Dam272

2+ Year Member
Oct 4, 2015
140
55
Gotham
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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Dam272

Dam272

2+ Year Member
Oct 4, 2015
140
55
Gotham
Same here! Just waiting for letters. Anyone know what's a good general date to have everything in by?
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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DO class of 2018

2+ Year Member
Dec 26, 2014
30
9
Status
DO/PhD Student
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.
 

psychbender

Cynical Member
Lifetime Donor
10+ Year Member
Jan 19, 2005
2,207
1,171
37
Nowhere, nowhere at all...
Status
Attending Physician
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.
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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Dam272

Dam272

2+ Year Member
Oct 4, 2015
140
55
Gotham
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.

Sent from my SM-G930V using SDN mobile
Wow. Those were amazingly insightful questions. Thanks a ton
 

Hamhock

10+ Year Member
May 6, 2009
1,264
572
Status
Attending Physician
@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
 

TimesNewRoman

EM/CCM
5+ Year Member
May 14, 2013
2,603
2,484
Status
Attending Physician
@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
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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Hamhock

10+ Year Member
May 6, 2009
1,264
572
Status
Attending Physician
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.
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
 
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