Cardiac Fellowship Rank List 2016

[Jimmy Chitwood]

I matched at UF, which was one of my top choices. My #1 was CCF, but I am really happy with this match. Earlier incarnations of my list had UF #1 as well.

Overall, I would say I am more relieved than excited. After going through all that, I am just happy to have a spot somewhere. There are a lot of smart people out there, and I feel like most of us look pretty much exactly the same on paper.

On the interview trail, some of the people who interviewed me told me that this was a far more competitive year than normal. At CCF, I was in one of their earliest interview dates, and they told me that they had already gotten like 50 more applications than they did last year. So I e-mailed sfmatch and asked if they had gotten more applications than normal, and they told me they had over 300 applications. I am curious how many rank lists were submitted. I wonder when that information will be released.

Did any programs not fill?

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[Man o War]

I matched at UF, which was one of my top choices. My #1 was CCF, but I am really happy with this match. Earlier incarnations of my list had UF #1 as well.

Overall, I would say I am more relieved than excited. After going through all that, I am just happy to have a spot somewhere. There are a lot of smart people out there, and I feel like most of us look pretty much exactly the same on paper.

On the interview trail, some of the people who interviewed me told me that this was a far more competitive year than normal. At CCF, I was in one of their earliest interview dates, and they told me that they had already gotten like 50 more applications than they did last year. So I e-mailed sfmatch and asked if they had gotten more applications than normal, and they told me they had over 300 applications. I am curious how many rank lists were submitted. I wonder when that information will be released.

Did any programs not fill?

That doesn't surprise me given the job market and strong compensation for cardiac anesthesiologists.

 

[deleted171991]

Didn't match.

Disappointed, but not really upset. Read to get to work!

I will be curious to see the stats when they come out, though. Considered myself fairly competitive.

You may not be, or you aimed too high. About 85% of ACTA applicants used to match in recent years.

The PDs have a lot of minions to choose from nowadays, more and more every year, especially since the number of residency grads interested in a fellowship is going up really fast, while the number of fellowship positions not that much.

 

[cf817]

I matched @ my #1 so I'm thrilled. But I know at least one program didn't fill initially. Which is strange b/c all I've heard from programs is that this has been a very competitive year, with more applications than previous years. Could it be that highly competitive applicants are just applying to more programs than in previous years and going on my interviews? Therefore programs are getting more applications but interviewing many of the same people, so their "safe" number of ranks isn't actually that?

 

[Shimmy8]

I mean I'm not terribly torn up about it, but in the email which we were notified of not matching, it did say all spots were filled.

 

[pgg]

I matched @ my #1 so I'm thrilled. But I know at least one program didn't fill initially. Which is strange b/c all I've heard from programs is that this has been a very competitive year, with more applications than previous years. Could it be that highly competitive applicants are just applying to more programs than in previous years and going on my interviews? Therefore programs are getting more applications but interviewing many of the same people, so their "safe" number of ranks isn't actually that?

I bet you're right. Congrats on matching.

 

[pgg]

You may not be, or you aimed too high. About 85% of ACTA applicants used to match in recent years.

The PDs have a lot of minions to choose from nowadays, more and more every year, especially since the number of residency grads interested in a fellowship is going up really fast, while the number of fellowship positions not that much.

Where I'm going (next week! ), fully 1/2 the people on one of the pre-orientation emails had that_institution.edu email addresses. (Most of the rest were from some program @ gmail.com ... must be pretty prestigious to be represented so well.)

I suspect that residency pedigree and the homer/inbreeding factor is probably as much or even more a factor now than it used to be. Despite the nationwide match.

 

[Robotic Wis-Hipple]

Where I'm going (next week! ), fully 1/2 the people on one of the pre-orientation emails had that_institution.edu email addresses. (Most of the rest were from some program @ gmail.com ... must be pretty prestigious to be represented so well.)

I suspect that residency pedigree and the homer/inbreeding factor is probably as much or even more a factor now than it used to be. Despite the nationwide match.

Going back to school pgg?

 

[pgg]

Going back to school pgg?

Yes. My enthusiasm can probably be partly explained by my distance from residency and defense mechanisms that have obscured bad residency memories with fond ones. But I'm really looking forward to it. A year of having no responsibilities at all except doing cases and learning with smart people standing behind me.

