Anesthesiology CCM Fellowship 2021-22

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Dam272

Dam272

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Let me be the first one to share that I have just submitted the application today. Anybody else here applying for the match?
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Katheudontas parateroumen said:
Same here! Just waiting for letters. Anyone know what's a good general date to have everything in by?
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Hey. I just submitted everything today. It think application till end of November will also be safe as most programs start interviews in Jan
 
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Jumping in. I submitted early this week. One invite so far. I'm most interested in multi-disciplinary programs. A question I open up to others, is questions to ask on interviews. Or things to look out for as a red flag at programs.
 
DO class of 2018 said:
Jumping in. I submitted early this week. One invite so far. I'm most interested in multi-disciplinary programs. A question I open up to others, is questions to ask on interviews. Or things to look out for as a red flag at programs.
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Things to ask or look out for:

- What is the role of the fellow on the service after the first few weeks? You should be running rounds, and the first person the team members go to with questions and concerns. If you're instead an observer or treated the same as a resident, then you're not getting a good experience.

- Will you be the sole fellow on service at a given time? If you're on Neuro, and the Neuro-CC fellow is on at the same time, your education is diminished.

- How much time do you get to spend alone (no attending) in the unit? There is a large amount of growth when you are primarily responsible for the care of your patients, and the attending is not physically present to bail you out.

- How much time is spent in each unit? Nine months of just Neuro and SICU are excessive, and you aren't going to be expressed to enough pathology. Be sure to go somewhere with exposure to most all adult ICU types.

- Are the units closed? If other services can override the plan you discussed on rounds, then you're not getting a good experience.

- What is the composition of teams in each unit (all NPs, mostly interns, PGY 3 and 4s, etc)? Teams composed primarily of off-service interns and junior residents are no fun, as you are going to have to actually do everything. You're not going to be able to tell the FM intern to go start an art line while you have a family meeting.

- Are you expected to supervise or train non-physicians with unit procedures? This should not be your job, but in some places, it is, as the attendings are giving up on their actual responsibilities.

- Similarly, who gets dibs on procedures? If you really want to do something, or to train a med student or intern, will you get to do that 100% of the time, or are you expected to let the NP/PA do them when they ask?

- Is there built in non-clinical time to study or work on academic projects?

- Are rotations in echo, nutrition, ID, etc available and encouraged?

- What does the call schedule look like/how much time is spent in house at night? No overnights/weekends decreases education, as does Q4 24+ hour call.

Those are a few off the top of my head.

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psychbender said:
Things to ask or look out for:

- What is the role of the fellow on the service after the first few weeks? You should be running rounds, and the first person the team members go to with questions and concerns. If you're instead an observer or treated the same as a resident, then you're not getting a good experience.

- Will you be the sole fellow on service at a given time? If you're on Neuro, and the Neuro-CC fellow is on at the same time, your education is diminished.

- How much time do you get to spend alone (no attending) in the unit? There is a large amount of growth when you are primarily responsible for the care of your patients, and the attending is not physically present to bail you out.

- How much time is spent in each unit? Nine months of just Neuro and SICU are excessive, and you aren't going to be expressed to enough pathology. Be sure to go somewhere with exposure to most all adult ICU types.

- Are the units closed? If other services can override the plan you discussed on rounds, then you're not getting a good experience.

- What is the composition of teams in each unit (all NPs, mostly interns, PGY 3 and 4s, etc)? Teams composed primarily of off-service interns and junior residents are no fun, as you are going to have to actually do everything. You're not going to be able to tell the FM intern to go start an art line while you have a family meeting.

- Are you expected to supervise or train non-physicians with unit procedures? This should not be your job, but in some places, it is, as the attendings are giving up on their actual responsibilities.

- Similarly, who gets dibs on procedures? If you really want to do something, or to train a med student or intern, will you get to do that 100% of the time, or are you expected to let the NP/PA do them when they ask?

