Texas Heart Institute CV Fellowship

[krodUT]

Hey guys,

I posted this to answer a question on a thread but just thought I'd throw it out there for your viewing. Good luck to all of you interviewing this year and let me know if you swing by our program. Myself (a current fellow) and all the others would be happy to answer whatever questions you have.

1. Case variety - you'll get everything; tons of thoracoabdominal aneurysms +/- CSF drains (Coselli is apparently the world's busiest aortic surgeon), elephant trunk procedures, ascending aneurysm, hemi-arch/total arch repairs, CABG's, valves, heart transplants, lung transplants, liver transplants, kidney transplants, LVAD's (HMII and HW), TAH's, TAVR's, AAA's open, TEVAR's, thoracic (Sugarbaker from the Brigham set up sip here last summer) and just about whatever else you can think of. The surgeons are fast.
2. 12 ORs (10 regular + 2 hydride rooms), 10 cath labs (although only 2-3 are doing cases with anesthesia)
3. 10 fellows, 8 residents (6 Baylor, 2 UT Houston); all doing their own cases
4. Plenty of cases to go around, that's never an issue
5. 2 really good AA's that do all the pre-ops and round on the epicurals
6. Call? 1st call is a resident 100% of the time and they're always in house. 2nd call is a resident thats last to leave. 3rd call is the fellow's call that's the last to leave for a fellow level case (about 90% of the time that's between 6 and 10PM); only once have I worked overnight. Average about 4 weekday 3rd calls a month
7. You'll be busy and but somehow I feel like we average in the mid 50 hours/week. How? Well we're busy but our surgeons are incredibly fast. You'll regularly do a CABG or am AVR and be out of the room by 9:45. Do the math and you can easily do 2-3 pump cases a day. A VAD is usually on the 4 hr range.
8. As a whole I would describe the place as a cardiothoracic, vascular and transplant fellowship.
9. The whole year you're only on call on the weekends when you chose to moonlight (extra $$$). This means you'll work around 12 weekend days a year +/- depending on how many moonlighting shifts you choose to take. So the rest of the weekends you have off.
10. Overall schedule: 6 months OR, 2 months TEE, 1 month perfusion/cardiology, 1 month thoracic at MD Anderson, 1 month peds hearts at Texas Childrens, 1 month ICU

Overall, I feel like we have a great balance between case variety and lifestyle. I work less than I did in residency but at the same time feel like I am learning way more than I ever could have as a resident. Strong didactics, incredible attendings, etc. Just my two cents since I know the SDN forums lack good info on the CV fellowships.

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[camedstudent23]

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[chocomorsel]

Sounds like a much better experience than I had with the Debakey Heart and Vascular Center. We were doubled up with SRNA's to do cases and the attending anesthesiologists were dinguses. Was not used to seeing dingus anesthesiologists, that was new to me. Horrible experience. And the old guy in charge of that program, what a douche. Cutthroat and they seemed to prefer working with CRNAs versus residents. They also were taking corpses on ECMO to and from the OR on a regular basis. Reminded me of anatomy lab in medical school.

 

[Noyac]

And nurses think they are as well trained as docs.
Wtf?
If I break another bone or injure myself in a way that I can't enjoy my outside activities in the manner I am accustomed too, I think I would apply for one of these fellowships.

Problem is, they probably won't take me.

 

[Noyac]

And nurses think they are as well trained as docs.
Wtf?
If I break another bone or injure myself in a way that I can't enjoy my outside activities in the manner I am accustomed too, I think I would apply for one of these fellowships.

Problem is, they probably won't take me.

And I did over 2000 hearts in a previous gig

 

[Noyac]

Sounds like a much better experience than I had with the Debakey Heart and Vascular Center. We were doubled up with SRNA's to do cases and the attending anesthesiologists were dinguses. Was not used to seeing dingus anesthesiologists, that was new to me. Horrible experience. And the old guy in charge of that program, what a douche. Cutthroat and they seemed to prefer working with CRNAs versus residents. They also were taking corpses on ECMO to and from the OR on a regular basis. Reminded me of anatomy lab in medical school.

This needs to be made public. Or at least posted on this forum.
People will ruin/waste a full year in a program like this and you can prevent it.

