zippy2u

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Been out in private practice for 8 years. AMG. Haven't done hearts since residency. Board certified. Thinking about doing a cardiac fellowship- 12 months and get TEE certified. Thoughts or opinions as to programs welcoming my fellowship desires? TIA --- zippy
 

dbiddy808

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How much more money would someone make if they did straight cardiac anesthesia vs. general?
 
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zippy2u

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Border of south Texas salaries range $400,000- $500,000 doing cardiac primarily. Locums rate is $200.00/hour doing cardiac. ---zippy
 

UTSouthwestern

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We'd take a look at you for sure. Not sure if we've filled the spot already though.
 
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zippy2u

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Was leaning towards Texas Heart in Houston or Univ. of Florida -Zippy
 

UTSouthwestern

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I doubt THI has filled yet. Have you contacted them yet?
 

GasPundit

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zippy2u said:
Was leaning towards Texas Heart in Houston or Univ. of Florida -Zippy
Zippy, curious as to why UF? I can understand THI. And don't get me wrong, loved my interview at UF, planning on ranking them highly if not number 1. Just curious about an outside perspective.
 
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zippy2u

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I haven't contacted THI yet and UF because they seem to have a decent program and the surrounding area near Gainesville would be awesome to live. Old Florida-- can't beat it.
 
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zippy2u

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Top three pick; where would you do a cardiac fellowship?
 

Tenesma

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texas heart
emory
brigham

those are probably the top 3.... don't go to uf... unless you have other reasons to be there...
 

Capsaicin

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As an applicant for residency this year...do you see most of these top level cards fellowships taking primarily their own, or do they take a healthy mix from top name places/recommended from known chairmen, as well as joe shmoes, etc?

Also, how do you guys currently in the biz see the cardiac fellowship going in the future, say 10 years down the road? I was told by a chair at a top tier residency that I should watch out for the cards fellowship as heart surguries will be on the decline as time goes on, and interventional cards get more and more aggresive. Just one opinion, but I'd like to know more, cause I'm quite interested in cards anesthesia.

Any thoughts?
 

UTSouthwestern

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Capsaicin said:
As an applicant for residency this year...do you see most of these top level cards fellowships taking primarily their own, or do they take a healthy mix from top name places/recommended from known chairmen, as well as joe shmoes, etc?

Also, how do you guys currently in the biz see the cardiac fellowship going in the future, say 10 years down the road? I was told by a chair at a top tier residency that I should watch out for the cards fellowship as heart surguries will be on the decline as time goes on, and interventional cards get more and more aggresive. Just one opinion, but I'd like to know more, cause I'm quite interested in cards anesthesia.

Any thoughts?
Again, since fellowships aren't in high demand among graduating residents, even the top level fellowships take a variety of applicants including FMG's.

As cardiac goes more and more toward interventional and fewer cases show up with private insurance, cardiac will likely decrease in compensation and popularity (already has significantly from the late 80's, early 90's). There is some talk about the SCA along with the ASA pushing Medicare hard to increase reimbursement for cardiac anesthesia but we'll see.

CVT programs are now gearing their programs to more greatly emphasize thoracic surgery to compensate for interventional taking such a big bite out of their paycheck.

In certain areas, private insurance hearts will likely remain high based on the demographics, but those groups in charge of those areas are likely to maintain a strangle hold on those areas.

Proficiency in CV anesthesia, regardless, remains something to hang your hat on and many hospitals and groups will look to the fellowship trained CV anesthesiologist or CV experienced anesthesiologist for positions of leadership, department chairs, etc.
 

GasPundit

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A good CV trained anesthesiologist will always come in handy. I think this group may become MORE appreciated in the future, but not in cardiac cases. Rather, they may be called upon more and more to care for the cardiac patient having noncardiac surgery. From managing a failing heart to understanding the assist-device populations (they're growing, and they're gonna come to an OR near you) to just plain being comfy with the TEE probe, I don't see how it can hurt your training.

Not to shift the thread too much, but has anyone used ICE intraoperatively (aside from device closures)? Cool tool without some of the contraindications of TEE, and perhaps more useful/safe than the Swan?
 
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zippy2u

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Anyone doing a cardiac fellowship now or recently in the past that would like to share their experiences? Thanks ---Zippy
 

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GasPundit said:
A good CV trained anesthesiologist will always come in handy. I think this group may become MORE appreciated in the future, but not in cardiac cases. Rather, they may be called upon more and more to care for the cardiac patient having noncardiac surgery. From managing a failing heart to understanding the assist-device populations (they're growing, and they're gonna come to an OR near you) to just plain being comfy with the TEE probe, I don't see how it can hurt your training.

Not to shift the thread too much, but has anyone used ICE intraoperatively (aside from device closures)? Cool tool without some of the contraindications of TEE, and perhaps more useful/safe than the Swan?
ICE is pretty darn new but I've seen the cardiologists use it. Cool 3D reconstruction, but still relatively experimental. I am hoping to try it on my TEE rotation in May.
 
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zippy2u

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wasnick ain't going to help you when the cardiac surgeon whines to the hospital administrator that he wants a fellowship trained anesthesia guy. The surgeon brings the money to the hospital and it is he who must be kept content. That's real world private practice stuff.
 

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zippy2u said:
wasnick ain't going to help you when the cardiac surgeon whines to the hospital administrator that he wants a fellowship trained anesthesia guy. The surgeon brings the money to the hospital and it is he who must be kept content. That's real world private practice stuff.
So tell him you did your fellowship in your CA-3 year and you just didn't get your TEE certification done yet. :D
 

redstorm

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whats so fing hard about doing hearts///

It aint hard..

you have to have rocks in your head to do a fellowship in cardiac.. just put the ****ing lines in (dont **** it up) and a **** load of narcotic. anticipate problems coming off pump and be ready. If the patient cant come off put a balloon in. if that dont work put a device if that dont work no fellowship will help you..
 
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zippy2u

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Redstone, I forgot to tell you that cardiac surgeon also wants the anesthesia guy to be TEE certified. Hows a boat load of sufenta goin' to solve that one. Regards, ---zippy
 

foshizzo

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Interesting reading that zippy2u was interested in doing a cardiac fellowship years ago.

Question about non-TEE imaging like epiaortic and ICE - anyone know if these are fair game on the advanced PTE exam? Don't have much experience with them since they're rarely used at my institution.
 

krodUT

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Interesting reading that zippy2u was interested in doing a cardiac fellowship years ago.

Question about non-TEE imaging like epiaortic and ICE - anyone know if these are fair game on the advanced PTE exam? Don't have much experience with them since they're rarely used at my institution.
Apparently the epiaortic views are fair game.

I would look at this:

http://www.asecho.org/wordpress/wp-content/uploads/2013/05/Performing-a-Comprehensive-Epicardial-Echo-Exam.pdf

When in doubt, just look at the top right and if you don't see the multiplane gauge you know you're epiaortic.
 

Mman

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quite the necro-thread bump from 10 years and 3 months ago, miss reading UTSW's posts. Life is short and we should all enjoy.
 

nimbus

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It is ironic how many people thought cardiac was a dying subspecialty and cardiac fellowship was not worthwhile in 2005 and how untrue that is in 2015.

Even smart people are terrible at predicting the future.
 
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DrBeaker

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Epiaortic and epicardial were on the test when I took it a couple years ago. No ICE. Regarding Epiaortic, look for the echo lucency closest to the probe indicating a stand off device to clue you in on Epiaortic images.