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an IMG in cardiology!

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royalmedicus

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by the title probably you wouldnt even care reading the description but i have an interesting question, i know that an img can almost never get into cardiology fellowship program after completing IM in usa, but i exactly want to do that not beacause of money but i just love the heart.

probably cards fellowship programmes requir much more than just good usmle score and good im residency, probably some research or lors from cardiiologists or publications etc.

the question is, can i take a break of 1 year after IM residency and finish those requirments and get into cardiology? or its of no use? what else do the programs require?

please answer even if you feel this childish cause if i have no chance at all for cardiology, i will go to neurology or peds or something else.
 

Handsome88

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Your last sentence just makes me want to advise you to just go into Neuro o Peds.
Cardiology isn't worth the trouble and risk for an IMG these days if you're actually willing to do something else. It should be: Cardiology or would rather not be a doctor. If that's you then get into a University IM program, do research, publish, do well on rotations, get good LORs and apply with the mindset that you probably will still not match but it's OK because you can't see yourself doing anything else anyways.

While I'm sure other specialties have their own difficulties, cards has:
1) Reducing income every year.
2) Tight job market (if you do HF then you can find a job but that's extra years of training ontop of general cards and you will make less money and work more).
3) Longer training years (and now EP is a 2 year fellowship and I feel interventional may be the same soon, that's 8 years AFTER medical school, that's if you even can get in straight away, a lot do 1-2 research years first).
4) Hour's are long and call schedule is one of the worst for a medical specialty.
5) Cardiothoracic surgeons are now also training residents interventional procedures and MAY make the market for interventional even worse.

No one said you have no chance "at all", but it's very difficult for IMGs nonetheless.
 
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FreakofMeds

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To the OP, Cardiology fellowships have PLENTY of IMGs. In the 2015 NRMP fellowship match data, only 472 US graduates applied to Cardiology fellowship, and there 835 positions offered. 393 IMGs matched into Cardiology. This is likely to change with time towards more US grads going into cardiology, but there should certainly be a significant chance for you to get into cardiology.

http://www.nrmp.org/wp-content/uploads/2015/02/Results-and-Data-SMS-2015.pdf

Your last sentence just makes me want to advise you to just go into Neuro o Peds.
Cardiology isn't worth the trouble and risk for an IMG these days if you're actually willing to do something else. It should be: Cardiology or would rather not be a doctor. If that's you then get into a University IM program, do research, publish, do well on rotations, get good LORs and apply with the mindset that you probably will still not match but it's OK because you can't see yourself doing anything else anyways.

While I'm sure other specialties have their own difficulties, cards has:
1) Reducing income every year.
2) Tight job market (if you do HF then you can find a job but that's extra years of training ontop of general cards and you will make less money and work more).
3) Longer training years (and now EP is a 2 year fellowship and I feel interventional may be the same soon, that's 8 years AFTER medical school, that's if you even can get in straight away, a lot do 1-2 research years first).
4) Hour's are long and call schedule is one of the worst for a medical specialty.
5) Cardiothoracic surgeons are now also training residents interventional procedures and MAY make the market for interventional even worse.

No one said you have no chance "at all", but it's very difficult for IMGs nonetheless.

1) While a cardiologists income is slightly decreasing, they are still sitting close to the top of the pile in most surveys.

http://www.medscape.com/features/slideshow/compensation/2014/public/overview#2

2) Unless you want to go to New York or LA, or any other saturated market, Cardiology jobs are most definitely available at this time. I personally know multiple fellows that signed while requiring H1 visas or J1 waivers for 400+ in smallish midwest, but close to relatively big cities.

3) Everything requires relatively long training. General Cardiology is really not much longer than most other sub-specialties, which would be 6 years.

4) Call schedule depends on your group / practice that you get into and it is entirely circumstantial. I don't understand the generalizations about lifestyle.

5) I have never seen or heard of CT surgery performing coronary interventions. Please link to the training place that is teaching Cardiothoracic fellows coronary interventions. Or perhaps you are talking about some other intervention? As far as peripheral interventions, it is fair game for Vascular surgery too.
 

