Pediatric Cardiac Fellowships

[floridaboy18]

Hey guys,

MS-4. I am very interested in congenital heart physiology and am thus interested in peds cards fellowships, but when I looked through the forums and also did a web search I could not find what I was looking for, which might eventually affect my ranking of programs for residency come rank list time.

(1) Anyone know of a list that compiles all of the programs that currently offer a fellowship in pediatric cardiac anesthesiology? I know of a couple (Baylor, Boston Children's)

(2) Also, what are people's thoughts about the usefulness of this fellowship (i.e. future of the field, competitive fellowship?, "marketability," job security, etc)?

Thanks!

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[michigangirl]

I don't have a list, but I can add that Hopkins has a peds cardiac fellowship program, although it's a bit more informal currently and is an extra 6-12 months on top of a peds anesthesia fellowship. I would be wary of choosing residencies basing too much on their availability of a formal pediatric cardiac program. As you know, peds cardiac anesthesia is extremely specialized, and once you start residency you might decide that you don't want to focus quite so much. But you might decide you do. So going to a strong anesthesia residency where you will get exposure to children with congenital heart disease in the general OR in addition to the cardiac OR would be important. Can't discount the large numbers of congenital cardiacs who need general surgical procedures out there. These programs may not have a fellowship. But you will figure out if that's what you want to do. And then you can decide whether the training is worth it and pursue it.

 

[somedumbDO]

Hey guys,

MS-4. I am very interested in congenital heart physiology and am thus interested in peds cards fellowships, but when I looked through the forums and also did a web search I could not find what I was looking for, which might eventually affect my ranking of programs for residency come rank list time.

(1) Anyone know of a list that compiles all of the programs that currently offer a fellowship in pediatric cardiac anesthesiology? I know of a couple (Baylor, Boston Children's)

(2) Also, what are people's thoughts about the usefulness of this fellowship (i.e. future of the field, competitive fellowship?, "marketability," job security, etc)?

Thanks!

well honestly you are 4 yrs to premature. There are alot of programs that offer an "sub-fellowship" in peds hearts texas childrens, ACH ect... If you go to a legit fellowship you should be able to to most peds hearts asd, vsd, pda, maybe norwoods, TOF repairs... You will learn this in FELLOWSHIP not residency. Residency you will get the basics and in fellowship you will learn the rest. Most peds cv guys have decent job security. I know some peeps who do peds cardiac w/o even fellowship. Money wont be more about the same if less than your peers. So when you are a Ca2 applying for fellowship you should post this and in 4 yrs we will answer this question better.

 

[countingdays]

well honestly you are 4 yrs to premature. There are alot of programs that offer an "sub-fellowship" in peds hearts texas childrens, ACH ect... If you go to a legit fellowship you should be able to to most peds hearts asd, vsd, pda, maybe norwoods, TOF repairs... You will learn this in FELLOWSHIP not residency. Residency you will get the basics and in fellowship you will learn the rest. Most peds cv guys have decent job security. I know some peeps who do peds cardiac w/o even fellowship. Money wont be more about the same if less than your peers. So when you are a Ca2 applying for fellowship you should post this and in 4 yrs we will answer this question better.

I agree. Plus, the presence of fellows may hurt your residency training though not everyone would agree with that.

The ones I know of are Texas Children's, CHOP, Boston Children's, Emory, Stanford.

 

[floridaboy18]

I agree. Plus, the presence of fellows may hurt your residency training though not everyone would agree with that.

The ones I know of are Texas Children's, CHOP, Boston Children's, Emory, Stanford.

I appreciate the help, guys. I know this is an early question (which is also why I was curious to simply know general info about it). I realize this is way too early in the ball game to be seriously worried about it, but as I figured a lot of things out too late because I never asked I thought it would be better to be on the other side of the fence this time.

I also think that it is reassuring that going to a strong residency program with some exposure will not get in the way of me being able to pursue this fellowship if I still chose to regardless of whether they have the fellowship at my residency or not.

 

[imfrankie]

Hey guys,

MS-4. I am very interested in congenital heart physiology and am thus interested in peds cards fellowships, but when I looked through the forums and also did a web search I could not find what I was looking for, which might eventually affect my ranking of programs for residency come rank list time.

(1) Anyone know of a list that compiles all of the programs that currently offer a fellowship in pediatric cardiac anesthesiology? I know of a couple (Baylor, Boston Children's)

(2) Also, what are people's thoughts about the usefulness of this fellowship (i.e. future of the field, competitive fellowship?, "marketability," job security, etc)?

Thanks!

