Cardiology fellowship without research

[Happyfeet1234567890]

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Is this possible? I absolutely loathe the idea of having to do a bunch of research during residency to get into a cardiology fellowship.

 

[cardsguy2017]

Maybe, if you have a strong app otherwise. Residency rep goes a long way here and certainly not having research on your resume, or research to talk about, will turn away many academic programs. While many share the same sentiments as you regarding research, and hate the research "game" for the sake of fellowship, it's a game that many will play to become a cardiologist, or at least putting themselves in the best position to be one. Academic programs are looking for research types and folks who'll be productive, but outside of that, having research or something similar (case reports, etc.) shows your interest and dedication to the field. If I were a PD and saw no cardiology related extra-curriculars on your app, that'll look weak compared to someone who does and who seems more dedicated to the field on paper. Even if I were a PD and understood the research "game" I'd look more favorably on someone who cared enough to play the game vs someone who thought they were too good, etc. It doesn't even have to be much, just get involved with a project, ask a fellow or attending, help a little here and there so you can put something down and have something to talk about. If you want an academic career, then yes having a big project and being productive in residency is good, but not quite as necessary for a clinical career. Cards is competitive and having research or something similar give you another edge. Whether that edge is needed is unknown and depends on the program, your app, that application cycle, etc. Up to you whether it's worth it or not.

 

[IMreshopeful]

Is this possible? I absolutely loathe the idea of having to do a bunch of research during residency to get into a cardiology fellowship.

Yeah that’s tough. You have to do it. I don’t have an everlasting love of research either but it’s a necessity.

Few reasons for this:

- Most programs require some form of research during fellowship. If you don’t have any background you are unlikely to produce.
- most academic fellowships are looking for fellows who are going to join academics after graduation. The reality is that the large majority of grads go into practice for a variety of reasons, but they still want grads who are going towards a research/academic career
- it’s a way to weed out candidates because so many folks apply to cardiology

Now your question: is it theoretically possible? Yes, but I only know of one person who did it and they were a rare combo of genius, phenomenal clinical skills with letters, top board scores and AOA, and a well regarded residency. It’s exceedingly rare and I doubt you should rely on that to coast through

If you’re an IMG, matching medicine residency without research is almost impossible let alone cardiology fellowship.

So... I wouldn’t roll the dice and would just plan to do some research project. This does not mean you are committing yourself to more research in your career

 

[UnbreakMyDearHeart]

Is this possible? I absolutely loathe the idea of having to do a bunch of research during residency to get into a cardiology fellowship.

I would say absolutely you don't have to. It all depends on a few variables - most importantly, where you're from and where you're trying to go.
If you came from the top residencies many programs will take you based on reputation alone.

It also depends on where you're trying to match. If you're trying to match at large academic centers, then yes - it may be challenging. If you're trying to match at smaller community programs, coming from a good residency with good letters is often all you need to get an interview invitation.

 

[IMreshopeful]

I would say absolutely you don't have to. It all depends on a few variables - most importantly, where you're from and where you're trying to go.
If you came from the top residencies many programs will take you based on reputation alone.

It also depends on where you're trying to match. If you're trying to match at large academic centers, then yes - it may be challenging. If you're trying to match at smaller community programs, coming from a good residency with good letters is often all you need to get an interview invitation.

Yeah so I would not rely on this. I know folks who have gone unmatched without any research coming from top residencies with good letters. Its a rare thing to do well without any research.

 

[Scottish Chap]

I would say absolutely you don't have to. It all depends on a few variables - most importantly, where you're from and where you're trying to go.
If you came from the top residencies many programs will take you based on reputation alone.

It also depends on where you're trying to match. If you're trying to match at large academic centers, then yes - it may be challenging. If you're trying to match at smaller community programs, coming from a good residency with good letters is often all you need to get an interview invitation.

This isn’t great advice.

I filtered the applications for our academic cardiology program over the last three years. This season, we had 554 applicants for five places. We only interviewed 60 people.

Here is what I do:
1. I look to see if the USMLEs were passed on the first attempt. It has little to do with how well someone will do in cardiology fellowship, but most programs are going to feel nervous about their statistics for fellows meeting board certification if there was an academic issue in medical school.

2. I next go to the scholarly activity section. Original research is far more meaningful than case reports or review articles. Same thing for first author publications. You’re in a medicine residency to become a great physician, not a researcher. We get that. BUT you absolutely MUST show something in the section. Believe it or not, there is a COCATS1 requirement in research for ACGME-accredited cardiology programs for an applicant to meet board eligibility. We won’t mess with the ACGME, and most of us are entirely too busy to police cardiology fellows who think they can get away with not satisfying this requirement. Most programs will expect 5 to 9 months of research (loosely defined). My own program has accepted cardiology fellows in the past who thought they could get away with avoiding research by trying to get level 2 in several areas instead, and it was an absolute nightmare to have to police. So, showing something on your ERAS application...anything is critical. If it is blank, you’re going to stand out as an outlier. We have interviewed some of our own medicine residents who showed nothing in that area, but I promise you this was out of courtesy and they were not ranked anywhere near the matchable range. There are just too many highly qualified applicants who (even if they are only playing the game) realize that believing they are entitled or special is not a desirable trait for a cardiology fellow. Those are the people that match. I’ve even had one or two people do a research rotation with me but blow it off. I still wrote them a warm letter of recommendation anyaway, but usually only if I’ve worked with them clinically. Guess what? They didn’t match anywhere.