- Is there built in non-clinical time to study or work on academic projects?

- Are rotations in echo, nutrition, ID, etc available and encouraged?

- What does the call schedule look like/how much time is spent in house at night? No overnights/weekends decreases education, as does Q4 24+ hour call.

Those are a few off the top of my head.

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Wow. Those were amazingly insightful questions. Thanks a ton
 
@psychbender 's post above should be appreciated by applicants.

I am not an anesthesiologist -- although 50% of my clinical group at one hospital is made up of triple-boarded anesthesia/CCM/cardiac anesthesia.

That said, I would also refer current anesthesiology applicants to the thread by @chocomorsel called "discrimination against...".

If you want to work in a MICU or multi-disciplinary ICU run by a traditional pulm-CCM director after fellowship, I would make sure to ask at interviews how much MICU experience there will be...or, in what ways is the fellowship multi-disciplinary? How does this fellowship show the pulmCCM doc who will hire me after fellowship that I am adequately trained to handle not just SICU but MICU patients?

It doesn't matter if you are adequately trained...it only matters if the director who is going to hire you FEELS that you are adequately trained.

HH
 
Hamhock said:
@psychbender 's post above should be appreciated by applicants.

I am not an anesthesiologist -- although 50% of my clinical group at one hospital is made up of triple-boarded anesthesia/CCM/cardiac anesthesia.

That said, I would also refer current anesthesiology applicants to the thread by @chocomorsel called "discrimination against...".

If you want to work in a MICU or multi-disciplinary ICU run by a traditional pulm-CCM director after fellowship, I would make sure to ask at interviews how much MICU experience there will be...or, in what ways is the fellowship multi-disciplinary? How does this fellowship show the pulmCCM doc who will hire me after fellowship that I am adequately trained to handle not just SICU but MICU patients?

It doesn't matter if you are adequately trained...it only matters if the director who is going to hire you FEELS that you are adequately trained.

HH
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To clarify, it does immensely matter if you are adequately trained. I think you’re trying to say it’s not sufficient to be adequately trained, you must also be able to prove that competence.
 
TimesNewRoman said:
To clarify, it does immensely matter if you are adequately trained. I think you’re trying to say it’s not sufficient to be adequately trained, you must also be able to prove that competence.
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Oh yes, you are correct. Thank you for clarifying. I didn't communicate that thought very well.

As @TimesNewRoman said, it is not sufficient to be adequately trained, you must be able to convince the MICU doc who is hiring you (likely a skeptical pulmCCM doc) that your training is adequate for the MICU.

The situation may not be just, but it's still the situation you will be facing; at least for the next 5+ years in most community and some academic hospitals.

My perspective on this situation has changed over the past few months. I think I have experienced and become more knowledgeable about the reality for the anesthesia-CCM folks recently.

Good luck! And remember to support multi-disciplinary CCM when able.

HH
 
What programs do folks feel are most multi-disciplinary? Unfortunately, not all of the programs display the details of their curriculum on their website. The programs that I've noticed which display their rotations and are multidisciplinary: WashU, U of Iowa, U of Colorado, UT Southwestern, U of Michigan.
 
One of the biggest features of a multidisciplinary CCM program is a diversity of ICU exposure (MICU, SICU, Trauma/Burn ICU, CVICU, onc-ICU, etc.) where you are the only fellow making decisions. Ideally, this means there is also a limited layer of housestaff; having multiple layers of residents making decisions only dilutes your exposure. My favorite set-up is a PGY1, me, and an attending - I get to be hands-on with all procedures without spending my entire day writing H&Ps and progress notes.

The problem that I see with some anesthesia CCM fellowships is that the anesthesia fellow may rotate through the CCU or MICU, but there are pulm/crit or cardiology fellows on the service absorbing the real decision making. That even occurs in the SICU where acute care surgery fellows want to drive the ship.
 
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Hi all, amazing thread so far! I am an EM applicant applying this cycle. Have a handful of interviews so far, have heard most go out mid jan to feb? What are some of the challenges EM applicants face in the process?
 
