other unsolicited email. The rest were replies from thank you emails that I put off until interviews were over (which I feel is better timed since all programs are put into perspective and it's closer to rank time, just my 2 cents)
 
does anyone know of any pulmonary vascular/hypertension fellowship programs other than the one at Stanford ?
 
endotracheal said:
does anyone know of any pulmonary vascular/hypertension fellowship programs other than the one at Stanford ?
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Not that I've heard of. Most places are not going to have the money to pay you to hang around for an extra year of just pulmonary hypertension, plus, I don't think there is any kind of huge interest to be honest.
 
Any opinions on Long Island Jewish Hofstra? They're just too far from home, and super expensive to go. Anyone has been there recently?
 
jdh71 said:
Not that I've heard of. Most places are not going to have the money to pay you to hang around for an extra year of just pulmonary hypertension, plus, I don't think there is any kind of huge interest to be honest.
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Just curious on why you feel that way. It seems there are many more therapies coming out and not a lot of people are comfortable managing the infusions, etc. Wouldnt it be advantageous for divisions (even financially) to have someone in the institution who can do this?
 
ResidentMD said:
Just curious on why you feel that way. It seems there are many more therapies coming out and not a lot of people are comfortable managing the infusions, etc. Wouldnt it be advantageous for divisions (even financially) to have someone in the institution who can do this?
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Many more therapies that do what?? Add 20 feet to a 6 minute walk test?? Treating pulmonary hypertension is freaking depressing and horrible.

Furthermore there isn't enough type I disease to go around. You just don't need that many experts in any location.

And bottom line is, where is the money going to come from to pay the salary for a super-fellow? You could maybe work out some kind of arrangement where they work as an attending part of the time? But most places will simply not have the infrastructure or extra cash sitting around to allow a guy to devote a whole year to it.
 
jdh71 said:
Many more therapies that do what?? Add 20 feet to a 6 minute walk test?? Treating pulmonary hypertension is freaking depressing and horrible.

Furthermore there isn't enough type I disease to go around. You just don't need that many experts in any location.

And bottom line is, where is the money going to come from to pay the salary for a super-fellow? You could maybe work out some kind of arrangement where they work as an attending part of the time? But most places will simply not have the infrastructure or extra cash sitting around to allow a guy to devote a whole year to it.
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Well....the first medication with a mortality benefit was FDA approved 2 weeks ago. But otherwise completely agree. Even the guys who this exclusively will tell you 90% of their referrals aren't even iPHTN
 
Hernandez said:
Well....the first medication with a mortality benefit was FDA approved 2 weeks ago. But otherwise completely agree. Even the guys who this exclusively will tell you 90% of their referrals aren't even iPHTN
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What did they buy people? A couple of weeks? Months?

I know you can appreciate my cynicism here. Is this like giving chemo to small cell??
 
jdh71 said:
What did they buy people? A couple of weeks? Months?

I know you can appreciate my cynicism here. Is this like giving chemo to small cell??
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You know the field is depressing when the lung cancer folks have better odds of survival than PAH and IPF

*depending on staging of course
 
I think we dont know jack about how to stop a fibroblastic response, no antifibrosis agent works (if fibrosis is a single entity or a common presentation of multiple underlying pathways is another thing). From keloids to ipf nothings works real good, or at all. Get that and the nobel is within your reach.
 
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