2008 Cardiology Interview Impressions

[HeartFailure]

I figure that people are now hitting the interview trail and thought it would be a good idea to provide feedback after interviews. I will start with Vanderbilt:

There is a pre-interview informal gathering at a local Nashville brewery. While the food was average, the turnout was great, with many fellows and faculty members. The fellowship director, Dr. Sawyer, was in attendance and was very nice and easy to talk to. 16 candidates were interviewed the next day, and everyone had 5 interviews, one with a fellow, one with Dr. Sawyer, and then 3 other faculty members. The interviews were laid back and were not intimidating at all. Most individuals either wanted to talk about my research or explain various stengths/weaknesses of the program. I think some of the strengths includes the flexibility the program affords fellows in terms of developing their career path. Any type of research is supported. Vandy is also one of 5 centers partcipating in the NIH cardiacc stem cell research network, and their goal is to train 2 fellows per year in the finer aspects of stem cell research. The center also has a SSCOR grant, a $16M award towards research on thrombosis. They also have an unique relationship with the cardiac surgeons, much more collegial than at most institutes. They even have hybrid OR's, where cardiologists and CT surgeons work side-by-side on cases. The VA is connected to the main hospital, which is nice. And volume is not a problem at Vandy, as they are a major referral center. In terms of weaknesses, the heartfailure-transplant program is in the rebuilding phase, but they are actively recruiting new faculty, and their transplant numbers are beginning to rise again. Fellows work very hard, and they are in the process of creating a non-teaching service to alleviate some of the burden on fellows, because although call is q10, they still have to admit patients occaisonally. They actually serve as a triage person, but it's additional work to an already busy call. And although technichally it's home call, most fellows stay in house because they're constantly being paged. Overall, I was impressed with the facilities, and they are building new cath labs and have new clinics that are about 1-2 years old. This is a very progrssive place that is moving in the right direction, and I was very impressed.

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[Crosnmafingers]

Thanks for starting this thread.

Michigan. Huge, new cardiovascular center. Day starts out in the atrium of the center at around 8 AM, where all the applicants meet up and are escorted to one of the academic office areas. The 15 applicants sat around a table, where we had a nice spread for breakfast, and got a folder with information about the program. The PD had some sort of horrible viral illness and his voice was totally hoarse throughout his presentation, but he made it through a-okay. I was really impressed by his enthusiasm and general attitude; he's the type of guy you'd expect to go to bat for you as a fellow if/when needed. After that, we were briefed about the direction of the program (and a breakdown by department) by the division chief. I was impressed by the expanding faculty and sheer quantity of new hires in almost every major area. Imaging truly is this program's weakness, though -- the PD even admitted it; several times. One of the fellows I talked to during lunch is going to another program out east to get some MRI training. After that, you get a talk about the CV center by its director (who happens to be Kim Eagle), who is as charismatic as you would expect. You go on a small-group tour around the CV center and the Cards ICU, which is still located in the main hospital (and about 5 minutes indoor walk/elevator ride from the CV center). Another one of the few potential downsides of the program presented itself at that time -- the unit is OPEN; meaning you have multiple attendings/teams potentially rounding at the same time and multiple people giving you orders/expecting calls when things go hairy. Not the ideal setup... We then proceeded to lunch, which was absolutely delicious, and then started interviews in the afternoon. During lunch, those of us that didn't have an interview scheduled with the PD, were called one by one to sit and chat with him for 10 minutes about our application and answer any questions he had. For some reason, internal applicants were only scheduled for 2 interviews and us outsiders got 4, but the PD said, "it's because the internal applicants are readily accessible." I interviewed with 4 pretty impressive faculty members and enjoyed the conversations. We talked about me, we talked about them -- very low key. The day ended around 4 pm after a brief recap/Q+A by the PD; they had cookies and coffee to close things out and complete my waistline expansion.

Nutshell: awesome program, proactive/fun PD, energetic and collegial fellows, BEAUTIFUL cardiovascular center; needs more development in imaging and needs to CLOSE the Cards ICU

Pre-interview dinner: local Irish pub where appetizers were plentiful, though mostly bland, and main courses were interesting (don't order the stew -- not that I did, but still; it looked horrible); Guinness, etc on-tap, with no attendings around and plenty a fellow drinking beer

Most impressive thing: the first year fellow on-call was at the bar

Least impressive thing: really, really hard to say, as this is an unbelievable program; had to be the weather though -- it was like -20 with the windchill the day I interviewed

 

[HeartFailure]

I figure if nothing else, posting my own impressions will help me out later when it's time to rank programs, because I have a feeling that by interview #10 programs will start to resemble each other and I may forget things.