Handsome88

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To the OP, Cardiology fellowships have PLENTY of IMGs. In the 2015 NRMP fellowship match data, only 472 US graduates applied to Cardiology fellowship, and there 835 positions offered. 393 IMGs matched into Cardiology. This is likely to change with time towards more US grads going into cardiology, but there should certainly be a significant chance for you to get into cardiology.

http://www.nrmp.org/wp-content/uploads/2015/02/Results-and-Data-SMS-2015.pdf



1) While a cardiologists income is slightly decreasing, they are still sitting close to the top of the pile in most surveys.

http://www.medscape.com/features/slideshow/compensation/2014/public/overview#2

2) Unless you want to go to New York or LA, or any other saturated market, Cardiology jobs are most definitely available at this time. I personally know multiple fellows that signed while requiring H1 visas or J1 waivers for 400+ in smallish midwest, but close to relatively big cities.

3) Everything requires relatively long training. General Cardiology is really not much longer than most other sub-specialties, which would be 6 years.

4) Call schedule depends on your group / practice that you get into and it is entirely circumstantial. I don't understand the generalizations about lifestyle.

5) I have never seen or heard of CT surgery performing coronary interventions. Please link to the training place that is teaching Cardiothoracic fellows coronary interventions. Or perhaps you are talking about some other intervention? As far as peripheral interventions, it is fair game for Vascular surgery too.

Thanks for the point of view.

1) Though it's still on the top of the list and I'm sure will still be, but the difference is narrowing a lot between it and other specialties and so the rigorous training and competitiveness of the field and its lifestyle makes the extra few bucks not (as) worth it.

2) General cards jobs are still there, I didn't say it's dying, but it's certainly difficult to find and you won't have the freedom to pick and choose the best area for you, your wife/husband, children. Not many want to live in a small town.

3) If you want to make the big bucks then you will have to do invasive cards and that's extra years of training. You can still go scopes as a general gastro and bronchs as a general pulm. Not true for cards, many gen cardiologists stopped doing diagnostic caths even, which is what used to bring in the money.

4) Sure, it always "depends". But in general, call and overall lifestyle of cards is arguably the most grueling of IM subspecialties now (Pulm/CC is no longer up there IMO)

5) Intervetional cardiologist Dr. Kleiman at Houston Methodist was supervising and training CT surgeons and there was a study I think (I saw an interview of him talking about it on youtube) showing that they can easily learn it and do it.
 

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Royalmedicus...My self and a lot of IMGs match in cardiology every year. If that is the only thing that you see yourself doing then go for it. Work very hard in residency, throw yourself into being a work horse, doing research, presenting at conferences. Prior to all this, as an IMG concentrate on matching into the strongest medicine residency possible. And be on the look out for residencies that have in house fellowship so that if u don't match anywhere at least u could guarantee yourself in your home program. One year research after residency is okay...if your visa allows it (assuming that you are not on a J1). If you sort of considering that then you could as well as do it before residency so that during residency you can actively write manuscripts from your gathered results in a year
 

royalmedicus

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thankyou sir, i needed to know that its possible and people are doing it so that i can have inspiration for it.
 

rokshana

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No one said you have no chance "at all", but it's very difficult for IMGs nonetheless.

not sure where you got this info...there are a lot of I/FMGs in cards fellowships...sure they worked hard during their residency but its not as Impossible as you make it out to be...who you know plays as much of a role in getting fellowships more than in residency selection so I/FMGs are not at as a great disadvantage..and with issues in the cards job market, i would say that the AMGs are gravitating away from cards and it may become easier for I/FMGs to get these spots (not easy mind you, but easier than say GI, Hem/Onc, or pull/cc).
 

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Eh edited since I had a moment where I confused IMG and FMG, yada yada.
 

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not sure where you got this info...there are a lot of I/FMGs in cards fellowships...sure they worked hard during their residency but its not as Impossible as you make it out to be...who you know plays as much of a role in getting fellowships more than in residency selection so I/FMGs are not at as a great disadvantage..and with issues in the cards job market, i would say that the AMGs are gravitating away from cards and it may become easier for I/FMGs to get these spots (not easy mind you, but easier than say GI, Hem/Onc, or pull/cc).

Yes it's SLIGHTLY less competitive than before the year 2010-2011, but I don't see cards getting less competitive than heme/onc or pulm/cc anytime soon. People still have this strange fascination with the heart no matter how bad the field will get...Not sure why. Unlike Nephro for example, not many find the kidneys fascinating.

