Best cards fellowships

(same post as in cardiology ranking thread)

Difficult to say as every program has its strengths & weaknesses.

Overall, for people interested in academic research cardiology, the general feeling/desirability of each program on the fellowship interview trail is as follows (and it's very difficult to distinguish programs within each tier):

TOP TIER
Brigham, Johns Hopkins, MGH, Duke, UCSF

SECOND TIER
Cleveland Clinic, Penn, Stanford, UCLA, BIDMC, Columbia

THIRD TIER
Mayo, Cornell, Emory, Michigan, Chicago, Univ Washington, Sinai, Chicago

What about UCSD? Which tier does it belong to?

lub-dub said:

UCSD

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.

What about Texas Heart?

Intermatic said:

(same post as in cardiology ranking thread)

Difficult to say as every program has its strengths & weaknesses.

Overall, for people interested in academic research cardiology, the general feeling/desirability of each program on the fellowship interview trail is as follows (and it's very difficult to distinguish programs within each tier):

TOP TIER
Brigham, Johns Hopkins, MGH, Duke, UCSF

SECOND TIER
Cleveland Clinic, Penn, Stanford, UCLA, BIDMC, Columbia

THIRD TIER
Mayo, Cornell, Emory, Michigan, Chicago, Univ Washington, Sinai, Chicago

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Many consider the Cleveland Clinic to have the #1 Cardiology program in the country. The fact that it wasn't even in your top tier is a joke. Even a major publication (U.S. News and World Report) ranked the Cleveland Clinic #1 in cardiology. Mayo is 2nd overall on their list and it's in your third tier. It sounds like you just made assumptions based on what you know of IM programs in general. You can't apply that knowledge to fellowships because it varies considerably. I see a lot of people make that mistake every year and will randomly place Hopkins and UCSF at the top when they have no real clue about the fellowship programs because those programs are the highest ranked IM programs.


Desirability is an overrated factor and is not a great indicator of the quality of the program. Making rankings based on the fellowship interview trail is not very objective. I know many fellows would prefer UCSF over CC because they would prefer to live in SF over Cleveland. The same applies to Mayo. Fellows would rather live in Boston over Rochester any day. That doesn't necessarily make the program better than the Cleveland Clinic or Mayo. So in many ways better programs like CC and Mayo may be less competitive to get into than MGH, Hopkins and UCSF but again that has more to do with fellows' egos than program quality. Those programs have great IM reputations in general and has more prestige in general but the individual fellowship programs are not more reputable. For example, UCSF is one of the most competitive programs to apply to but it's not necessarily one of the best cardiology programs. UCSF's cardiology program wasn't even in the top 10 on USNEW's rankings(ranked 19th). UCSF's location in a swank area of downtown SF has a lot to do with the competitiveness of it's program aside from it's great academic reputation. We always joke that if you transplanted UCSF to Kansas City or some other smaller sized city in the midwest, that program's rankings would fall considerably.

Better indicators of a program's quality are major publications (U.S. News and World Report) and observing journals and seeing where most of the authors hail from. Physician recruiters can also tell you how competitive candidates will be for jobs and other academic positions upon graduating from that particular program.

daelroy said:

Many consider the Cleveland Clinic to have the #1 Cardiology program in the country. The fact that it wasn't even in your top tier is a joke. Even a major publication (U.S. News and World Report) ranked the Cleveland Clinic #1 in cardiology. Mayo is 2nd overall on their list and it's in your third tier...

... UCSF's cardiology program wasn't even in the top 10 on USNEW's rankings(ranked 19th).

...Better indicators of a program's quality are major publications (U.S. News and World Report)...

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utter garbage. US News and World Report ranking is designed for patient consumers, and it's an imperfect ranking at that. it has no bearing for training programs and is NOT designed for that purpose. i am willing to wager that either you are NOT a cardiologist OR you are a resident/fellow at mayo/CC.

Intermatic said:

Overall, for people interested in academic research cardiology, the general feeling/desirability of each program on the fellowship interview trail is as follows (and it's very difficult to distinguish programs within each tier):

TOP TIER
Brigham, Johns Hopkins, MGH, Duke, UCSF

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intermatic's top tier ranking of ACADEMIC RESEARCH CARDIOLOGY training programs is spot on. your rantings and ravings at thrusting mayo or CC into this group is just a dream.

I'd humbly disagree with the previous post. To say that somebody is better trained in cardiology for having trained at the Brigham or Hopkins than at Mayo or Cleveland Clinic is such a loaded statement. If you're worried about academic research cardiology, then you have to look at how much research comes out of these institutions. I doubt most people would say that Mayo or the Cleveland Clinic are lacking in the area of medical research. However, the research focus may be different (more basic bench research vs. translational research). Even if you talk within the Harvard system, many say that MGH is well below Brigham in terms of cardiology and vice versa. I wouldn't want to go to Mayo for fellowship but that's because of location, NOT because of the quality of the program, and if it was based in a more palatable location, I would easily rank it higher than most any other program in the country.