 

[krodUT]

Sounds like a much better experience than I had with the Debakey Heart and Vascular Center. We were doubled up with SRNA's to do cases and the attending anesthesiologists were dinguses. Was not used to seeing dingus anesthesiologists, that was new to me. Horrible experience. And the old guy in charge of that program, what a douche. Cutthroat and they seemed to prefer working with CRNAs versus residents. They also were taking corpses on ECMO to and from the OR on a regular basis. Reminded me of anatomy lab in medical school.

Just to clarify things, we're not the hospital that had Debakey that this post was referring to.

In Houston, there are more than one CV anesthesia fellowships.

1) There's Texas Heart Institute which is structurally attached to St. Luke's Episcopal Hospital. This is the program affiliated with Baylor College of Medicine; It was founded by Cooley back in the 1960's and he's still the honorary president of THI

2) There's UT Houston, which is literally down the street. It's an ACGME accredited program

3) There's Methodist Hospital which is sandwiched between THI and UT Houston in the Texas Medical Center. This is where Debakey was it which was Cooley's rival, etc. I'm not sure if they have an accredited CV fellowship, but I'm sure you can all look that up.

We don't use CRNA's, only AA's.

Our attendings are great guys. Myself and others have never had problems with them and they're all really good - they'll push you in the sense that you'll aspire to have their level of knowledge, which is really impressive.

Working in the cardiac OR's can be tough. No matter where you go I think you'll see that patient on ECMO who you think shouldn't be. Anything and everything will happen will happen at our program but in the end, your clinical skill set, fund of knowledge and experience will be awesome.

 

[chocomorsel]

Sure Noyac. It's the world famous "THE METHODIST" hospital in Houston Debakey Vascular and Heart Center. I only rotated there a month, but it was horrible. We were literally assigned to rooms with SRNA's concurrently. They take residents and/SRNA's from Houston; both UT and I think Baylor; Galveston and multiple Out of State for rotations. I honestly think they just do it for the money and not because they care so much about the resident education. Too many residents/srna's for the cases. Don't know if they are accredited.

Now maybe the fellows have a different take on it since they are there for a whole year. But I still think the attendings favored the CRNA's who worked there to do the cases, because they didn't seem interested in teaching much. You have to be quite aggressive to get along there well and I wasn't. There was one attending from Europe who was really nice and cool. The rest were jerks.

 

[Noyac]

Sure Noyac. It's the world famous "THE METHODIST" hospital in Houston Debakey Vascular and Heart Center. I only rotated there a month, but it was horrible. We were literally assigned to rooms with SRNA's concurrently. They take residents and/SRNA's from Houston; both UT and I think Baylor; Galveston and multiple Out of State for rotations. I honestly think they just do it for the money and not because they care so much about the resident education. Too many residents/srna's for the cases. Don't know if they are accredited.

Now maybe the fellows have a different take on it since they are there for a whole year. But I still think the attendings favored the CRNA's who worked there to do the cases, because they didn't seem interested in teaching much. You have to be quite aggressive to get along there well and I wasn't. There was one attending from Europe who was really nice and cool. The rest were jerks.

Now that's what I'm talking about. Thanks.

 

[IveGotTwins]

The UT Houston CV Anesthesia Fellowship is split between The Methodist Hospital and The Heart and Vascular Institute (which is semi-separate from the main campus of Memorial Hermann Texas Medical Center). If you match into the UT Houston CV anesthesia fellowship you spend several months, maybe 5-6 at Methodist and the rest at HVI.

I've rotated through all three environments (THI, HVI and TMH) and all have their pros and cons. I have co-residents who are going to both fellowships and both are excited about their choices.

 

[Chris88]

Hi my name is Chris. I am a student of medicine. I read that many people do felloship at the Texas Heart Institute. I dream about that after graduation I'll go to Houston to THI for training !
I heard that this place is changing lives!
I read that You worked with Dr. Ott, Coselli and Duncan. Amazing! Please write to me a little more how looks like work of surgeons in the THI. I am very interested in heart failure (HTx LVAD). Have you worked with Dr. Frazier? My mentor and hero is Dr. O.H. Frazier
Chief Cardiopulmonary transplantation and cardiovascular suregry research. But I have a question about the
operation of aortic aneurysms and other pump cases by dr Frazier. How often O.H. "Bud" Frazier other cases like performs aortic aneurysms
(ascending, arch, descending, thoracoabdominal) or other difficlut heart operation. Is he performed CABG, Valves, Aneurysm or he send this patient to other surgeons like Coselli, Ott ,Duncan. How looks his typical day?
How many heart or aortic operations he performed per day. How often works in the lab
How it looks in the THI.
I was very interesting repair of aortic aneurysms by Dr. Frazier because I
Im very intrested in heart failure surgery (Htx and LVAD) bud I would love to do something else.
I'm looking for someone who worked at THI. If you can please answer my questions. Please email me about the work of the surgeons there especially Dr. Frazier.