Prior to all this, as an IMG concentrate on matching into the strongest medicine residency possible. And be on the look out for residencies that have in house fellowship so that if u don't match anywhere at least u could guarantee yourself in your home program. One year research after residency is okay...if your visa allows it (assuming that you are not on a J1). If you sort of considering that then you could as well as do it before residency so that during residency you can actively write manuscripts from your gathered results in a year

1) You think it's easy for FMGs to get a strong IM program? IMGs these days are lucky to even land ANY program. Most get low-tier university programs and community programs. It is VERY rare to see IMGs in mid-high tier programs. And it's only getting harder.

2) What?! In-house guarantees you fellowship? What program is that? Usually programs take AMGs from their residents first so no, it doesn't guarantee you.

3) What visa allows you to do an extra year? H1b is 6 years, and you can't stay and do just research on a J1.
 
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rokshana

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Yes it's SLIGHTLY less competitive than before the year 2010-2011, but I don't see cards getting less competitive than heme/onc or pulm/cc anytime soon. People still have this strange fascination with the heart no matter how bad the field will get...Not sure why. Unlike Nephro for example, not many find the kidneys fascinating.



1) You think it's easy for FMGs to get a strong IM program? IMGs these days are lucky to even land ANY program. Most get low-tier university programs and community programs. It is VERY rare to see IMGs in mid-high tier programs. And it's only getting harder.

2) What?! In-house guarantees you fellowship? What program is that? Usually programs take AMGs from their residents first so no, it doesn't guarantee you.

3) What visa allows you to do an extra year? H1b is 6 years, and you can't stay and do just research on a J1.

how does a med stud know so much?

you would be surprised at where true FMGs are in residency...remember these are people who were the best and brightest in their countries...they can be very impressive...and yes, your best shot at a fellowship is in house...and in house, where you went to med school isn't going to make as much difference as you seem to think...
 

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how does a med stud know so much?

you would be surprised at where true FMGs are in residency...remember these are people who were the best and brightest in their countries...they can be very impressive...and yes, your best shot at a fellowship is in house...and in house, where you went to med school isn't going to make as much difference as you seem to think...

Yes I know an IMG who just matched to IM at Mayo but he had 15+ publications and a phd with 250+ step 1. But 90+% don't match at top places. I may be a bit of a pessimist but the reality is that even with progams that have inhouse fellowships, most have 3-6 cards positions available, half of those may go outside residents which leaves 1-3 only for own residents, and in university programs expect 25-40 residents in a given year, on average 1/4 want to do cards which is ~6-10 per year. So you are competing with ~5-9 other people (and can be including those chief residents that will more than likely be favored over you, and can include applicants from past years) for 1-3 positions, and though they don't look at which medschool you came from, they WOULD rather take someone with green card than someone with J1 or (even worse) H1b visa. So no, you are not guaranteed in-house, not even close, it's still very difficult.

I'm really not sure why cardiology is still that competitive. Maybe things will change in the next few years when US grads turn away from it and the $$$ gap between hospitalist medicine/PulmCC and Cards narrows further.
 
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rokshana

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Yes I know an IMG who just matched to IM at Mayo but he had 15+ publications and a phd with 250+ step 1. But 90+% don't match at top places. I may be a bit of a pessimist but the reality is that even with progams that have inhouse fellowships, most have 3-6 cards positions available, half of those may go outside residents which leaves 1-3 only for own residents, and in university programs expect 25-40 residents in a given year, on average 1/4 want to do cards which is ~6-10 per year. So you are competing with ~5-9 other people (and can be including those chief residents that will more than likely be favored over you, and can include applicants from past years) for 1-3 positions, and though they don't look at which medschool you came from, they WOULD rather take someone with green card than someone with J1 or (even worse) H1b visa. So no, you are not guaranteed in-house, not even close, it's still very difficult.