I thinks it great you are thinking about peds cardiac anesthesia. If so, I'd look at residencies at centers that do a lot of that and do it well. You might want to check out the congenital cardiac anesthesia society also for some ideas. In addition to the programs mentioned, I know that MUSC and Nationwide Childrens have fellowships in peds cardiac. You do a fellowship in peds cardiac and you will call the shots. Very highly sought out. Excellent choice in my opinion. You'll never be looking long for a job. Never.

 

[Masseter Spasm]

There are different options to pursue that route but plan on doing a pediatric anesthesia fellowship at a center with a strong pediatric cardiac surgery program. You could add an additional fellowship in pediatric cardiac anestheisa if you like. However, many centers will train you to do peds hearts on the job (as an attending with an attending salary) if you had solid exposure to it during fellowship and/or residency.

Another option would be to do a combined pediatric anesthesia and critical care fellowship. Unfortunately, that usually requires that you have done a pediatric residency in addition to anesthesia residency. There may be a few combined pediatric/anesthesia residencies in the future. But health care reform and funding of GME may make this unrealistic.

If doing anesthesia for peds hearts is your goal, your residency and fellowship training will take 5 or more years. The benefit is that your credentials will be highly demanded. It seems that good anesthesia jobs are hard to find these days. Most children's hospitals, however, could use more pediatric anesthesiologists and certainly more pediatric cardiac anesthesiologists.

 

[michigangirl]

There are different options to pursue that route but plan on doing a pediatric anesthesia fellowship at a center with a strong pediatric cardiac surgery program. You could add an additional fellowship in pediatric cardiac anestheisa if you like. However, many centers will train you to do peds hearts on the job (as an attending with an attending salary) if you had solid exposure to it during fellowship and/or residency.

Another option would be to do a combined pediatric anesthesia and critical care fellowship. Unfortunately, that usually requires that you have done a pediatric residency in addition to anesthesia residency. There may be a few combined pediatric/anesthesia residencies in the future. But health care reform and funding of GME may make this unrealistic.

If doing anesthesia for peds hearts is your goal, your residency and fellowship training will take 5 or more years. The benefit is that your credentials will be highly demanded. It seems that good anesthesia jobs are hard to find these days. Most children's hospitals, however, could use more pediatric anesthesiologists and certainly more pediatric cardiac anesthesiologists.

If by combined peds anesthesia and CC fellowship you mean picu fellowship, you MUST do a peds residency. In addition, combined peds anes/PICU fellowships are a thing of the past because of the ABA/ABP rules on doing 2 ACGME fellowships at one time. I did one, and the issues surrounding certification in both are serious. If you are set on anesthesia and want to go this route, then I would seriously look into the combined peds and anesthesia residencies, which will still take approximately 9 years total to do everything-- add to that a peds cardiac fellowship-- you can do the math. This route takes a lot of foresight-- to know as a med student that you want to be a pediatrician and an anesthesiologist who wants to do PICU and peds anesthesia. That's big and often not possible.

But food for thought.

 

[imfrankie]

If by combined peds anesthesia and CC fellowship you mean picu fellowship, you MUST do a peds residency. In addition, combined peds anes/PICU fellowships are a thing of the past because of the ABA/ABP rules on doing 2 ACGME fellowships at one time. I did one, and the issues surrounding certification in both are serious. If you are set on anesthesia and want to go this route, then I would seriously look into the combined peds and anesthesia residencies, which will still take approximately 9 years total to do everything-- add to that a peds cardiac fellowship-- you can do the math. This route takes a lot of foresight-- to know as a med student that you want to be a pediatrician and an anesthesiologist who wants to do PICU and peds anesthesia. That's big and often not possible.

But food for thought.

Sick Kiddies in Toronto has a two year pediatric anesthesia, pediatric ICU fellowship. That would be some superb training. Lotsa pedi-cardiac there also.

 

[michigangirl]

Sick Kiddies in Toronto has a two year pediatric anesthesia, pediatric ICU fellowship. That would be some superb training. Lotsa pedi-cardiac there also.

Not denying it's good training. But there's a reason CHOP, Boston and Hopkins don't have this formal program anymore. Can't sit for the new ABA peds anesthesia board exam if you do this program because you need to do one full year of uninterrupted, uncombined peds anesthesia fellowship. Don't know how the fact it's in Canada changes things, but the ABA rules are strict.

 

[imfrankie]

Not denying it's good training. But there's a reason CHOP, Boston and Hopkins don't have this formal program anymore. Can't sit for the new ABA peds anesthesia board exam if you do this program because you need to do one full year of uninterrupted, uncombined peds anesthesia fellowship. Don't know how the fact it's in Canada changes things, but the ABA rules are strict.

