Best Cardiology where?

[greenteapudding]

I'm really interested in doing cardiology for a specialty in the future (Oh yes, a long future since I'm applying MD-PHD this year), do you guys think that for MD-PHDs it would be easy/difficult to get into this speciality (even if I am in a non-MSTP and non-ivy league school but I have a combined degree? I am not confident about getting in top programs at this point.)I want to do research about CV diseases for my PHD so hopefully that would be useful for my specialty Which program in the country is the best for Cardiology? I heard the U of Minnesota has a good research program (Visible Heart Lab) and Cleveland is famous too. Am I wrong or there are better programs? Thanks for your help!

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[Circumflex]

Before applying for Cardiology, you have to apply for an Internal Medicine residency, but there are basically 2 routes to go.

1. Apply for internal medicine residency programs (3 years), then during residency, apply for a cardiology fellowship (3-5 years, depending on what area of cardiology).

2. Apply to a fast-track internal medicine residency (Someone on this forum has posted a list of all IM fast-track residencies on the UAB website). These are designed for people who want to be physician-scientists. When you apply to these programs, you are basically guaranteed a fellowship spot at that institution. You do 2 years of internal medicine, then the clinical fellowship + 1-3 years of a post-doc experience. These programs are competitive.

Many places have good cardiology programs - all of the big-name schools. I don't know how far along you are, but once you do your lab research and find an interest, apply to schools doing the kind of research you want, or that are doing the kind of clinical work (clinical trials, using new technology) that you might want to do. Look at Brigham and Women's (or any Harvard program), Stanford, UCSF, UT Southwestern, UAB, Johns Hopkins. But, again, Cardiology comes after IM, and IM is not as competitive (unless you are applying to the places I listed).

 

[CCLCMer]

I'm really interested in doing cardiology for a specialty in the future (Oh yes, a long future since I'm applying MD-PHD this year), do you guys think that for MD-PHDs it would be easy/difficult to get into this speciality (even if I am in a non-MSTP and non-ivy league school but I have a combined degree? I am not confident about getting in top programs at this point.)I want to do research about CV diseases for my PHD so hopefully that would be useful for my specialty Which program in the country is the best for Cardiology? I heard the U of Minnesota has a good research program (Visible Heart Lab) and Cleveland is famous too. Am I wrong or there are better programs? Thanks for your help!

Cleveland Clinic is the top-rated cardiology hospital, if you go by USNWR. If you're interested in coming to CCF for med school, you have a couple of choices. One is to join the Case Western MSTP. The Case students take their first two years of classes at Case the first two years, but they can rotate at the Cleveland Clinic during M3/M4. I'm not sure how they'd feel about you doing research at the Lerner Institute here though. You'd have to talk to them about it. The other option is to go through the CCLCM program. That's what I'm doing. We are still Case students, but we take our first two years of classes at CCF. Our program is kind of halfway between an MD and an MD/PhD. We spend five years total and do 1.5 years of required research, including two required summer rotations in basic and clinical science. You have the option of getting an MD/MS. If you're in the CCLCM program, you could definitely do cardio research at Lerner. But it won't be an MD/PhD program like you said you wanted.

You can also just go somewhere else for med school and come here for your residency or fellowship in cardio. It's not like you wouldn't get a good background at other med schools. But I can tell you that most people here are absolutely crazy for cardio.

 

[greenteapudding]

It's not like you wouldn't get a good background at other med schools.

What is the odds of getting a MD-PhD spot by the way? 10%? 20% admission chance? How many spots are there every year? Does it mean as long as i get an MD-PhD it's a great achievement already?

 

[Neuronix]

I wouldn't worry at all about this factor in choosing a school. Not only are your interests likely to change, but you're getting an MD/PhD. The next stage of your life is to find a program to get those two degrees at. If you're really serious, find out which schools have the best basic science labs in Cardiology that you could go work in. What makes a school rank highly for Cardiology often times isn't its basic science research. There's often alot of clinical research, device engineering, and procedural excellence that you probably won't be able to get involved in for your PhD. Though even having strong basic science cardiology research isn't crucial, because you could work in pretty much any type of cell biology and apply on that for Cardiology later. Being an MD/PhD you will likely end up getting your choice of Cardiology spots.

Think more about program location and other factors that will lead to happiness for the next 8 years. Worry about fellowship later.

As for your later questions, You should check out the standard sites like www.mdphds.org and http://www.aamc.org/research/dbr/mdphd/applicantfaq.pdf. To answer directly, I don't think I have any national information, but several schools do mention their admissions statistics, the most in-depth being this site:
http://www.bcm.edu/mstp/admissions_statistics.html

The accpetance rate at the programs I've seen data on is on the order of 20%-25% (at our program too), but don't be fooled. The average GPA at MD/PhD programs is usually above 3.8 and the average MCAT is almost always over a 34 (which corresponds to something like 95th percentile and up!). You will need to have several years of research as an undergrad also to be competitive.