 

[Chris88]

Did You work with dr Igor Gregoric ? How looks his work in Operating room. Is he too performed other cases like Valve, CABG, Anuerysm, Lung Cancer and other.. or only Htx and LVAD.

 

[BLADEMDA]

Just to clarify things, we're not the hospital that had Debakey that this post was referring to.

In Houston, there are more than one CV anesthesia fellowships.

1) There's Texas Heart Institute which is structurally attached to St. Luke's Episcopal Hospital. This is the program affiliated with Baylor College of Medicine; It was founded by Cooley back in the 1960's and he's still the honorary president of THI

2) There's UT Houston, which is literally down the street. It's an ACGME accredited program

3) There's Methodist Hospital which is sandwiched between THI and UT Houston in the Texas Medical Center. This is where Debakey was it which was Cooley's rival, etc. I'm not sure if they have an accredited CV fellowship, but I'm sure you can all look that up.

We don't use CRNA's, only AA's.

Our attendings are great guys. Myself and others have never had problems with them and they're all really good - they'll push you in the sense that you'll aspire to have their level of knowledge, which is really impressive.

Working in the cardiac OR's can be tough. No matter where you go I think you'll see that patient on ECMO who you think shouldn't be. Anything and everything will happen will happen at our program but in the end, your clinical skill set, fund of knowledge and experience will be awesome.

Texas Heart sounds like a Top 5 Cardiac Fellowship and a great way to jump start a career in Anesthesiology.

 

[veetz]

I did my CV Anethesiology fellowship at Texas Heart. It was a phenomenal experience. The entensive case mix and benign nature of the CV anesthesiologists were the highlights. I've been well-served having that experience & will forever be grateful for the opportunity.

 

[RK.md]

Texas Heart sounds like a Top 5 Cardiac Fellowship and a great way to jump start a career in Anesthesiology.

I'm bouncing around between fellowship possibilities, but THI for CV is definitely in my top 3 choices. The faculty are awesome and the surrounding facilities in the Texas Medical Center are incredible.

 

[dhb]

Sounds like an awesome experience, kudos krodUT

 

[wickedskillz]

UT Houston CA3 here. I've done 2 months at HVI (affiliated with Memorial Hermann Hospital), 1 month at Methodist/DeBakey CV ORs, one month at the Methodist/DeBakey CVICU, and one month at THI. Honestly I've liked all 3 rotations, each have their own strengths and weaknesses. Methodist and THI are both homes to former pioneers in CV Surgery and people really know how to operate.
Many of Methodist's surgeons trained under DeBakey and it's a true joy work with them and watch them operate, people like Lawrie and Scheinin. I found most of the attendings to be friendly and collegial (Drs Montero, Herrera, Gibson, Woj, Singh were all awesome, to name just a few). They like their CRNAs, but that's because they work with the same CRNAs every day for multiple years, so they all know each other very well and hang out socially also. I just got there early every morning and they used to let me pick which cases I wanted to do. I thought the experience was great. The surgeons would come hang out with the anesthesiologists some time and tell stories about when DeBakey was around and what it was like to train with him, etc. Lots of history.
THI was also amazing. I really liked the faculty, the OR staff is all very friendly, a couple of the surgeons used to call me by first name. It seems like a private practice type arrangement. Like OP posted, they have great cases, and they're quick. When I was there they mostly were putting residents in the chip shot AV Fistula and other easy rooms and giving the fellows more pump cases, which is great for the fellows. I still got a decent number of pump cases though and still felt like I learned a lot. I really liked a lot of the Anesthesiologists there, there's a good mix of younger and older guys, most of them are really smart and super friendly. Their liver surgeon (Goss?) has to be one of the top nationally, he breezes through livers with minimal blood loss and short case times. I was worried about getting spoiled The fellows there were all pretty cool too, good mix of people from around the country, everyone seemed pretty smart and friendly.
Personally, I think both places had great cases and good, fast, super competent surgeons to work with. They both have CV/ICU trained faculty also which will help add to your education. I liked working at both places and feel I learned a lot.