My understanding is Toronto is one year uninterrupted peds anesthesia then another peds ICU. Don't know how else one would get a year of peds ICU without doing the longhaul pediatrics/peds CCF route. Anesthesia CCF is nice, but if you want kiddies watchyagonnado?

 

[michigangirl]

My understanding is Toronto is one year uninterrupted peds anesthesia then another peds ICU. Don't know how else one would get a year of peds ICU without doing the longhaul pediatrics/peds CCF route. Anesthesia CCF is nice, but if you want kiddies watchyagonnado?

You answered your own question. There are no good shortcuts anymore. In order to be board certified (American Board of Pediatrics) in pediatric critical care, you must do TWO years minimum of PICU fellowship training. You're not going to get a job in a PICU with just one year of picu fellowship training--you may be able to work in a PCICU but then you would have to be either board certified in cardiology OR PICU. It gets complicated. The best shortcut now if you want to practice in a picu AND do peds anesthesia in the US is to do a combined peds and anesthesia residency (five years) and then spend the three years to do the two fellowships-- requires LOTS of foresight. and then get peds cardiac training on top of that somehow. I've rehashed this more times than you know for my trainees and myself.

 

[imfrankie]

You answered your own question. There are no good shortcuts anymore. In order to be board certified (American Board of Pediatrics) in pediatric critical care, you must do TWO years minimum of PICU fellowship training. You're not going to get a job in a PICU with just one year of picu fellowship training--you may be able to work in a PCICU but then you would have to be either board certified in cardiology OR PICU. It gets complicated. The best shortcut now if you want to practice in a picu AND do peds anesthesia in the US is to do a combined peds and anesthesia residency (five years) and then spend the three years to do the two fellowships-- requires LOTS of foresight. and then get peds cardiac training on top of that somehow. I've rehashed this more times than you know for my trainees and myself.

My comment about the Toronto method was not for purposes of becoming a PICU doc. The inquiry was about good training for pedi-cardiac anesthesia. I think two years as pediatric anesthesia fellow/PICU fellow would be good training. Don't know where else a person could do this.

 

[michigangirl]

Thanks for clarifying-- yes, that makes complete sense, if the PICU is a combined cardiac-medical unit or the one year is in a dedicated peds cardiac ICU. I can say from experience that some of our peds cardiac anesthesia fellows do not want take care of any kids in the picu except for the cardiacs, which makes sense. This is basically what our peds cardiac anesthesia training is as well, one year of peds anesthesia fellowship, one year of combined peds cardiac OR only and PICU taking care of cardiacs.

 

[imfrankie]

Thanks for clarifying-- yes, that makes complete sense, if the PICU is a combined cardiac-medical unit or the one year is in a dedicated peds cardiac ICU. I can say from experience that some of our peds cardiac anesthesia fellows do not want take care of any kids in the picu except for the cardiacs, which makes sense. This is basically what our peds cardiac anesthesia training is as well, one year of peds anesthesia fellowship, one year of combined peds cardiac OR only and PICU taking care of cardiacs.

How malignant is your program's pediatric cardiac anesthesia fellowship for someone older that is peds anesthesia fellowship trained?

 

[michigangirl]

How malignant is your program's pediatric cardiac anesthesia fellowship for someone older that is peds anesthesia fellowship trained?

Not at all-- if I understand your question, if you are older and practicing peds anesthesia for a few years and decide you want to do peds cardiac anesthesia, you would just spend a few months learning the ropes (like an apprenticeship) with one of the experienced peds cardiac attendings. You woudln't be expected to do picu/ccu time most likely because you have taken care of enough sick kids as a peds anesthesiologist and have a knowledge/experience base that is much different from a fresh CA-3 turned peds anesthesia fellow who wants to do peds cardiac. unless you really wanted to. You still get paid as an attending since you can attend in the peds GOR from time to time while you do your "apprentice" time. It's actually pretty low key.

 

[imfrankie]

Not at all-- if I understand your question, if you are older and practicing peds anesthesia for a few years and decide you want to do peds cardiac anesthesia, you would just spend a few months learning the ropes (like an apprenticeship) with one of the experienced peds cardiac attendings. You woudln't be expected to do picu/ccu time most likely because you have taken care of enough sick kids as a peds anesthesiologist and have a knowledge/experience base that is much different from a fresh CA-3 turned peds anesthesia fellow who wants to do peds cardiac. unless you really wanted to. You still get paid as an attending since you can attend in the peds GOR from time to time while you do your "apprentice" time. It's actually pretty low key.