 

[Dr.Watson]

As has been stated - cardiology as a specialty and cardiology-related research for a PhD are two very different things. US News might give you a good idea of residencies with good reputations in cardiology, but MSTP research is different. Cardiology-related basic science research for a PhD varies widely from program to program. Your best bet is to look through the graduate school research websites for lots of programs and see who has a cardiology research related department or cardiovascular disease interdisciplinary program. From here, you'll get a good idea of where their focus is (arrhythmias, vascular disease, ischemia, developmental, etc), the variety of research available (engineering, biochem, cell-based, etc) and how much collaboration there is with different types of labs. It's worth looking into because some places have a strong commitment to CV disease and a large variety of labs - some with clinical correlates. Other places have like 2-3 labs that may be related to cardiology but just within traditional science departments. This breadth has nothing to do with ranking fyi, but I think more with disease-oriented, somewhat translational focus rather than hardcore basic science focus. Yeah, your interests may change, but people always talk about choosing programs based on their research opportunities. Chances are the former has a strong breadth of research beyond cardiology, too. I'd go with former programs rather than the latter if you've got choices to make.

 

[greenteapudding]

Thx you folks for your answers!

What about genetics? Or are cell biology are electrophys seem to be the only relevant thesis topics?

 

[greg12345]

You can do a PhD in practically anything and have it relate to cardiology. I wouldn't stress about this now. Get into a solid MSTP with multiple good basic science departments first, perform well, and the rest will fall into place. Also, if you really want to do cardiology you should spend some time with a cards fellow on a call night so you can realize what you are getting yourself into.

 

[Dr.Watson]

Yup, as greg said, the PhD can be in almost anything (genetics, pharmacology, tissue engineering, biochem, MCB, whatever). The nice part about schools with some sort of cardiology umbrella (usually everyone under it is associated with a basic science dept too) is that there tends to be more interdisciplinary talk/work. Often times, there's a clinical branch included in the umbrella. And, there are colloquia and symposiums organized under the umbrella, which would give you a broad exposure to the types of research related to the field.

 

[greg12345]

Here is some research you should do before you pursue cards training: How long can you tolerate being paged out of bed at home in the middle of the night to rush to the ED in 20 minutes so the ED-door-to-balloon-cath time is <90 minutes in the 130948713205981234058972340578 patients with STEMI that you are going to see in your training? Or how many call nights where you are up all night admitting rule-out MI after rule-out MI after rule-out MI can you tolerate as an IM resident before stabbing yourself with your Toprol XL drug rep pen? Just kidding, cards is pretty cool but I'm too lazy for that stuff.

 

[greenteapudding]

Here is some research you should do before you pursue cards training: How long can you tolerate being paged out of bed at home in the middle of the night to rush to the ED in 20 minutes so the ED-door-to-balloon-cath time is <90 minutes in the 130948713205981234058972340578 patients with STEMI that you are going to see in your training? Or how many call nights where you are up all night admitting rule-out MI after rule-out MI after rule-out MI can you tolerate as an IM resident before stabbing yourself with your Toprol XL drug rep pen? Just kidding, cards is pretty cool but I'm too lazy for that stuff.

I'm so idealistic about the specialty owing to family history but it is sth that I believe will truly give me satisfaction and a mission to fulfil What do you guys think about electrophysiologists? They and cardiologists seem to be hating each other or sth...but electrophysiologists do not have the same amount of patient contact though, am i right?

 

[Circumflex]

I'm so idealistic about the specialty owing to family history but it is sth that I believe will truly give me satisfaction and a mission to fulfil What do you guys think about electrophysiologists? They and cardiologists seem to be hating each other or sth...but electrophysiologists do not have the same amount of patient contact though, am i right?

Electrophysiologists are cardiologists. It is one of the longest training routes you can take. 3 years IM + 3 years cardiology + 2-3 years EP. They have a great deal of patient contact, but since they don't do MIs, they don't see as many patients and don't have as many night emergencies. Plus, most of them are at academic institutions, so they have residents/fellows to do a lot of the scut work.

I did my PhD in cardiac electrophysiology and would periodically go to the EP lab. Some of the arrhythmia mappings would take 6-8 hours - it was brutal.

 

[greenteapudding]

I did my PhD in cardiac electrophysiology and would periodically go to the EP lab. Some of the arrhythmia mappings would take 6-8 hours - it was brutal.

What can i say, you are my hero

So you're not going to do clinical stuff but only lab?

 

[Circumflex]

What can i say, you are my hero

So you're not going to do clinical stuff but only lab?

Once I got to 3rd year and did my IM rotation, I knew that I would rather have all my fingernails pulled out than go through an IM residency, not to mention the excrutiating hours of a cardiology fellowship only to do mostly basic science research. Plus, I want to have a significant amount of time devoted to research. I did a pathology elective in the first month of 4th year and decided to do that (I'm a 4th year). Pathology is very felxible with regard to schedule, career path, research areas, etc. So, I want to do basic research and have some clinical duties (in a subspecialty of path).

Most MD/PhD students start out gung-ho, ready for all the challenges, can handle anything, but after a while, the endless training tends to wear on you. I just couldn't do an 8 year MD/PhD, followed by 6-7 years of residency and trying to work in a post-doc experience.

