Advanced Cardiac Imaging fellowships- worth it?

[Sapien3]

Hello SDN cards community,

These questions are directed to those who have done advanced cardiac imaging fellowship or work closely with cardiologists who have done these fellowships

1) How did the fellowship help in the new job hire (better pay/better offer)?
2) Will having the additional year of training gave them the opportunity to read Cardiac CT/CMR in institutes where radiologists are already reading these studies?
3) If one works in an institute with no advanced imaging, do you read studies at a place where you can use the skills to read these studies?
4) Would you reconsider your decision of having done the fellowship and do something different?

TYIA

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[timpview]

1. No one is going to pay you “more” however it definitely can help land you a better job at a more competitive place over your run of the mill general cardiologist. I think it would be almost required for a GC (That it heart failure) at many large tertiary or academic centers which usually are the most competitive or “best” jobs.

2.Just varies. Radiology just controls some places so it’s not a given you can always read. But obviously you should be smart enough to know that before signing up with such places

3. not sure what you’re asking

4. wish I could help but the above advice is from an IC.. can’t seem to recall hearing anyone ever regretting the pathway.

 

[disorder]

From having talked with people.
1. Not extra pay. But, to some groups out there it was a plus to have MR experience. CT experience is almost becoming standard. Structural is also becoming more pervasive and community docs are getting trained.
2. No. Just depends on where you work. Radiology most often owns the scanners, therefore there must be rapport between the departments to allow a cardiologist to read. Furthermore, some institutions co-read (you read with the radiologist to assist with incidentals) vs you read everything on your own.
3. ? I don't understand this question. Most big academic centers have/need/want an imager.
4. If it interests you, do it. Don't expect to do it in your job as many things go into that decision- ie location, practice type, etc etc. Reading ends up being a perk. Will it save you clinical time? Maybe.

 

[Sapien3]

Thank you @timpview and @disorder for your insight

3. not sure what you’re asking

RE #3. I am on J-1 visa. So, after fellowship I would be working in the underserved area for 3 years. It is most likely that I will practice at a smaller non-academic site. I believe such smaller places are unlikely to have advance cardiac imaging facilities and may not need for the imager. In such case, lets say I do advance imaging fellowship, would I be able to use those skills at another larger facility? is it a feasible option?

 

[MyTachyBradyHeart]

Thank you @timpview and @disorder for your insight



RE #3. I am on J-1 visa. So, after fellowship I would be working in the underserved area for 3 years. It is most likely that I will practice at a smaller non-academic site. I believe such smaller places are unlikely to have advance cardiac imaging facilities and may not need for the imager. In such case, lets say I do advance imaging fellowship, would I be able to use those skills at another larger facility? is it a feasible option?

If wherever you are working for 3 years after fellowship training will not have advanced imaging, then the fellowship won't help you at all. Many general cardiologist will read their own echo's/nucs that do not require advanced imaging training. This not only increases their productivity, but diversifies their practice.

You should consider this fellowship if 1) you intend to be at a large academic institution with research interest in advanced cardiac imaging, 2) if the job you're looking for requires it AND there aren't any radiologists reading cardiac images, or 3) you like it so much that you're willing to give up an entire year worth of attending salary and stay a fellow for one more year just to gain skills that you may or may not ever use.

 

[timpview]

In your scenario you very well could (and would) lose those skills. Unless you had some arrangement to read remotely (seems highly unlikely esp with mri). You might have coronary ct but even then likely low volume. You also would only read (echo/Nuc) what you generate.. so that means lots of clinic!

 

[Chromium Surfer]

1. No one is going to pay you “more” however it definitely can help land you a better job at a more competitive place over your run of the mill general cardiologist. I think it would be almost required for a GC (That it heart failure) at many large tertiary or academic centers which usually are the most competitive or “best” jobs.

2.Just varies. Radiology just controls some places so it’s not a given you can always read. But obviously you should be smart enough to know that before signing up with such places

3. not sure what you’re asking

4. wish I could help but the above advice is from an IC.. can’t seem to recall hearing anyone ever regretting the pathway.

I will be starting med school in the fall but am pretty interested in cardiology. If you don't mind me asking, why are jobs at large tertiary or academic centers seen as the "best". I assume landing these jobs would require a lot of connections and coming from an academic powerhouse fellowship. However people have also told me that staying in academic medicine results in a huge paycut. Are you saying these jobs are the best for people who have an interest in remaining in academics?

 

[Egghead34]

I will be starting med school in the fall but am pretty interested in cardiology. If you don't mind me asking, why are jobs at large tertiary or academic centers seen as the "best". I assume landing these jobs would require a lot of connections and coming from an academic powerhouse fellowship. However people have also told me that staying in academic medicine results in a huge paycut. Are you saying these jobs are the best for people who have an interest in remaining in academics?

same reasons why some people would rather live in SF/NY/LA than rural Oklahoma despite the high cost of living. PP may make you more money, but you will lose all relevance and renown in cardiology circles. Academics means prestige, respect, relevance as you climb up the ranks. It also means not worrying about the financial instability of the private world. You’ll never see CNN interview the worlds foremost private practitioner as an expert in the field. They’ll always call upon high ranking professors in major academic centers.

The idea of disappearing from the “public eye” and losing social standing/respect by moving into private practice can be worse than death. And for elite physicians who have competed for the top spots their entire life, getting a top job at a top hospital means winning the game.

Personally, having been through academic circles, I’ll take high pay and good quality of life in a place with lower cost of living to raise my family. But there’s no wrong answer,

 

[Sapien3]

In your scenario you very well could (and would) lose those skills. Unless you had some arrangement to read remotely (seems highly unlikely esp with mri). You might have coronary ct but even then likely low volume. You also would only read (echo/Nuc) what you generate.. so that means lots of clinic!

My thoughts as well when I consider doing advanced imaging fellowship as I may very well not use them. On the contrary, I want to be board certified in CT, echo and nuclear cardiology for sure before I start to practice. Hopefully, that could make my profile strong for an employer. I have heard certain institutes today let Gen cards person read CTs, but in the future the imaging fellowship may become mandatory to read CTs.

 

[timpview]

I will be starting med school in the fall but am pretty interested in cardiology. If you don't mind me asking, why are jobs at large tertiary or academic centers seen as the "best". I assume landing these jobs would require a lot of connections and coming from an academic powerhouse fellowship. However people have also told me that staying in academic medicine results in a huge paycut. Are you saying these jobs are the best for people who have an interest in remaining in academics?

 

[timpview]

2 separate things

1. tertiary centers in “private practice” are basically all hospital employed positions - I referenced them as the best only because generally they are highly sought after. They provide An easier lifestyle gig with dilution of call frequency (large group). They have the most mid level support for the nonsense. They have all sub specialties (EP, heart failure). They have most leverage with industry. They have volume and cases fed to them. They can still be prominent in the medical community (give national talks)

2. academics- different beast

the alternative is being in a group of 4 in a small hospital on q4 call, with no midlevels where u see 30 year olds with palpitations and afib and other nonsense as u see 25-30 pts in clinic with 8 pts on the floor on your post call day after u did a STEMI at 2 am.

 

[MadLVAD]

How difficult is it to match into a spot, is this a highly sought after fellowship position, especially with CT being an increasingly used modality, also increased need for TEE in mitraclip and TAVR cases?

Also, it’s hard to tell, but when do you apply? Midway through 2nd year or beginning of 3rd year?