 

[Robotic Wis-Hipple]

Yes. My enthusiasm can probably be partly explained by my distance from residency and defense mechanisms that have obscured bad residency memories with fond ones. But I'm really looking forward to it. A year of having no responsibilities at all except doing cases and learning with smart people standing behind me.

I know you're in a cards thread but CCM or Cardiac? I feel like I've read plenty of cardiac posts where you've sounded like you were doing hearts but maybe I'm wrong. I guess the TEE requirement could still be an issue. But either way congrats man, it's gotta be tough to go back, especially after already being a badass. That program got a deal

 

[pgg]

I know you're in a cards thread but CCM or Cardiac? I feel like I've read plenty of cardiac posts where you've sounded like you were doing hearts but maybe I'm wrong. I guess the TEE requirement could still be an issue. But either way congrats man, it's gotta be tough to go back, especially after already being a badass. That program got a deal

CT, yes. I've been wallowing in mostly B&B non-cardiac cases since residency. Where I've learned plenty, don't get me wrong, but one of the reasons I'm doing the fellowship is I miss those cases, and it's hard to get credentialed to do them after being out of those rooms a couple years. The ego is staying at home. I will enter with the humble knowledge that every one of the faculty there knows 100x as much about cardiac anesthesia and TEE as I do. I sure hope they don't expect me to be running already. Besides, I'm in the military, I'm used to doing what I'm told.

The program is getting a deal with me ... I'm free fellow, in an ACGME temporary complement increase slot, since the Navy's paying my salary, not them. I'm not merely free labor, I'm bringing CMS tuition with my free labor.

 

[deleted171991]

Where I'm going (next week! ), fully 1/2 the people on one of the pre-orientation emails had that_institution.edu email addresses. (Most of the rest were from some program @ gmail.com ... must be pretty prestigious to be represented so well.)

I suspect that residency pedigree and the homer/inbreeding factor is probably as much or even more a factor now than it used to be. Despite the nationwide match.

That means that your institution is run by smart people.

I am the kind of person who believes that the devil you know is better than the devil you don't. Recruiting 50% insiders is an excellent idea. My former residency program tends to do the same, even when hiring. Yes, it leads to inbreeding, and old habits die hard, but also to familiarity and fidelity.

On the other hand, the pedigree thing is hard to fight.

 

[deleted171991]

CT, yes. I've been wallowing in mostly B&B non-cardiac cases since residency. Where I've learned plenty, don't get me wrong, but one of the reasons I'm doing the fellowship is I miss those cases, and it's hard to get credentialed to do them after being out of those rooms a couple years. The ego is staying at home. I will enter with the humble knowledge that every one of the faculty there knows 100x as much about cardiac anesthesia and TEE as I do. I sure hope they don't expect me to be running already. Besides, I'm in the military, I'm used to doing what I'm told.

The program is getting a deal with me ... I'm free fellow, in an ACGME temporary complement increase slot, since the Navy's paying my salary, not them. I'm not merely free labor, I'm bringing CMS tuition with my free labor.

Let's talk about this in a month or two. I was as open-minded as you in my first few months, but then, as time passed and knowledge piled on, my tolerance for BS decreased exponentially. It's very annoying to see bad medicine, even worse to have to apply it.

Right now I have to control myself not to frown too much during rounds. I know I have pissed off some less intelligent or understanding people already.

 

[pgg]

That means that your institution is run by smart people.

I am the kind of person that believes that the devil you know is better than the devil you don't. Recruiting 50% insiders is an excellent idea. My former residency program tends to do the same, even when hiring. Yes, it leads to inbreeding, and old habits die hard, but also to familiarity and fidelity.

Oh, I don't blame them at all.

You know your CA-2 class a lot better than you can possibly know even the best applicant from another institution based on paper and an interview. Big name fellowship programs tend to have big name residencies, which get strong people. And it's totally natural for them to remain strong, and then want to stay put for fellowship.

I just think it's interesting that the nationwide match doesn't seem to have had much effect on where a program's fellows come from. I'm really not sure I understand the value SF Match is actually adding to fellowship application process. (Then again, I'm at least 1/2 talking out my nether regions, since I got my spot outside the match.)

 

[pgg]

Let's talk about this in a month or two. I was as open-minded as you in my first few months, but then, as time passed and knowledge piled on, my tolerance for BS decreased exponentially. Right now I have to control myself not to frown during rounds.

LOL

I think two months might still be the honeymoon phase.

Let's set a date for January 2017, when the days are cold, and short, and dark, and rainy and I'll be deep enough in the tunnel to not be able to see the light at the end of it, or remember the light at the start of it either.