I'm really not sure why cardiology is still that competitive. Maybe things will change in the next few years when US grads turn away from it and the $$$ gap between hospitalist medicine/PulmCC and Cards narrows further.
now i know that you have no real world experience with this...25% of a class going for cards? really? not even close...especially in the last few years...hospitalist is much more the hot button at the moment and in a given program, maybe 10% are going towards cards...GI, pull/cc and hem/onc are taking their share of those that go toward sub specialization...and while i don't know that much about visas, i do know the J1 will give you 6 years and it doesn't cost the programs anything extra so its not a huge issue, especially for in-house applicants...

no one (with the exception of a chief resident maybe) is guaranteed a fellowship, but trust me, the in house applicant has a leg up on anyone from the outside and a program may very well take all form in house if they have candidates that they like, but generally 50% in house is not uncommon...

and matching at the "top" (whatever that means) isn't the goal here...matching cards is...whether its the #1 place or the last ACGME accredited place, 3 years later you come out as a cardiologist...

wait til you are actually a resident and have gone through the fellowship application route to be able to give a more educated opinion on this.
 
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Handsome88

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now i know that you have no real world experience with this...25% of a class going for cards? really? not even close...especially in the last few years...hospitalist is much more the hot button at the moment and in a given program, maybe 10% are going towards cards...GI, pull/cc and hem/onc are taking their share of those that go toward sub specialization...and while i don't know that much about visas, i do know the J1 will give you 6 years and it doesn't cost the programs anything extra so its not a huge issue, especially for in-house applicants...

no one (with the exception of a chief resident maybe) is guaranteed a fellowship, but trust me, the in house applicant has a leg up on anyone from the outside and a program may very well take all form in house if they have candidates that they like, but generally 50% in house is not uncommon...

and matching at the "top" (whatever that means) isn't the goal here...matching cards is...whether its the #1 place or the last ACGME accredited place, 3 years later you come out as a cardiologist...

wait til you are actually a resident and have gone through the fellowship application route to be able to give a more educated opinion on this.

I admit I have no real life experience with this but I was looking at some of the match lists when I interviewed for IM programs, about 2-3 per 10 residents went the cards route, which is where I got my number from but I could be wrong because that's just speculation. Where did you get your 10% from, I hope you're right actually.

J1 is 7 years.
 
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ROBINHO

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thankyou sir, i needed to know that its possible and people are doing it so that i can have inspiration for it.

Aspire and Work hard .
Internet forum can be a place to get inspiration but it is a place that you can also be made to lose your way. This thread is a perfect example. Somebody with no practical experience as resident in the USA and who has never gone through the fellowship application process, telling you to go into neuro or peds based on his/her pessimistic outlook.
 
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FreakofMeds

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Yes it's SLIGHTLY less competitive than before the year 2010-2011, but I don't see cards getting less competitive than heme/onc or pulm/cc anytime soon. People still have this strange fascination with the heart no matter how bad the field will get...Not sure why. Unlike Nephro for example, not many find the kidneys fascinating.



1) You think it's easy for FMGs to get a strong IM program? IMGs these days are lucky to even land ANY program. Most get low-tier university programs and community programs. It is VERY rare to see IMGs in mid-high tier programs. And it's only getting harder.

2) What?! In-house guarantees you fellowship? What program is that? Usually programs take AMGs from their residents first so no, it doesn't guarantee you.

3) What visa allows you to do an extra year? H1b is 6 years, and you can't stay and do just research on a J1.

Your information is not supported by 2015 match data. In 2015, 6,770 Internal medicine positions were offered. 51% (3381) were filled by non-US seniors, the vast majority of them being IMGs. That certainly indicates that it is not difficult,let alone lucky, for IMGs to land in "ANY" IM program.

http://www.nrmp.org/wp-content/uploads/2015/03/ADT2015_final.pdf

From my personal experience as a senior general cardiology fellow who matched in an mid-higher tier university based interventional cardiology fellowship this year, and being an IMG myself, I can say that there is definitely a tendency to recruit fellows in both general cardiology fellowship and Interventional fellowship from in-house candidates, to the extent that even if the in-house candidate was an IMG and the external candidate was an AMG, there would be a better chance for the internal candidate.

Again, no one is saying it is easy, but if you feel strongly about cardiology, and you have significantly better than average USMLE scores and you are willing to work hard to publish, Cardiology is very much possible. Being an IMG should not deter you from taking this path and most certainly you should not be going to Neuro/peds (entirely different scope of practice) just because you are an IMG.

5) Intervetional cardiologist Dr. Kleiman at Houston Methodist was supervising and training CT surgeons and there was a study I think (I saw an interview of him talking about it on youtube) showing that they can easily learn it and do it.

I still can not find this information. Regardless, this is not the trend. CT surgery is not going to be doing coronary interventions anytime soon. Additionally, CT surgery's referral base is invasive / interventional cardiologists, who would never refer a patient to them if the patient requires percutaneous intervention.
 