I think in the end most people should be able to agree that these three top tiers are all very similar if not the same. It just allows people to put a feather in their cap to feel like they got into a more competitive institution. And I agree that those top tier institutions are harder to get residency or fellowships at, but I think most people would agree that there are many institutions that if you transplanted to the Northeast or California coast (Mayo's a prime example) the competitiveness would skyrocket into the upper tier with ease.

The entire concept of which programs are the best for cardiology is problematic because the best programs for general academic cardiology are not necessarily the best ones for training in EP, interventional, or other subfields. So if you have a subspecialization interest, then your rankings become essentially worthless because those tiers get totally mixed up and multiple programs that weren't there get included in the upper tiers, displacing others.

Finally, if you actually talk to different people who are well known in cardiology, they will all say different things about the best places to go. I was told by the chair of cardiology at one of those second tier institutions that if I had the opportunity to train at Mayo, I should do it in a heartbeat because it's by far one of the best and I could easily come back afterwards. I'm not saying our opinions are worthless, but I think our opinions will change as we become more involved in academic cardiology about where the premier players in these fields actually are and where the "best people" come from (which is really a number of places).

BlahtoThis said:

Finally, if you actually talk to different people who are well known in cardiology...

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i have... actually talked with the chairmen of cardiology at JHMI, MGH, Duke, BWH, and UCSF. we generally talked about the afrementioned programs. CC and Mayo are fine programs, but they did not even enter into the discussions...

certainly, specific research interests should drive an applicant's ultimate decision with regard to insitution choice in academic cardiology.

Duke, aside from an aggressive research program, has the DCRI. Hopkins, beside having the most NIH resarch grant $$$, has a collaborative agreement for research years at NIH intramural labs. UCSF also has Gladstone. MGH has the CVRI. BWH and MGH have close relationships with HMS, HSPH, MIT, Whitehead, Broad, Children's, TIMI group, and more.

same tier? how's about NIH grant money as a surrogate for research productivity?

NIH awards in 2004 in hundreds of millions of $:
Johns Hopkins -- 599
UCSF -- 473
Duke -- 343
Harvard -- 325, plus 231 from Brigham, plus 285 from MGH (841 total)

Mayo -- 166
Cleveland Clinic -- 7

Qtip96 said:

i have... actually talked with the chairmen of cardiology at JHMI, MGH, Duke, BWH, and UCSF. we generally talked about the afrementioned programs. CC and Mayo are fine programs, but they did not even enter into the discussions...

certainly, specific research interests should drive an applicant's ultimate decision with regard to insitution choice in academic cardiology.

Duke, aside from an aggressive research program, has the DCRI. Hopkins, beside having the most NIH resarch grant $$$, has a collaborative agreement for research years at NIH intramural labs. UCSF also has Gladstone. MGH has the CVRI. BWH and MGH have close relationships with HMS, HSPH, MIT, Whitehead, Broad, Children's, TIMI group, and more.

same tier? how's about NIH grant money as a surrogate for research productivity?

NIH awards in 2004 in hundreds of millions of $:
Johns Hopkins -- 599
UCSF -- 473
Duke -- 343
Harvard -- 325, plus 231 from Brigham, plus 285 from MGH (841 total)

Mayo -- 166
Cleveland Clinic -- 7

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So your so-called discussions with all of these PD's(which I find dubious at best) are a scientific evaluation as to the ranking of these cardiology programs but a nationally recognized and well regarded publication's evaluation lacks merit. Wow! You just sound bitter that your cardiology program isn't ranked as high CC or Mayo and you are trying to justify that on a public forum. NIH awards doesn't make or break a program either. Many heavily awarded programs like the University of Pittsburgh and Case Western lack the reputation of programs that have far less NIH funding.

so, are you a cardiologist? what is your personal experience?

daelroy said:

but a nationally recognized and well regarded publication's evaluation lacks merit...

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any one of the numerous ACGME accredited training programs will be sufficient to learn clinical cardiology

the US News ranking, like i said previously, is a survery-based study intended for patient consumers and only an idiot would place significant weight on this publication for training programs.

The discussion is asinine, but mostly from the perspective of being hurt or helped by having gone (or not having gone) to one of those "top tier" places versus the tier right below. You can find many huge name cards people who have trained at Mayo, same as MGH, Hopkins, and many other great institutions. There are also amazing researchers at all of them doing very impressive work. In the end, your career will not be significantly hurt for not having gone to one of Qtip's top tier places and having gone to places like Mayo or the Cleveland Clinic.

There is some credibility to the concept that who you are makes the biggest difference and not so much where you go (the main benefits from going to a big name place are getting to meet the right people to help bring you up with them and having the resources available to do what you want to do). Also, going to a big name institution in cards says nothing about how good you might be clinically on your way out into the real world.

WashU and Michigan belong in there somewhere.