 

[deleted171991]

LOL

I think two months might still be the honeymoon phase.

Let's set a date for January 2017, when the days are cold, and short, and dark, and rainy and I'll be deep enough in the tunnel to not be able to see the light at the end of it, or remember the light at the start of it either.

You're probably right. When I re-read some of my more excited posts from the last 12 months, even from a couple of months ago, I can see the still naive and hopeful fellow that has now been replaced by the cynical, tired, and fed up almost graduate.

 

[Robotic Wis-Hipple]

I'd be worried if I saw a fellowship without a good percentage of their own residents matching there. If your own don't want to stay what's that say?

 

[confusingleaf]

LOL

I think two months might still be the honeymoon phase.

Let's set a date for January 2017, when the days are cold, and short, and dark, and rainy and I'll be deep enough in the tunnel to not be able to see the light at the end of it, or remember the light at the start of it either.

PGG where you're going are you doing mostly your own cases or supervising? that makes a big difference. at my program i did probably 50/50 and it made the year very bearable--the days i had to be there at 0600 to set up room and stuck finishing a CABG late into the evening balanced by supervisory days where once the second case was started and on pump i was outta there.

 

[pgg]

Mostly my own cases. Two other programs I was considering were more 50/50 ... those fellows did look a little better rested, but there are a lot of variables there. I'll have 4 OR days per week, one academic day, rare weekend work, doesn't sound too bad. I'm moving a fairly short drive from my current location to be a fellow, and my family is staying put for the year. Kids are in high school and I don't want to uproot them for the year. Weeknights I'll be at an apartment across the street from the hospital. Honestly, if I got off at 3 PM it's not like I'd go do anything.

Going home early is nice and that's been my job the last few years. If I'm going to be a fellow I want to see and do as many cases as I can for the year. At least that's what I think right now.

 

[Jimmy Chitwood]

@Shimmy8 If you remain interested in a fellowship, I would be willing to bet that there will be a handful of spots opening up throughout the year. Some people who matched will take jobs instead, decide not to do the fellowship, etc.. If you stay on top of it, you may be able to get something.

It is a bit of a crapshoot, and I don't totally know how you'd go about it, but I'd say maybe just email every program in a couple months and let them know you're still out there if something opens up. Then remind them again every month or two.

 

[confusingleaf]

Mostly my own cases. Two other programs I was considering were more 50/50 ... those fellows did look a little better rested, but there are a lot of variables there. I'll have 4 OR days per week, one academic day, rare weekend work, doesn't sound too bad. I'm moving a fairly short drive from my current location to be a fellow, and my family is staying put for the year. Kids are in high school and I don't want to uproot them for the year. Weeknights I'll be at an apartment across the street from the hospital. Honestly, if I got off at 3 PM it's not like I'd go do anything.

Going home early is nice and that's been my job the last few years. If I'm going to be a fellow I want to see and do as many cases as I can for the year. At least that's what I think right now.

whoa--one academic day per week is AWESOME. i think that will make you just as well rested as doing 50/50. having a day that you don't have to get up at 0530 makes a big difference. enjoy! i don't have any kids so i came in for basically everything on nights and weekends. my philosophy was that i have one year to se everything that i can, and i think i maximized it. plus i'd rather just stay up all night doing a heart transplant or dissection and sleep through the boring daytime cabg the next day anyways (they would always make sure i wasn't in OR the next day if I was up all night).

 

[deleted171991]

PGG where you're going are you doing mostly your own cases or supervising? that makes a big difference. at my program i did probably 50/50 and it made the year very bearable--the days i had to be there at 0600 to set up room and stuck finishing a CABG late into the evening balanced by supervisory days where once the second case was started and on pump i was outta there.

The days of supervising in a cardiac fellowship are going away. They have enough minions applying, so why not squeeze them.

 

[deleted171991]

@Shimmy8 If you remain interested in a fellowship, I would be willing to bet that there will be a handful of spots opening up throughout the year. Some people who matched will take jobs instead, decide not to do the fellowship, etc.. If you stay on top of it, you may be able to get something.

It is a bit of a crapshoot, and I don't totally know how you'd go about it, but I'd say maybe just email every program in a couple months and let them know you're still out there if something opens up. Then remind them again every month or two.

Doesn't happen a lot for cardiac. Usually the spots are filled by word of mouth. What you see on sfmatch is crap that nobody wanted. Now CCM is a different story.

