Sep 3, 2017
3
2
Hi SDN, I need some candid advice. I'm a cardiology fellow and I'm trying to decide if it's worth doing an advanced echo/CT year. I go back and forth on a daily basis if I should or not. Part of me thinks it's a good idea, the other part of me thinks it is probably a waste of time.

I'd like to split my work 80/20 non-invasive/clinical. Mainly echo and CT. It can be an academic or private setting, I dont care. What I really need advice on is:

1. What is the job market like for grads with level 3 echo and CT boarded? Good, bad? Has the explosion of structural procedures increased demand for 'interventional echo' guys?

2. Do echo/imaging guys work harder, make less then the general cards attendings?

3. Should I suck it up and include CMR and do a 2 year super fellowship of echo, CT and CMR? Would that make me a lethal candidate for any echo/imaging job at a half decent hospital or be a royal waste of time?

4. Are echo/imaging guys happy? it is hard to tell at my program. When I ask they say yes, but I'm skeptical...

5. Is non-invasive (echo/ct/mr) a path to a balanced lifestyle as a cardiologist or is that a pipe dream?

6. Is an interventional echo year a better path to a job than general echo?

thanks everyone!
 
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epicandprivate

2+ Year Member
Jun 25, 2017
103
16
Hi SDN, I need some candid advice. I'm a cardiology fellow and I'm trying to decide if it's worth doing an advanced echo/CT year. I go back and forth on a daily basis if I should or not. Part of me thinks it's a good idea, the other part of me thinks it is probably a waste of time.

I'd like to split my work 80/20 non-invasive/clinical. Mainly echo and CT. It can be an academic or private setting, I dont care. What I really need advice on is:

1. What is the job market like for grads with level 3 echo and CT boarded? Good, bad? Has the explosion of structural procedures increased demand for 'interventional echo' guys?

2. Do echo/imaging guys work harder, make less then the general cards attendings?

3. Should I suck it up and include CMR and do a 2 year super fellowship of echo, CT and CMR? Would that make me a lethal candidate for any echo/imaging job at a half decent hospital or be a royal waste of time?

4. Are echo/imaging guys happy? it is hard to tell at my program. When I ask they say yes, but I'm skeptical...

5. Is non-invasive (echo/ct/mr) a path to a balanced lifestyle as a cardiologist or is that a pipe dream?

6. Is an interventional echo year a better path to a job than general echo?

thanks everyone!
I'm merely a confused resident but will soon be a confused fellow and would like to here some opinions as well.
 
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Sep 3, 2017
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Anyone? cu'mon someone must have an opinion. I appreciate the stressful time you residents are going through, we've all been there. But right now I need a fellow/Attending to weigh in. Unfortunately the uncertainty doesn't end once you get a fellowship.
 

residentk3

7+ Year Member
Sep 2, 2011
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Anyone? cu'mon someone must have an opinion. I appreciate the stressful time you residents are going through, we've all been there. But right now I need a fellow/Attending to weigh in. Unfortunately the uncertainty doesn't end once you get a fellowship.
Fellow here,

I struggled with this same decision. To answer your question, you have to know what you want to do after fellowship. If you want to run your own echo or nuclear lab, then you will likely need to pursue the extra training. I saw the imaging fellowship as additional tools to add to your toolbelt when practicing general cardiology. 90-95% of your practice will be general cardiology. You do not need extra training to be boarded in CT, but would need it for CMR.

The opportunity cost would be 300-400k for a year that would really only help you in 5-10% of your daily practice.
 

nlax30

10+ Year Member
Oct 4, 2006
4,056
771
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Attending Physician
Recently completed general fellowship and briefly considered a imaging year before taking an EP spot so take my advice for what it's worth.

I think the decision is going to rest on how you actually want to practice. Honestly I enjoyed most aspects of imaging, especially echo and CT. I enjoyed advanced echo/TEE and even interpreting CTs which is why I considered an imaging year, but ultimately realized that I did not want "Imaging career" and really didn't have interest in academic spot in running an imaging lab. I enjoy procedures and clinical practice and ended up going EP.

I still ended up getting Level II in echo, and boarded in both echo and nuc, but decided that for me an extra year just to get level III in Echo and CT was not worth it.

That said, if you would like to structure a good portion of your practice around imaging, go into academics or direct an imaging dept then it could be a good option for you.

I can't speak to the job market or other parts of the question (lifestyle, pay) as I would assume the actual lifestyle would be highly variable and depend on many factors.... private vs academic, primarily imaging vs primarily clinical, etc...

Anecdotally though, during my brief job search for general non-invasive jobs (limited to a single state), I did see several listings specifically mentioning that advanced imaging experience/training was a plus as I'm sure some of those placed are now starting structural programs (TAVR, Mitraclip, Watchman, etc...).

So a round about answer, but if you really enjoy the modalities and would like to incorporate them into a large part of your future practice then it's probably worth it. If not and you're primarily going to be doing general non-invasive clinical cardiology then not sure the extra time is needed.
 
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epicandprivate

2+ Year Member
Jun 25, 2017
103
16
Is it safe to say that doing an advance imaging fellowship at least opens up the job market for private practice, "non-invasive" general cardiology positions? Ill take the salary cut for a year If it means i'll have an easier time finding a job in a bigger market. Even if imaging is only <10% of practice after fellowship for me still worth it.
 
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nervousivy

Junior Member
10+ Year Member
Jul 2, 2006
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Is it safe to say that doing an advance imaging fellowship at least opens up the job market for private practice, "non-invasive" general cardiology positions? Ill take the salary cut for a year If it means i'll have an easier time finding a job in a bigger market. Even if imaging is only <10% of practice after fellowship for me still worth it.
I do not think an imaging fellowship opens up the market for a private practice job. It will only help if you are doing fellowship in a so-so ranked program that does not have a good track record of putting grads in their desired jobs. If you are from a "strong" (in quotes, b/c that is so relative based on the region), an additional year of imaging may hurt you for private practice b/c they are looking for people to see patients, read echo, nuc and vascular studies...Now, if you cannot get those three modalities in 3 years and do an extra year for that, that is one thing. But I would not do an extra year to get level 3 echo or CT. Most private practices do not own CTs, so it's not a useful skill unless you're in an academic place where Radiology is open to collaborating with Cardiology in reading cardiac CT.

I say this as someone who graduated fellowship recently...
 

ROBINHO

Junior Member
10+ Year Member
Dec 27, 2004
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Part of the decision making will be based on if you want to do academics or private practice. In private practice/community not very common to use the CT/MRI. But for academic career, it is very useful
 
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