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I always wanted to do a Cardiothoracic fellowship after residency. It was my plan from day one, and I worked hard since the start of residency to make it possible. I have good test scores and publications, however I am having trouble getting a good letter of recommendation - so my application this year will not be a sure thing.

In light of that, someone recommended I apply to both Cardiac and Critical Care this year. Is this even possible? What if I happened to match in both?
 

Hoya11

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I always wanted to do a Cardiothoracic fellowship after residency. It was my plan from day one, and I worked hard since the start of residency to make it possible. I have good test scores and publications, however I am having trouble getting a good letter of recommendation - so my application this year will not be a sure thing.

In light of that, someone recommended I apply to both Cardiac and Critical Care this year. Is this even possible? What if I happened to match in both?
I would apply broadly to cardiac, and to a few safety CC programs and not mention to the CC programs you applied to cardiac (obviously none at the same institution) Then hope you get into cardiac and use CC programs as backup. Good luck! Neither are too competitive...
 

psychbender

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I would apply broadly to cardiac, and to a few safety CC programs and not mention to the CC programs you applied to cardiac (obviously none at the same institution) Then hope you get into cardiac and use CC programs as backup. Good luck! Neither are too competitive...
The match for CC is before CT, so that wouldn't work. Also, CT has become more competitive, and only 77 percent of applicants matched this year, with no vacant slots after the match.

OP, don't apply to CC if you don't want to do CC. If you're set on CT, then you have a few more months to get your letters together, so focus on that. Do whatever you can to ensure that you get good letters to improve your application. If you actually are interested in both (doesn't sound like it, but if you are), then some programs have a mechanism to apply to both at the same time, allowing you to do the fellowships consecutively (usually CCM, followed by CT) with only one application/interview process.

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rishk789

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...then some programs have a mechanism to apply to both at the same time, allowing you to do the fellowships consecutively (usually CCM, followed by CT) with only one application/interview process.
This is true (and extremely helpful in minimizing interview days during residency). If you're trying to do both, PM me.
 
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I had a hard time getting letters too. But I was able to get them around Sept / Oct even with being on an off site rotation (after multiple attendings said no because they didn't really "know me"). I just had the rest of my application ready before my letter writers were finished with the letters. So once they were written, I was ready to go. You only need two cardiac letters and a program director letter. But getting the letters is the hardest part. But I think you worked very hard to get to this point. I would stick to whichever fellowship you're mainly interested in. Don't give up. Be persistent. You can do it!
 

thinkorswim

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I'm curious as to why you are finding it difficult to secure a letter of recommendation if you have rotated through cardiac. Your best shot is to match at your home program, so getting to know those attendings is an absolute must.

Also, in the end, you need to realize that letters of recommendation are mostly worthless. Everyone will have good letters with various adjectives describing their work ethic and clinical knowledge. Your application only needs one thing to match into a good cardiac program -- either an email or a phone call made on your behalf.
 
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Vergie

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The match for CC is before cardiac so you'll have to take that into consideration. You interview for both during about the same time frame though so you could interview for both and if you get enough hits for cardiac just don't rank any CC programs and take chances with the cardiac match. If you have good test scores you'll get lots of interviews no matter how your letters look.
 

AdmiralChz

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There's some great advice here above, and I definitely agree with most of what has been said. I would change a little bit in that letters actually can make a big impact, especially if it comes from a big name, since the cardiac anesthesiology world is pretty small and very close knit. A strong letter from a f That being said, why do you say you are having trouble getting LORs? You really don't need them for some time (late November at the earliest if I recall) and have plenty of time to work with certain attendings if you need more interaction with them. What about the people you have done research with?

As for CCM, I would proceed only if you want to. I agree with everyone else - the match process doesn't really work for having CCM as a "backup" since there are different dates (CCM a month earlier), plus if you submit a CCM rank list (and cardiac) it asks you withdraw from other matches - not doing so would lead to some consequences, including not being able to do either fellowship potentially. Do not do CCM as a method of getting into a cardiac fellowship as it would add an unneeded year and probably wouldn't help boost your application all that much. I strongly considered doing combined CCM/CT, but decided against it since it wasn't what I wanted to do with my own career. There are only a few places that formalize a combined fellowship (from what I remember - Penn, Stanford, Wash St. Louis, UF) with others offering one after the other. This is USUALLY combined with CCM because programs have had issues filling those spots, but I know several who have done cardiac first and then CCM. It's a personal decision for you, and one that I and others would be happy to discuss with you further if you'd like.
 

G-Man82

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We routinely accept people for both - it takes some coordinating and I'm not the program director for either, but I can put you in touch. PM me if you want details.

This year we have a Ccm fellow who started now and goes on to CT here and we have another starting CT first and coming to CCM next year.


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demubckma

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As a side question, how much do USMLE scores matter at this point? I notice that many programs still ask for this information. Would very strong ITE scores and good letters from residency outweigh what amounts to a pretty lackluster performance in MS1-2 years?

The match for CC is before cardiac so you'll have to take that into consideration. You interview for both during about the same time frame though so you could interview for both and if you get enough hits for cardiac just don't rank any CC programs and take chances with the cardiac match. If you have good test scores you'll get lots of interviews no matter how your letters look.
 

Vergie

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I'm not a fellowship director or anything but based on my interviews and how successful my resident colleagues were I would say a 70% ITE and a 220 would have more interviews than say a 30% ITE and 240+ USMLE. If you have 70%+ ITE score for CA1 you shouldn't have a problem getting many cardiac interviews.

As a side question, how much do USMLE scores matter at this point? I notice that many programs still ask for this information. Would very strong ITE scores and good letters from residency outweigh what amounts to a pretty lackluster performance in MS1-2 years?
 

AdmiralChz

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As a side question, how much do USMLE scores matter at this point? I notice that many programs still ask for this information. Would very strong ITE scores and good letters from residency outweigh what amounts to a pretty lackluster performance in MS1-2 years?
Most ask for it but usually are more interested in passing scores (on first attempts), multiple failures may predict the same fate for a difficult echo boards exam at the end. As Vergie said above, ITE is much much more important. That being said, less of an emphasis than residency with USMLEs.
 

lostlost2

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Honestly, just apply to CT fellowship and give it your best. CCM fellowship was not very competitive at all this year with a lot of open spots left unfilled in big programs across the country even after scramble/soap. If you like CT go for it, it is getting more competitive but 77% of people who applied match this year.