 

[Jimmy Chitwood]

Doesn't happen a lot for cardiac. Usually the spots are filled by word of mouth. What you see on sfmatch is crap that nobody wanted. Now CCM is a different story.

You're probably right, but I am a ca3 who just matched, and a classmate of mine was also interviewing, and the PD asked for both of our phone numbers. She got a call an hour after the interview and got a spot starting this upcoming year, instead of waiting until 2017. So it is possible.

 

[deleted171991]

You're probably right, but I am a ca3 who just matched, and a classmate of mine was also interviewing, and the PD asked for both of our phone numbers. She got a call an hour after the interview and got a spot starting this upcoming year, instead of waiting until 2017. So it is possible.

That's exactly what I was saying. You won't see the empty spots on sfmatch, or gaswork, or anywhere. At the most, your PD might get an email advertising them.

 

[Jimmy Chitwood]

That's exactly what I was saying. You won't see the empty spots on sfmatch, or gaswork, or anywhere. At the most, your PD might get an email advertising them.

I see what you mean. That's why I was thinking @Shimmy8 might be able to uncover something if he reached out to the programs periodically. Its a shot in the dark, but it may be worth trying.

 

[Shimmy8]

Yea I'm gonna keep ear to the ground while working contacts back home for PP jobs.

 

[contango]

I'm heading to Duke next year. So excited!

I have no doubt this year was a tough match -- a few highly qualified coresidents either didn't match or fell very far down their lists. The PD at my home program mentioned about 25% of people that were ranked failed to match anywhere. And those are only including the ones who were ranked, not everyone who applied or even interviewed.

 

[Random Anesthesiologist]

Yea I'm gonna keep ear to the ground while working contacts back home for PP jobs.

Or you could do a CCM year and try to match ct after. Or go to work and make some $$. There are options.

 

[Consigliere]

Didn't match.

Disappointed, but not really upset. Read to get to work!

I will be curious to see the stats when they come out, though. Considered myself fairly competitive.

Dude, 5 years from now you will realize this is the best thing to have happened to you.

 

[cf817]

This year's match data...very competitive year....77% match rate...100% fill of 199 positions.

https://sfmatch.org/SpecialtyInsideAll.aspx?id=24&typ=1&name=Adult Cardiothoracic Anesthesiology#

 

[Man o War]

View attachment 206895
This year's match data...very competitive year....77% match rate...100% fill of 199 positions.

https://sfmatch.org/SpecialtyInsideAll.aspx?id=24&typ=1&name=Adult Cardiothoracic Anesthesiology#

Wow. I know a strong resident who didn't match so I wondered.

 

[deleted171991]

There aren't enough cardiac cases for the number of cardiac-trained people these programs are pumping out.

 

[Man o War]

There aren't enough cardiac cases for the number of cardiac-trained people these programs are pumping out.

Hate to hear that. My program was pretty brutal call wise since we had to cover 24/7, but there were more than enough cases and TEEs to go around.

 

[deleted171991]

I foresee cardiac anesthesiologists doing much more non-cardiac cases than cardiac. CT anesthesia is the latest mania, like pain and peds before. As a society, we don't need so many specialized people and so few generalists but, hey, it does look good on the resume (and the truth is, it does prepare one to handle sick patients). Just expect less and less return on the $300K investment.

My 2 cents for those who missed the boat this year.

 

[Laryngophed]

I know I'm super pumped up for this years application season. The only real downside is trying to soft out all of the programs that will let me do CCM->ACTA at the same place with one application.

 

[deleted171991]

I know I'm super pumped up for this years application season. The only real downside is trying to soft out all of the programs that will let me do CCM->ACTA at the same place with one application.

Most of the time, the best programs in CCM don't coincide with the best programs in ACTA.

If you're gonna waste two years, make the best out of them. Don't be lazy. Or, at least, get the best two in the same large geographical area.

 

[Man o War]

I foresee cardiac anesthesiologists doing much more non-cardiac cases than cardiac. CT anesthesia is the latest mania, like pain and peds before. As a society, we don't need so many specialized people and so few generalists but, hey, it does look good on the resume (and the truth is, it does prepare one to handle sick patients). Just expect less and less return on the $300K investment.

My 2 cents for those who missed the boat this year.