I hear conflicting reports of what is appropriate training. Apprenticeship or OJT work is fine versus a whole extra formal year at someplace like Texas Children's still won't be enough. Opinions? I expect it takes a long time before one has little fear either way.

 

[michigangirl]

I hear conflicting reports of what is appropriate training. Apprenticeship or OJT work is fine versus a whole extra formal year at someplace like Texas Children's still won't be enough. Opinions? I expect it takes a long time before one has little fear either way.

Can only give you my opinion as someone who decided to stop the training madness before peds cardiac. PICU and peds anesthesia was enough for me, and I strongly believe you can't be good at peds cardiac anesthesia unless you commit all of your OR time to it, and I wasn't willing to give up all the other stuff. I think one year of formal training is ideal, depending on how much peds cardiac you get during your peds anesthesia fellowship. This debate continues into the picu/peds ccu, where the cardiologists feel they are the only ones qualified to take care of pedi hearts postop, and the picu folks disagree (as I do). It's a very good question, needs to be answered by someone actually in the peds cardiac trenches.

 

[imfrankie]

Can only give you my opinion as someone who decided to stop the training madness before peds cardiac. PICU and peds anesthesia was enough for me, and I strongly believe you can't be good at peds cardiac anesthesia unless you commit all of your OR time to it, and I wasn't willing to give up all the other stuff. I think one year of formal training is ideal, depending on how much peds cardiac you get during your peds anesthesia fellowship. This debate continues into the picu/peds ccu, where the cardiologists feel they are the only ones qualified to take care of pedi hearts postop, and the picu folks disagree (as I do). It's a very good question, needs to be answered by someone actually in the peds cardiac trenches.

People nice, friendly in the peds anesthesia world where you are--surgeons included in inquiry?

 

[michigangirl]

Yes, very much so!

 

[imfrankie]

Yes, very much so!

You folks recruiting?

 

[michigangirl]

will pm you.

 

[imfrankie]

will pm you.

Great state Michigan--thank you.

 

[floridaboy18]

I thinks it great you are thinking about peds cardiac anesthesia. If so, I'd look at residencies at centers that do a lot of that and do it well. You might want to check out the congenital cardiac anesthesia society also for some ideas. In addition to the programs mentioned, I know that MUSC and Nationwide Childrens have fellowships in peds cardiac. You do a fellowship in peds cardiac and you will call the shots. Very highly sought out. Excellent choice in my opinion. You'll never be looking long for a job. Never.

Thanks a ton for the insight! It is definitely reassuring to know about the security of the field.

It is ironic, too, that this thread turned partially into a talk about PICU training and PICU work as that is exactly what spurred my interest in congenital heart physiology was spending a month in the PICU during the early part of my 4th year. I was definitely bummed to find out that the "appropriate" way to work in the PICU was to do a peds residency and then a PICU fellowship. I actually gave thought to doing a combined peds/anesthesia residency, but decided not to in the end and that I would really enjoy taking care of a lot of the same patients in the OR instead where a mastery of the congenital heart physiology is still necessary.

 

[floridaboy18]

Also, to compile a list for future use...it looks like the following places have peds cards anesthesia fellowships from the forum here:

Boston Children's
Texas Children's (Baylor)
Stanford
MUSC
ACH (unsure what this is)
CHOP
Emory
Toronto?

 

[imfrankie]

Also, to compile a list for future use...it looks like the following places have peds cards anesthesia fellowships from the forum here:

Boston Children's
Texas Children's (Baylor)
Stanford
MUSC
ACH (unsure what this is)
CHOP
Emory
Toronto?

add Nationwide Childrens in Columbus Ohio

 

[core0]

If by combined peds anesthesia and CC fellowship you mean picu fellowship, you MUST do a peds residency. In addition, combined peds anes/PICU fellowships are a thing of the past because of the ABA/ABP rules on doing 2 ACGME fellowships at one time. I did one, and the issues surrounding certification in both are serious. If you are set on anesthesia and want to go this route, then I would seriously look into the combined peds and anesthesia residencies, which will still take approximately 9 years total to do everything-- add to that a peds cardiac fellowship-- you can do the math. This route takes a lot of foresight-- to know as a med student that you want to be a pediatrician and an anesthesiologist who wants to do PICU and peds anesthesia. That's big and often not possible.

But food for thought.

For what its worth adding peds to anesthesia or vice versa is only five years according to this:
http://www.theaba.org/Home/AnnouncementLetter
So in theory you could do peds anesthesia/CCM in eight years (which is still quite a while).