SevenSummitz said:
Hi all, amazing thread so far! I am an EM applicant applying this cycle. Have a handful of interviews so far, have heard most go out mid jan to feb? What are some of the challenges EM applicants face in the process?
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You will likely be offered a contract outside of the Match which means you need to batch your interviews since these offers often expire within a week. These offers outside of the SF Match are called match exceptions, and programs are allowed to offer them to any candidate staying for more than 2 years of training. Although they were designed for internal candidates or anesthesiologists staying for multiple years (CCM + cardiac), programs can and do offer them to fill their EM spots since those spots are for 2 years.

For example, I had a general idea of what were my top 2 programs based on faculty profiles, research interests, etc. when I submitted my SF Match profile, but wanted to use the interview before making a final decision. I scheduled the interview for my first choice in Feb and second choice in March. However, my top choice offered me a position a week after my interview, and the offer expired before I could attend my second choice interview. In fact, I kept in touch with a couple of the other EM applicants that I meet on the interview trail and all of us were offered positions ahead of the Match.

Also, keep in mind that many programs have 4 or more slots per year, but only 1 or 2 are funded and ABA approved for EM applicants. That means that the competition is very different for EM and anesthesia applicants but most of us eventually landed somewhere.

Finally, have fun. Enjoy meeting the other applicants. They are you colleagues and medicine is a very small world.
 
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I have received interviews at:

University of Alabama
Loma Linda
University of Iowa
University of Cincinnati
University of Florida

Can anyone comment on the above programs (if you have interviewed there or are a fellow there) about what you liked and disliked / general impression of them ?
 
Submitted my app 12/26, status says complete with letters and app received. Did it really take up to 2 weeks for distribution or hopefully earlier? Thanks

Update: Got distributed today 1/2! Fingers crossed!
 
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Katheudontas parateroumen said:
Submitted my app 12/26, status says complete with letters and app received. Did it really take up to 2 weeks for distribution or hopefully earlier? Thanks
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Not surprising. You should also get an email when your application is distributed to a program if my memory is correct. If not, make sure that you check the “Program Selection” tab on your portal page and check the date that your application was made available to your chosen programs.
 
anyone get an interview changed to remote teleinterview in light of current events? I've had one already. Another hasn't, it kind of seems they all should.... Thoughts?
 
Question! I accepted an outside of the match offer to a CCM program. All they sent me was an email asking that the position is offered and that I emailed back saying that I accepted it. They are now asking me to withdraw form the match and the contract to be signed by April 2021. Has anyone done these outside of the match things? Is this how it normally goes? Just feel a little nervous. Thanks!
 
Katheudontas parateroumen said:
Question! I accepted an outside of the match offer to a CCM program. All they sent me was an email asking that the position is offered and that I emailed back saying that I accepted it. They are now asking me to withdraw form the match and the contract to be signed by April 2021. Has anyone done these outside of the match things? Is this how it normally goes? Just feel a little nervous. Thanks!
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Is it only ccm? Or dual ccm cardiac. I signed dual out of match. They made me fill the socca exception. But I am still in the match, just that they will be ranking only me and I will be ranking only them


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Dam272 said:
Is it only ccm? Or dual ccm cardiac. I signed dual out of match. They made me fill the socca exception. But I am still in the match, just that they will be ranking only me and I will be ranking only them


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It is only CCM. I just find it strange feeling just sitting around for the next year with not a true "match". Congratulations to you btw! I haven't decided if i want to pursue the CV year but that rocks for you. Good luck
 
There are specific criteria for a Match Exception which can be found here: Fellowships Overview - The Society of Critical Care Anesthesiologists

Probably the most common reasons are 1) internal candidates and 2) candidates staying for more than 1 year. The latter includes fellows staying for a cardiac fellowship and all EM fellows who must complete 2 years to be Board Eligible. Match exceptions are extremely common for the EM applicants, and most of us lock-in our spots a couple of months before SF Match Day. I was asked to complete the Match Exception Agreement and only rank that 1 program when I submitted my rank list. Within a week, my name appeared on the SOCCA website as someone who had accepted a match exception with my program so that other programs knew that I was committed.
 