I'm seeing a trend toward CT anesthesia handling more of the thoracic and liver transplant cases. Even more vascular too, which has always been (and could continue to be), the realm of general anesthesia. I don't know how I feel about that yet, I'll get back to you on that!

 

[Man o War]

Most of the time, the best programs in CCM don't coincide with the best programs in ACTA.

If you're gonna waste two years, make the best out of them. Don't be lazy. Or, at least, get the best two in the same large geographical area.

I agree with this, don't limit yourself like that. My opinion of course.

 

[Laryngophed]

I agree with this, don't limit yourself like that. My opinion of course.

I have some geographic limitations.

 

[deleted171991]

I'm seeing a trend toward CT anesthesia handling more of the thoracic and liver transplant cases. Even more vascular too, which has always been (and could continue to be), the realm of general anesthesia. I don't know how I feel about that yet, I'll get back to you on that!

Yeah, cardiac anesthesiologists doing livers.

I know it's happening in certain places. I still find it funny. Liver transplant has CCM written all over it, especially the sick ones.

 

[Man o War]

Yeah, cardiac anesthesiologists doing livers.

I know it's happening in certain places. I still find it funny.

Not me thank god!

 

[Man o War]

Yeah, cardiac anesthesiologists doing livers.

I know it's happening in certain places. I still find it funny. Liver transplant has CCM written all over it, especially the sick ones.

Maybe we will now have requirements to be double boarded in CT and CCM to do liver transplants. Seems to be the way of things now, eh?

 

[deleted171991]

Maybe we will now have requirements to be double boarded in CT and CCM to do liver transplants. Seems to be the way of things now, eh?

They can use their TEE as a colonoscope (as in shove it), as far as I am concerned. Nobody needs both to do anything, except for maybe cardiac critical care.

 

[Laryngophed]

They can use their TEE as a colonoscope (as in shove it), as far as I am concerned. Nobody needs both to do anything, except for maybe cardiac critical care.

I don't know, I'd think if you wanted to do hearts AND critical care at an academic place, you might need both.

 

[deleted171991]

I don't know, I'd think if you wanted to do hearts AND critical care at an academic place, you might need both.

That, too.

In an academic place, if you want to scratch your nose with one hand and your butt with the other you need two fellowships.

 

[thinkorswim]

Yeah, cardiac anesthesiologists doing livers.

I know it's happening in certain places. I still find it funny. Liver transplant has CCM written all over it, especially the sick ones.

Right. Because your year out of the OR writing tube feed orders will be infinitely more valuable for post-reperfusion syndrome.

 

[AdmiralChz]

View attachment 206895
This year's match data...very competitive year....77% match rate...100% fill of 199 positions.

https://sfmatch.org/SpecialtyInsideAll.aspx?id=24&typ=1&name=Adult Cardiothoracic Anesthesiology#

let's get back on target and maybe away from the who is better argument...

wow almost a 25% increase in applicants, goes along with what many were being told on the interview trail. Much, much more competitive overall. Probably some good applicants didn't make the cut who likely would have in other years.

 

[deleted171991]

Right. Because your year out of the OR writing tube feed orders will be infinitely more valuable for post-reperfusion syndrome.

You mean my big part of a year resuscitating crazy sick people on 3-4 pressors? Or the kind with EF under 10%, playing pheo crysis on me? I am soooo scared of the reperfusion syndrome. Never seen anything like that. Nope. I have no idea what tubefeeds to prescribe for them. Let me look it up on my iPad...

Oh wait, I did reperfusion back in residency on sick mofos after 12 hours of surgery. I still remember loading them up with pressors to an SBP of 180, then roller coaster down to 50-60, while pushing some more sticks of pressors and, voila, calm waters. This coupled with labs every 30 mins for most of the surgery (these were sick dudes), and really textbook management of the patients (including TEE when needed), only with intensivists. You know, the kind of people who don't push a stick of bicarbonate just so that the blood gas looks better on paper, because studies prove it would alter tubefeed absorption.

With all due respect for cardiac anesthesiologists, who are great for cardiovascular and hemodynamic stuff, this is intensive care territory, unless it's on not so sick recipients.

Just because all you learned in the ICU in residency is how to write tube feed orders, there is no need to denigrate critical care. It makes you sound like a CRNA, with their "years of ICU experience".

 

[deleted547339]

Right. Because your year out of the OR writing tube feed orders will be infinitely more valuable for post-reperfusion syndrome.

If you're putting in the daily tube feed orders as a fellow, you went to the wrong program.