UNC: First of all, the area is beautiful and georgeous. Not for the big-city lover. But there appears to be enough to do (2 Million people in the research triangle area). Anyways, there were only 6 applicants, and we had 3 interviews each, one with the chief fellow, one with Dr. Willis, the program director, and one with Dr. Patterson , the chief of cardiology. All 3 interviews were chill and laid back. They didn't even ask about my research or 5/10 year plans. Very relaxed. The day began with Dr. Parks talking for an hour about the program and how each year is set up. You have 3 months of call all 3 years, and call consists of a team of an attending/fellow/resident/intern, working on a cards team with an open CCU. The call is q4, and if the resident is competent, you can eventually leave the hospital and go home. Like most programs, you have an abundance of elective time during your second and third year. This program has plenty of research opportunities, but it's not forced down your throat. The school of public health, which is one of the best in the nation, works closely with UNC and there are ample opportunities for outcomes and population based research. Some fellows pursue a MPH. The Carolina Cardiovascular Biology Center also provides plenty of research opportunities. What I found funny was that the chief here is going into private practice. Actually, 85% of the fellows go into private practice (this was after speaking with a fellow, because the program directior does not give this impression). The reason for this may be due to the strong clinical training one receives here.
POS: Very friendly faculty and fellows, collegial environment. School of public health. Only 3 months of call per year, with home call. New EP guy that has the division moving into the new millenium (ablations, etc.)
NEG: Call as a 2nd and 3rd year. Only 2 cath labs, and fellows only do around 85-100 caths over 2 months, where at other programs this can be accomplished in one month. The number of transplants is low.
Overall, a solid program where one will become a competent clinician.

 

[tibor75]

Most impressive thing: the first year fellow on-call was at the bar

how is that impressive?

 

[Crosnmafingers]

how is that impressive?

OK, let me clarify... He was at the pre-interview dinner (not drinking or anything), taking home call with the pager (and it didn't go off). Maybe you would like to get paged a ton when you're on call and not be able to make it out of the hospital, but not me

 

[HeartFailure]

Crossnmafingers, thanks for participating, hopefully we can have more input soon, I know that others are reading these threads and have been on interviews and could provide some useful information.

 

[dadr]

What I found funny was that the chief here is going into private practice.

Actually, the chief fellow at Cleveland Clinic is also going into private practice, so you never know.

 

[tibor75]

Actually, the chief fellow at Cleveland Clinic is also going into private practice, so you never know.

The majority of fellows even at academic institutions go into private practice.

 

[grendelsdragon]

The majority of fellows even at academic institutions go into private practice.

~3/4 of fellows from my former program are in academics, and 6/6 from my year are in academics. The stats used to be >85%, but there has been a small exodus of these academic-types into industry jobs.

That being said, I honestly look longingly at the lifestyles of my friends who went into private practice or industry. I do have a lot of intellectual gratification and job satisfaction, but the financial compensation is simply just enough to get by with children. The academic route is definitely not easy and worth thinking hard about.

 

[HeartFailure]

Now back to the reason this thread was created, INTERVIEWS
Virginia:
Interview day began at 7:45. A total of 13 applicants present. The day began with Dr. Dent giving an informal introduction to the program. Very nice and easy to talk to. The strengths seem to be Imaging, then EP. They have a strong imaging fellowship that is one of the best in the nation. They can fund you for 2 years via a NIH grant. HF seems a little weak with only 1 attending, but a fellow was able to do interventional HF for a year. Dr. Beller is the acting chief, and a new guy from Duke is on the way in June (can't remember his name right now!). He has a HF and angiogenesis background. Fellows seem happy, did not see a ton. Call starts after 6 weeks, and there is no CCU call during the 1st year. Call is performed all three years. Call is from home and is about q5-6. Fellows would have to come in 10-15 times/year on average for acute emergencies. Minimal HF research at this time, tons of imaging research, weak Interventional research. I think the cath volume is starting to decrease some, because they are changing from 2 interventional fellows to one next year. It appears fellows get their numbers. 70/30 private/academic split. Charlottesville is a big college town, but is absolutely beautiful. I think with the new chair research should take off and more faculty hirings are to be expected, especially in heart failure from what I was told.

 

[Myostatin]

Cleveland Clinic

Clinical: Probably the best training anywhere in the country, in terms of volume and zebras to be taken care of. Spectacular resources and physical plant. Tremendous procedural volume, far above likely anywhere else in the country. Call is overnight in house - there are 3-4 fellows in house at any given time. You are required to cover the CCU q13 on average, and all other calls are optional and well compensated. The "optional" call shifts must be filled one way or another. It seems that the fellows are responsible for many resident level jobs - i.e. routinely field questions for nurses and are expected to be involved in the details of paitent care.

Research: Very strong clinical research, and basic science research is improving. Many fellows publish in top journals, and several have won ACC young investigator awards.