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Mad Jack

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Cardiology is far from impossible as an IMG. Your chances at getting into cards are far more dependent upon where you completed your residency than they are upon where you got your diploma.
 
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Handsome88

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Your information is not supported by 2015 match data. In 2015, 6,770 Internal medicine positions were offered. 51% (3381) were filled by non-US seniors, the vast majority of them being IMGs. That certainly indicates that it is not difficult,let alone lucky, for IMGs to land in "ANY" IM program.

http://www.nrmp.org/wp-content/uploads/2015/03/ADT2015_final.pdf

From my personal experience as a senior general cardiology fellow who matched in an mid-higher tier university based interventional cardiology fellowship this year, and being an IMG myself, I can say that there is definitely a tendency to recruit fellows in both general cardiology fellowship and Interventional fellowship from in-house candidates, to the extent that even if the in-house candidate was an IMG and the external candidate was an AMG, there would be a better chance for the internal candidate.

Again, no one is saying it is easy, but if you feel strongly about cardiology, and you have significantly better than average USMLE scores and you are willing to work hard to publish, Cardiology is very much possible. Being an IMG should not deter you from taking this path and most certainly you should not be going to Neuro/peds (entirely different scope of practice) just because you are an IMG.



I still can not find this information. Regardless, this is not the trend. CT surgery is not going to be doing coronary interventions anytime soon. Additionally, CT surgery's referral base is invasive / interventional cardiologists, who would never refer a patient to them if the patient requires percutaneous intervention.

Can you tell us what the average USMLE scores are for cardiology and which one would matter most? What's considered competitive? Just curious.
 
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Can you tell us what the average USMLE scores are for cardiology and which one would matter most? What's considered competitive? Just curious.

I am not a program director and have never been involved in candidate selection. From personal experience at my fellowship, most fellows were >235 in their Step 1 / Step 2, who did their steps sometime between 2008 and 2010, when the average scores for the time period were 218-220. Which one is more important, I have no idea. Based on NRMP data from 2011, which I believe is the latest available, and is probably outdated for the most recent match, the mean Step 1 score for a Non-US citizen IMG was 231 on step 1, and 234 on step 2. Probably for the most recent matches, this has crept up to the 240 range.

I speculate with how the averages for Step 1/Step 2 keep going up even on the latest IM match data, that the mean will start going up to the high 240s.

http://www.nrmp.org/wp-content/uplo...ng-Service-1st-Edition-Published-May-2013.pdf
 

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I am not a program director and have never been involved in candidate selection. From personal experience at my fellowship, most fellows were >235 in their Step 1 / Step 2, who did their steps sometime between 2008 and 2010, when the average scores for the time period were 218-220. Which one is more important, I have no idea. Based on NRMP data from 2011, which I believe is the latest available, and is probably outdated for the most recent match, the mean Step 1 score for a Non-US citizen IMG was 231 on step 1, and 234 on step 2. Probably for the most recent matches, this has crept up to the 240 range.

I speculate with how the averages for Step 1/Step 2 keep going up even on the latest IM match data, that the mean will start going up to the high 240s


.
 
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FreakofMeds

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IMG here, You only quoted step 1 and 2 CK scores. What is the impact of Step 2 CS and Step 3 on Cardiology matching?
My creds: Step 1: 252, Step 2 CK: 245,Step 2 CS (passed on 2nd attempt), Step 3: 206. in a univ. affiliated community IM program.

I do not know, nor do I want to go down the path of speculating about candidates' chances on this thread. My only advice is stop dwelling on what you cannot change and work on what you can change, aka publications / research / connections / letters of recommendation. Good luck.
 

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IMG here, You only quoted step 1 and 2 CK scores. What is the impact of Step 2 CS and Step 3 on Cardiology matching?
My creds: Step 1: 252, Step 2 CK: 245,Step 2 CS (passed on 2nd attempt), Step 3: 206. in a univ. affiliated community IM program.
Average Step 3 scores are in the same document @FreakofMeds quoted above. Look it up. Your score is near the median for IMGs (5 years ago). So your scores a probably competitive for the 2011 match. Nobody can tell you how that changes over time other than to say, it gets harder every year.