 

[imfrankie]

add Nationwide Childrens in Columbus Ohio

add (at least formerly) Cleveland Clinic

 

[michigangirl]

For what its worth adding peds to anesthesia or vice versa is only five years according to this:
http://www.theaba.org/Home/AnnouncementLetter
So in theory you could do peds anesthesia/CCM in eight years (which is still quite a while).

Theoretically, yes, if you cut a 3 year picu fellowship down to 2 and then do 1 year of peds anesthesia fellowship. PICU in 2 years is no joke. Let's not forget you need to get a "scholarly activity" in during those 2 years. There's a lot of service time to cram in a very short period of time. It's doable. But from a lifestyle perspective, it's brutal. Let's not forget that you would have crammed 2 residencies into five years and TWO sets of boards-- one peds, anesthesia written and oral, and THEN you have to do two more sets of boards, peds anesthesia and peds critical care.

 

[imfrankie]

Theoretically, yes, if you cut a 3 year picu fellowship down to 2 and then do 1 year of peds anesthesia fellowship. PICU in 2 years is no joke. Let's not forget you need to get a "scholarly activity" in during those 2 years. There's a lot of service time to cram in a very short period of time. It's doable. But from a lifestyle perspective, it's brutal. Let's not forget that you would have crammed 2 residencies into five years and TWO sets of boards-- one peds, anesthesia written and oral, and THEN you have to do two more sets of boards, peds anesthesia and peds critical care.

"where did my wife and kids go? they were here when I left?"

 

[sevoflurane]

My old residency had on average one pedi heart per day (2 pedi heart surgeons). 2 of our Pedi Fellows stayed on and are now providing care for pedi hearts. Total time invested = 1 year of pedi fellowship. They do a little bit of everything.

 

[michigangirl]

"where did my wife and kids go? they were here when I left?"

 

[doctor712]

My old residency had on average one pedi heart per day (2 pedi heart surgeons). 2 of our Pedi Fellows stayed on and are now providing care for pedi hearts. Total time invested = 1 year of pedi fellowship. They do a little bit of everything.

Sev,

May I ask if they are more greatly compensated compared to other partners that didn't do Peds Anes Fellowship?

Just curious....

D712

 

[amyl]

Cleveland Clinic has a fellowship in peds hearts

 

[sevoflurane]

Sev,

May I ask if they are more greatly compensated compared to other partners that didn't do Peds Anes Fellowship?

Just curious....

D712

It is my impression that fellowship trained academic positions pay better when compared to generalists. This is not always true as some older anesthesiologists have been grandfathered into peds, cardiac, pedi-cardiac, etc. However, pay also changes depending on status, publications, funding, overtime, call, etc. Some magical formula I don't really get.

Other academic physicians on this board are better equipped to answer that question.

 

[imfrankie]

It is my impression that fellowship trained academic positions pay better when compared to generalists. This is not always true as some older anesthesiologists have been grandfathered into peds, cardiac, pedi-cardiac, etc. However, pay also changes depending on status, publications, funding, overtime, call, etc. Some magical formula I don't really get.

Other academic physicians on this board are better equipped to answer that question.

Pay varies widely depending on the academic center. I have heard of a three-fold range in income for working in various "academic" ORs. Just like private practice, I don't think it is generalizable.

 

[doctor712]

thanks.

 

[btbam]

Egleston in Atlanta does an 18 month peds cardiac fellowship, 9 months regular peds 9 months hearts.

 

[imfrankie]

Egleston in Atlanta does an 18 month peds cardiac fellowship, 9 months regular peds 9 months hearts.

Glad to hear they are still doing that. I thought that was a thing of the past.

 

[bcmak]

Theoretically, yes, if you cut a 3 year picu fellowship down to 2 and then do 1 year of peds anesthesia fellowship. PICU in 2 years is no joke. Let's not forget you need to get a "scholarly activity" in during those 2 years. There's a lot of service time to cram in a very short period of time. It's doable. But from a lifestyle perspective, it's brutal. Let's not forget that you would have crammed 2 residencies into five years and TWO sets of boards-- one peds, anesthesia written and oral, and THEN you have to do two more sets of boards, peds anesthesia and peds critical care.

Sorry to bring up an old thread out of the blue but I read this and was wondering if it's still possible to cut a PCCM fellowship to 2 years if you do the peds-anes combined residency?

 

[physicsnerd42]

Sorry to bring up an old thread out of the blue but I read this and was wondering if it's still possible to cut a PCCM fellowship to 2 years if you do the peds-anes combined residency?

Unfortunately, no. The ABP just changed this so that it is no longer possible to shorten the PICU fellowship if you have anesthesia training. The only way I know of to shorten a pediatrics fellowship is if you already have a PhD.