Pros: Probably the best clinical training you can get, anywhere. Excellent clinical research oportunities. Collegial atmosphere. Nationally known faculty.

Cons: Very heavy workload, overnight inhouse call. Residents are not very involved, so you will often be responsible for routine care. Limited basic science oportunties relative to the program's overall strength.

Interview day: ~15 interviewees, each with the same 4 faculty members. Overall laid back. They pay for 1 night stay in a fancy hotel, and a nice lunch. Fellows are easily accessible to answer questions and were very honest in their answers.

 

[guzmaa]

Started with pre-interview dinner day before presentation by PD and chair of cardiology, interview started with cardiology grand rounds in am, after which we were taken on hospital tour, then 4 interviews, with PD, chair, chair of medicine and an associate PD, all benign, no medical/cards questions asked.

However the program is an average one, first year fellows take about 6-8 months of house all front loaded, they meet their procedure requirements, they donot have Interventional Cardiology or EP fellowship, first year fellows are generally not allowed much of cath experience.

well a rural setting and laidback, but many fellows have matched at good places for IV and EP fellowships.

An average program, but if there are no there options i would certainly go there to train.

 

[ucla2usc]

Any thoughts on West coast programs: Cedars, UCLA, UCSD, Stanford, UCSF?

 

[tachycardia105]

No pre-interview dinner
Interview day: 10 candidates all from top institutions around U.S. Good overview by the chief of cardiology (who is leaving for Miami this year), PD (who's been around for >15 years in this position) and associated PD. Each person had around 5 interviews

Strenghts: Excellent reputation. Second to none basic science research opportunities (comparable to Brigham's, Hopkins), good clinical exposure

Weakness: No clinical research, no epidemiological data sets to do research off. Fellow's have to support their own salary if pursuing 1-2 years of research. Most of the staff looked tired of the rigors of academic profession. Some scut work. Busy due to enormous size of the hospital.

 

[dadr]

UCSD: The day started pretty casually at the Hillcrest campus cardiology offices with some breakfast and a presentation by the PD. It was a basic nuts-and-bolts of the program and different hospitals as well as some of the advanced training opportunities. This was followed by a series of interviews with the PD, Chair and one or two other faculty. It was pretty loosely organized. We then had lunch and a tour of the main hospital with one of the fellows. The physical plant of the Hillcrest hospital is nice enough, with a beautiful ocean view. The fellow said they have a good EMR which is accessible from home. We were then on our own to go up to the La Jolla campus, where the VA hospital is located, to interview with 1-2 other faculty. I did not see Thornton hospital, which is the private UCSD hospital in La Jolla where fellows spend a couple months per year.

Call schedule: Quite different from other programs. When you are on CCU, you are on call basically Monday 7AM-Friday 5PM uninterrupted the whole month; the nights are obviously home call. The rest of the year you don't have call except for an occasional weekend coverage for the CCU. The fellows said you don't come in very often though. There is a relatively new cardiology moonlighter service which seems to have decreased the need for the on-call fellow to come in from home. Call at the VA and Thornton is shared between the two. Fellows said Thornton inpatient service is very busy because you're the only one--no residents or interns.

One concern was that the transplant program has been inactivated due to low volumes. They refer patients to Sharp Hospital in town, and there is some talk of involving fellows in that program. The director of the heart failure program is currently the president of the HFSA so I would expect things to grow in the coming years.

 

[HeartFailure]

UIC: About 10 applicants invited on the interview day. Everyone interviewed with the PD, chief of cardiology, chief of Christ Hospital or Dr. Kondos, sectional chief and apparently a legendary clinician. They utilize the Harvey mannequin to help improve clinical skills. All of the interviews were laid back and non-malignant. A very stress free day. The new chief of cardiology is this Basic Science guy from Emory, and he is making all kinds of changes to the program. He is hiring new HF and imaging faculty, and is adding a research track to the fellowship with 1-2 extra fellows. The call is front-loaded, about q7 from home during your 1st year. You cover the VA, UIC, and Christ Hospital. Call can be tough at UIC. Christ is a private hospital big on imaging and HF. They just started doing transplants there. Christ is the 3rd biggest center in the US in terms of placing LVAD's for destination therapy. UIC has an interventional position, and are adding EP in 2009. They are also in the process of getting a new cardiac CT and MRI, because the imaging is subpar at UIC, but the VA and Christ have all of the imaging modalities. Fellows have about 2 months at Christ a year, and seem to enjoy this rotation. There is a 24 hour echo tech available there. The interventional fellow gets first crack at all STEMI's at Christ (except on Sunday, where it's the general fellow). At the VA (which is brand new, will be completed in 2 months) and at UIC, the general fellow gets the to cath the STEMI's that come in on call. Research is available and encouraged, and basic science and translational research seems to be their strength. They have a huge clinical echo database that is a good resource for developing clinical research.