WashU and Michigan definitely. Also missing Texas Heart and UTSW. I'd also have to say that places like UAB and Indiana, while not as well known, certainly deserve very honorable mention.

Go where you feel comfortable! Who cares about the name.

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the OP's primary question was regarding "solid" programs, of which there are many. like i said before, all programs that have decent teaching and volumetric criteria for procedures should satisfy this. the thread got caught in a flaming war when the discussion took a tangent to discussing the "best academic training programs."

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mr_bertman said:

as a quick example: tony rosenzweig, whom you mentioned, is a fantastic mentor by all accounts. he's now at BIDMC, the "ugly stepsister" to MGH and the brigham. would i do cards at BIDMC and work in his lab, or would i rather flounder at MGH with some big name but have a crap experience? i'd pick the first choice 10 out of 10 times, and i'd be in a better position for an academic cardiology career too...

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unfortunately, your example is incorrect. cardiology fellows at the Brigham (Libby) and MGH (after Bill Dec took over for Fishman) can choose to do their research ANYWHERE. the host institutions in this case are confident enough that MGH fellows can do their research at Brigham, BIDMC, MIT, Tijuana, etc., so long as you have a good academic strategy. in this case, you can do your clinical training at MGH and do your research in Rosenzweig's lab (if stem cells give you the warm fuzzies), and STILL call yourself an MGH fellow. this is precisely what i mean by diversity of resources and opportunities.

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mr_bertman said:

okay, so harvard's the best place to do academic cardiology. is that what you want me to say?

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no.

listen. despite your enthusiasm about academic cardiology, you are still quite green. being a Sarnoff fellow means that you are still in medical school and not even a doctor yet. you have not yet gone through clinical residency, not to mention the cardiology application process nor clinical cardiology training itself. i agree with you that very few people end up at the top institutions. ambitious people do not need to be coddled nor pampered. those interested in scientific endeavors have to make real choices based upon a multiplicity of complicated factors. people should not be depending upon "US New and World Report" surveys or the like (as a few respondents here did) to make important decisions about mentors and resources. very few people have discerned their exact research trajectory to choose their specific scientific endeavors even by the end of fellowship training. most people along the way prefer to have the freedom and latitude to make choices, especially in such important matters affecting academic trajectory. which is why i am an advocate of seeking out programs that give you a diversity of choices in mentors.

the stuff you spend so much time saying (i.e. there are many great programs, there are many places where you can be happy, etc. etc.) is all very intuitive and EVERYONE knows this. it's a waste of space just talking about it.

my advice is not to make the most of what is around you. if you or other readers are truly interested in chasing something as competitive as academic cardiology, you have to be willing to go the extra step. seek out the best mentor for you and be willing to travel. certainly, if there is an ideal mentor at home base, groovy. otherwise, time to do some serious research and footwork. isn't this what YOU did? why would you ascribe an approach or outlook that you yourself did not follow?

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From an IM resident NOT applying in Cards.

Top programs by reputation, in no particular order, actually, its geographic!

Mgh
Brigham
Columbia
Penn
Hopkins
Duke
Cleveland Clinic
Mayo
UCSF
Stanford
UCLA

Some programs are better for basic research: ie Harvard, UCSF while others are stronger in clinical/clinical research: ie Cleveland and Mayo. Others are more of a mix: ie Stanford.

I'm sure programs like Chicago, WashU, etc are great, but by reputation, I wouldn't put them in the top tier. Besides, for the vast majority of people who are viewing this thread, any cardiology program would be great, especially an academic program. Cards is super competitive, you guys might know that.

Just my unbiased opinion from being around the interview circuit and knowing a lot of people who are doing/want to do Cards. Personally, I can't understand why.

Good luck on applications. I notice these fellowship threads are always dead compared to the general IM forum.

allow me some parting words of advice. it is far better to spend substantial effort in building a good scientific foundation than obtaining numerous superficial experiences. i sincerely wish you lots of luck.

kobester said:

...Just my unbiased opinion from being around the interview circuit and knowing a lot of people who are doing/want to do Cards. Personally, I can't understand why. .

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me neither!

Man who could have guessed that Eugene Braunwald viewed these boards.

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Saabdriver said:

Man who could have guessed that Eugene Braunwald viewed these boards.

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mr_bertman said:

to be perfectly honest, i don't think i'll survive in academic cards. ...
...didn't mean for this to be some big debate with you, qtip. i just thought a different perspective would be nice for anyone still reading.

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now, don't be down on yourself. keep pluggin' away bro'.

i wouldn't call it a debate. open discourse is good for all. i wouldn't even be participating if i didn't think it was fun.

honestly, you sound like you're getting a lot out of your experiences. everyone needs to go through a "feeling-the-terrain" phase (just as grad students are required to rotate through a bunch of labs). however, most academicians will agree with me that a solid experience in one lab, of AT LEAST 2-3 years, with resulting publications is better than floating though a lot of labs.
best of luck.