The biggest problem I see in your scores is the clear and significant downward trend. The Steps get easier as they go along. Doing worse as you go along is a bad sign. And failing CS is a red flag.

But look, I'll give you the same advice I give everybody who asks a WAMC question. Just apply. It's cheap and the only thing you have to lose (aside from a bit of money) is ego. If you don't apply OTOH, your chance of matching can be very easily calculated as 0.
 

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I am not a program director and have never been involved in candidate selection. From personal experience at my fellowship, most fellows were >235 in their Step 1 / Step 2, who did their steps sometime between 2008 and 2010, when the average scores for the time period were 218-220. Which one is more important, I have no idea. Based on NRMP data from 2011, which I believe is the latest available, and is probably outdated for the most recent match, the mean Step 1 score for a Non-US citizen IMG was 231 on step 1, and 234 on step 2. Probably for the most recent matches, this has crept up to the 240 range.

I speculate with how the averages for Step 1/Step 2 keep going up even on the latest IM match data, that the mean will start going up to the high 240s.

http://www.nrmp.org/wp-content/uplo...ng-Service-1st-Edition-Published-May-2013.pdf

Thanks FreakofMeds.

I think you're right about scores going up to 240s. Seeing that within 5 years the average step 1 score went up 10 points. I hope programs look at the most recent step (Step 3>Step 2> Step 1), which would make more sense.

My score is 235 step 1, 246 step 2, IMG on J1 visa, at low-mid tier University program. 5 publications. Would my step 1 preclude me at most programs right off the bat as a cut-off?
 
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FreakofMeds

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Thanks FreakofMeds.

I think you're right about scores going up to 240s. Seeing that within 5 years the average step 1 score went up 10 points. I hope programs look at the most recent step (Step 3>Step 2> Step 1), which would make more sense.

My score is 235 step 1, 246 step 2, IMG on J1 visa, at low-mid tier University program. 5 publications. Would my step 1 preclude me at most programs right off the bat as a cut-off?

No, I do not think your Step 1 would preclude you right off the bat.
 

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Your last sentence just makes me want to advise you to just go into Neuro o Peds.
Cardiology isn't worth the trouble and risk for an IMG these days if you're actually willing to do something else. It should be: Cardiology or would rather not be a doctor. If that's you then get into a University IM program, do research, publish, do well on rotations, get good LORs and apply with the mindset that you probably will still not match but it's OK because you can't see yourself doing anything else anyways.

While I'm sure other specialties have their own difficulties, cards has:
1) Reducing income every year.
2) Tight job market (if you do HF then you can find a job but that's extra years of training ontop of general cards and you will make less money and work more).
3) Longer training years (and now EP is a 2 year fellowship and I feel interventional may be the same soon, that's 8 years AFTER medical school, that's if you even can get in straight away, a lot do 1-2 research years first).
4) Hour's are long and call schedule is one of the worst for a medical specialty.
5) Cardiothoracic surgeons are now also training residents interventional procedures and MAY make the market for interventional even worse.

No one said you have no chance "at all", but it's very difficult for IMGs nonetheless.

HF doesn't make less than general cards. The fellows from my program who had the highest offers were actually from HF not from interventional/EP last year.

IMG here, You only quoted step 1 and 2 CK scores. What is the impact of Step 2 CS and Step 3 on Cardiology matching?
My creds: Step 1: 252, Step 2 CK: 245,Step 2 CS (passed on 2nd attempt), Step 3: 206. in a univ. affiliated community IM program.

The impact of step 2 CS is essentially none unless you failed. Then it is a red flag.
Step 3 doesn't matter all that much mainly because most people do just fine if they passed the other steps. I agree with JDH, a downward trend is concerning. The last thing a program wants is someone at risk for failing the cards boards.

With regard to cutoffs for step 1, I suspect most places don't have very high cutoffs but remember those applying for cards tend to be more competitive than the average IM cohort. For a given candidate, the things they can do is go to the strongest IM program, get strong letters, do research and don't be a creeper during your interviews.
 

taurus70

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Thanks for the point of view.

1) Though it's still on the top of the list and I'm sure will still be, but the difference is narrowing a lot between it and other specialties and so the rigorous training and competitiveness of the field and its lifestyle makes the extra few bucks not (as) worth it.