 

[Dr.Watson]

Here is some research you should do before you pursue cards training: Or how many call nights where you are up all night admitting rule-out MI after rule-out MI after rule-out MI can you tolerate as an IM resident before stabbing yourself with your Toprol XL drug rep pen? Just kidding, cards is pretty cool but I'm too lazy for that stuff.

Haha. Too bad IM residency will suck and involve countless MI-related admits/rule-outs no matter which IM speciality fellowship I choose. At least, I'll know all the cardiac drugs without a moment's thought during fellowship. Besides, there eventually is a lazy option - one could always subspecialize in nuclear cardiology. Isn't that basically just a really long way to radiology?

 

[gbwillner]

Most MD/PhD students start out gung-ho, ready for all the challenges, can handle anything, but after a while, the endless training tends to wear on you. I just couldn't do an 8 year MD/PhD, followed by 6-7 years of residency and trying to work in a post-doc experience.

Circumflex,
I think we are in similar situations. However, I'm curious how you will manage to avoid the above situation in Path.
ASSUMING you want to do AP/CP (4yrs) and a subspecialty in Path (1yr), you STILL have to do a post doc (2-3yr) to land a faculty spot with research. This post-doc may be considered part of your fellowship, but if you still want to do science and not just deal with AP/CP, you're still going to have to wait 7-8 years after your MD/PhD. I think the medicine route is just as quick, IMHO. THere are tons of Fast-track programs, unlike in Path, that get you to your specialty after 2 years AND give you protected research time during the 5 year total residency. It ends up being the same if not quicker. Plus there are tons of these programs.

there are examples here...
http://www.dpo.uab.edu/~paik/rr.html

 

[greg12345]

I would have done path in a heartbeat if I enjoyed looking through a microscope (which I absolutely loathe). And the medicine route might be just as quick if not quicker (6 years total with up to 3 years protected research time if you fast track and do a clinical specialty that only requires 1 year of clinical fellowship training) BUT YOU STILL HAVE TO DO A MEDICINE RESIDENCY, compared to a PATH RESIDENCY. There is a huge difference in the torture factor there. Not only that, but you have to do your inpatient time in 2 YEARS as opposed to 3 YEARS if you are fast tracking, so gone are those cush outpatient derm months that make PGY3 so lovely for a non-fast-tracker. I'd rather spend more time in path to get to the same destination than suffer intensely for a shorter period of time. Just my take on it.

And isn't EP the dermatology of cardiology? My cards fellow when I was on IM was going into EP, and he described it as such.

 

[Circumflex]

Circumflex,
I think we are in similar situations. However, I'm curious how you will manage to avoid the above situation in Path.
ASSUMING you want to do AP/CP (4yrs) and a subspecialty in Path (1yr), you STILL have to do a post doc (2-3yr) to land a faculty spot with research. This post-doc may be considered part of your fellowship, but if you still want to do science and not just deal with AP/CP, you're still going to have to wait 7-8 years after your MD/PhD. I think the medicine route is just as quick, IMHO. THere are tons of Fast-track programs, unlike in Path, that get you to your specialty after 2 years AND give you protected research time during the 5 year total residency. It ends up being the same if not quicker. Plus there are tons of these programs.

there are examples here...
http://www.dpo.uab.edu/~paik/rr.html

You are totally right - I should have qualified my statement. There are a few fast-track path programs, too. I'm doing AP only at the NIH. Like Greg12345 said, the difference between IM and Path residencies is huge when it comes to having time to participate in research endeavors. This doesn't mean that you can get a post-doc experience during residency, but the way it is structured is much more conducive to doing research. So, I'm looking at 3 years AP (1 of those years can be used as almost all elective) + 2 years fellowship (most 2-year fellowships have a year of devoted research time).

 

[Circumflex]

BUT YOU STILL HAVE TO DO A MEDICINE RESIDENCY, compared to a PATH RESIDENCY. There is a huge difference in the torture factor there.

And isn't EP the dermatology of cardiology? My cards fellow when I was on IM was going into EP, and he described it as such.

I like that - it's so true. But, you have to do what you love. From what I saw, EP is definitely a nice lifestyle, but the training is pretty brutal, unless you really love it.

 

[noMDPHDsucks]

isn't EP the dermatology of cardiology? .

What do you mean by that

 

[CCLCMer]

What is the odds of getting a MD-PhD spot by the way? 10%? 20% admission chance? How many spots are there every year? Does it mean as long as i get an MD-PhD it's a great achievement already?

Sorry, I don't know what the odds are. I didn't apply MD/PhD. But yeah, I think it's a pretty competitive process, especially if it's an MSTP program like we have at Case.

 

[TheBoondocks]

What do you mean by that

dermatology is considered a lifestyle specialty. One generally gets to work from 8-5 and has little if any call. An EP generally installs pacemakers, icds, etc. Generally an EP has a much better lifestyle than an interventional cardiologist because they are called in to save heart attack victims and deal with other complications. I'm looking to apply to MDPHD and am also interested in cardiology.