Looked like a lot of openings today. Why has Stanford been going unmatched for multiple years? I thought that was a top program? No? Anyone interview at Mt Sinai? Any thoughts on either of those? which good programs are still unfilled ? What makes them good?


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BIGphysician said:
Looked like a lot of openings today. Why has Stanford been going unmatched for multiple years? I thought that was a top program? No? Anyone interview at Mt Sinai? Any thoughts on either of those? which good programs are still unfilled ? What makes them good?


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Can you link the list please, I'm having trouble accessing it
 
Seems like there were fewer post match vacancies this year compared to last year?
 
ToKingdomCome said:
what were your stats to garner such interviews? I’m thinking similar programs hopefully
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hey. sorry for late reply. ITE 90+ percentiles, Basic top 10 percentile, poster presentations and journal articles, the usual. Plus a great personal statement
 
Dam272 said:
hey. sorry for late reply. ITE 90+ percentiles, Basic top 10 percentile, poster presentations and journal articles, the usual. Plus a great personal statement
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dang those are really good numbers lol....
 
BIGphysician said:
where did you end up? @Dam272 and what was your rank list?
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Hey. I took a dual CCM-Cardiac position in Michigan

Among other programs, I really liked Stanford>Duke>WashU

I am incredibly shocked that Stanford did not fill out
 
Dam272 -

Congrats. Excellent choice. My CCM year at Michigan was the best year of my educational career, by orders of magnitude.

Big Match, bro (or sis).
 
BIGphysician said:
Looked like a lot of openings today. Why has Stanford been going unmatched for multiple years? I thought that was a top program? No? Anyone interview at Mt Sinai? Any thoughts on either of those? which good programs are still unfilled ? What makes them good?


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Click to expand...
The spots open at Stanford for 2020 were just recently posted (like April of his year?). As an applicant this cycle I didn't see them on the vacancy list when apps opened in November. During interview PD mentioned the program was recently approved for more fellows, so maybe that's why? This year, not sure what happened, other than again instead of filling 10 spots now it's 12.
 
Sushirrit0 said:
The spots open at Stanford for 2020 were just recently posted (like April of his year?). As an applicant this cycle I didn't see them on the vacancy list when apps opened in November. During interview PD mentioned the program was recently approved for more fellows, so maybe that's why? This year, not sure what happened, other than again instead of filling 10 spots now it's 12.
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It is a phenomenal program. I was surprised that It did not fill out. I am sure there is more to it


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Would love to hear some reviews of some anesthesia CCM programs as the app cycle gets closer
 
When should you have complete application in by for anesthesia CCM that is letters, passing basic (taking in November), etc. ? When do they usually start reviewing applications ?
 
In the past, some programs start reviewing immediately, and give out interviews on a rolling basis. Others will wait until some arbitrary date (like mid-December), then start sending out invites in batches. Get as much of your packet together as possible, and submit as soon as you have it (don't need your November board scores in hand to submit).
 
So what’s confusing to me is that we can’t log on to the SFMatch portal until November 2nd, correct? And that’s the same day you can submit a completed application?

Wish you could have it all put together on the portal ahead of time.
 
FiO2@21 said:
So what’s confusing to me is that we can’t log on to the SFMatch portal until November 2nd, correct? And that’s the same day you can submit a completed

Wish you could have it all put together on the portal ahead of time.
Click to expand...

Hm that’s seems different from last year if I remember correctly. I was able to input all my things including LOR and submission started around November something.
 
No, that's par for the course. On the day that the match process starts, you can log in, upload all of your files, and submit to programs, if you have everything ready. That's why preparation is key.
 
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