2) General cards jobs are still there, I didn't say it's dying, but it's certainly difficult to find and you won't have the freedom to pick and choose the best area for you, your wife/husband, children. Not many want to live in a small town.

3) If you want to make the big bucks then you will have to do invasive cards and that's extra years of training. You can still go scopes as a general gastro and bronchs as a general pulm. Not true for cards, many gen cardiologists stopped doing diagnostic caths even, which is what used to bring in the money.

4) Sure, it always "depends". But in general, call and overall lifestyle of cards is arguably the most grueling of IM subspecialties now (Pulm/CC is no longer up there IMO)

5) Intervetional cardiologist Dr. Kleiman at Houston Methodist was supervising and training CT surgeons and there was a study I think (I saw an interview of him talking about it on youtube) showing that they can easily learn it and do it.

I didn't have any problem securing multiple job offers , and I was very exclusive to location due to having 3 children and other family constraints. There are plenty of offers out there.

BTW, love to see those CT surgroens get Level 3 certification from a correspondence course or you tube video.
 
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future heart fixer

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IMG's can get into cardiology. I have matched into cardio at a mid-tier university program after 5 years being a hospitalist. I am an IMG from a community program. No Cardiology papers, step 1 240, step 2 ck 218, step 2 cs passed, step 3 218. on H1 visa. well I think most important thing is connections as most program takes their own residents. I planned it , secured a job at university and made connections with cards people and now I will be starting in July. well if you have publications then it improves your chances at other programs. At your own institution, all you need is people to think that you are a good person and hard working guy.
 
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MADD!!!

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Any1 from this thread still active on SDN?! Just read through the whole convo and thank you guys for this!! I have a few small questions if any of you are still available. :)
 

IMDoc607

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Your last sentence just makes me want to advise you to just go into Neuro o Peds.
Cardiology isn't worth the trouble and risk for an IMG these days if you're actually willing to do something else. It should be: Cardiology or would rather not be a doctor. If that's you then get into a University IM program, do research, publish, do well on rotations, get good LORs and apply with the mindset that you probably will still not match but it's OK because you can't see yourself doing anything else anyways.

While I'm sure other specialties have their own difficulties, cards has:
1) Reducing income every year.
2) Tight job market (if you do HF then you can find a job but that's extra years of training ontop of general cards and you will make less money and work more).
3) Longer training years (and now EP is a 2 year fellowship and I feel interventional may be the same soon, that's 8 years AFTER medical school, that's if you even can get in straight away, a lot do 1-2 research years first).
4) Hour's are long and call schedule is one of the worst for a medical specialty.
5) Cardiothoracic surgeons are now also training residents interventional procedures and MAY make the market for interventional even worse.

No one said you have no chance "at all", but it's very difficult for IMGs nonetheless.


1. It's only 1 extra year.
2. As an advanced HF fellow, I have at least 4 job offers in the middle of training and the salaries are higher than all my friends doing interventional, general, and EP. I will say though that if you are on a production level, then interventional and EP will outpace you.
3. HF is still a new field....if you get involved in the right circle you can run a program and you can see high 6 figure salary as a director.
 

Shark7500

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Thanks for the point of view.

You can still go scopes as a general gastro and bronchs as a general pulm. Not true for cards, many gen cardiologists stopped doing diagnostic caths even, which is what used to bring in the money.

Why did they decide to stop doing diagnostic caths? What procedures do general cardiologists perform?
 

IMreshopeful

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Why did they decide to stop doing diagnostic caths? What procedures do general cardiologists perform?

There are many general cardiologists who still do diagnostic cath, just for the record. I know of at least three fellows who graduated from my program who are doing so. That particular user is incredibly misinformed (as you can tell by his claims that HF has a "bad job market", which is absurd). It's less common but it's not uncommon.

There's TEE, transvenous pacing, right heart cath for the other procedures gen cards does. The individual procedures don't bring in as much cash as they used to, FWIW.
 

Shark7500

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There are many general cardiologists who still do diagnostic cath, just for the record. I know of at least three fellows who graduated from my program who are doing so. That particular user is incredibly misinformed (as you can tell by his claims that HF has a "bad job market", which is absurd). It's less common but it's not uncommon.

There's TEE, transvenous pacing, right heart cath for the other procedures gen cards does. The individual procedures don't bring in as much cash as they used to, FWIW.

Thanks for the clarification! I appreciate it.
 
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