** A special note about the comment regarding the lack of research not being a problem for community programs: we have a couple of those in our region, and guess what they use to select their applicants? Research. Residents and fellows who can do research give community programs a certain amount of prestige, and the more visibility they can get, the more patient referrals they get. You’re going to be judged by the same standard and they’re not going to look at you unless you check the research box.

3. What does the IM program director say? We all know that letters of recommendation pretty much are going to come from people who will say favorable things, so they have not as much impact. A medicine program director tends to be very straightforward. I will also add that it’s extremely obvious if the letter is written by somebody that doesn’t know you, or they are too busy to take their job as a letter writer seriously (usually write one or two paragraphs, often there are typos, and sometimes they even use the wrong name for the applicant). The best letters are two pages or more and really go on about how good the applicant is. Make sure this is somebody who really knows you.

4. Caliber of the residency program. This is important. If you think you want to do cardiology, do yourself a favor and try to match into the most competitive IM program you can. Again, I have seen a certain amount of entitlement from one or two of our local medical students who stayed at this institution for residency, and then thought that they were entitled to stay here for cardiology fellowship. IM residents who worked hard and checked all the boxes (including research) were fine. Those that didn’t were ranked nowhere close to the matchable range.

When at the interview, I really don’t look at the application again. I just want to see if this is somebody who’s going to be a good match. If there is any hint that the applicant is anything less than hard-working, or if there is any hint that the applicant might not play well in the sand box, they are not ranked in the matchable range.

Lastly, cardiology really isn’t that difficult. It’s only one organ system…. But that doesn’t mean you don’t have to play the game to get there.

I hope that helps.

 

[nlax30]

Possible? Yea but not very likely. The above posts pretty much nail it here.

The programs realize that a lot of you will not continue on to academic careers, but involvement in research serves two main purposes in my opinion:
1. It helps develop a part of your brain that may not get a lot of mental exercise from just clinical hands on experience. May be a cliche but you've probably heard the term "physician-scientist". Research is not my strong suit nor a big interest of mine though I certainly see the value in some sort of exposure and involvement in research as it does help build a certain skill set that's useful for physicians.

2. Purely from a practical standpoint residents/fellows allow for these academic departments to publish like they do. We are built-in research labor and they rely on us to continue to remain active. While not all of us will continue on in an academic career, that attending and department will and they will always have the need for others to help them pump stuff out.

In any event, your residency is going to require some sort of academic/research project from you so will have to have at least some research experience. If you only plan on doing what's required to fulfill residency requirements then you best make sure the rest of your application is top notch and even then may want to focus on more community based programs as opposed to big name academic ones.

 

[Scottish Chap]

Possible? Yea but not very likely. The above posts pretty much nail it here.

The programs realize that a lot of you will not continue on to academic careers, but involvement in research serves two main purposes in my opinion:
1. It helps develop a part of your brain that may not get a lot of mental exercise from just clinical hands on experience. May be a cliche but you've probably heard the term "physician-scientist". Research is not my strong suit nor a big interest of mine though I certainly see the value in some sort of exposure and involvement in research as it does help build a certain skill set that's useful for physicians.

2. Purely from a practical standpoint residents/fellows allow for these academic departments to publish like they do. We are built-in research labor and they rely on us to continue to remain active. While not all of us will continue on in an academic career, that attending and department will and they will always have the need for others to help them pump stuff out.

In any event, your residency is going to require some sort of academic/research project from you so will have to have at least some research experience. If you only plan on doing what's required to fulfill residency requirements then you best make sure the rest of your application is top notch and even then may want to focus on more community based programs as opposed to big name academic ones.

I agree with most of what you say here except #2. I do a lot of mentoring at every level. Maybe if you’re talking about a chart review or case report, I would agree. But for real, hypothesis-driven research, this is not the case. I absolutely promise you that mentoring takes far more time and a lot more effort on the part of the mentor. It’s far easier for me to just to do the work myself than to mentor unless the fellow has had a substantial amount of previous research experience and statistical training. Mentoring is a privilege, although I do appreciate not everybody who mentors remembers that.

 

[nlax30]

I agree with most of what you say here except #2. I do a lot of mentoring at every level. Maybe if you’re talking about a chart review or case report, I would agree. But for real, hypothesis-driven research, this is not the case. I absolutely promise you that mentoring takes far more time and a lot more effort on the part of the mentor. It’s far easier for me to just to do the work myself than to mentor unless the fellow has had a substantial amount of previous research experience and statistical training. Mentoring is a privilege, although I do appreciate not everybody who mentors remembers that.

Very true. I think I was more referring to the bread and butter single site retrospective or small 2-3 center collaberaticr prospective type stuff I’m more familiar with in the EP world.

 

[IMreshopeful]

Possible? Yea but not very likely. The above posts pretty much nail it here.

The programs realize that a lot of you will not continue on to academic careers, but involvement in research serves two main purposes in my opinion:
1. It helps develop a part of your brain that may not get a lot of mental exercise from just clinical hands on experience. May be a cliche but you've probably heard the term "physician-scientist". Research is not my strong suit nor a big interest of mine though I certainly see the value in some sort of exposure and involvement in research as it does help build a certain skill set that's useful for physicians.

2. Purely from a practical standpoint residents/fellows allow for these academic departments to publish like they do. We are built-in research labor and they rely on us to continue to remain active. While not all of us will continue on in an academic career, that attending and department will and they will always have the need for others to help them pump stuff out.

In any event, your residency is going to require some sort of academic/research project from you so will have to have at least some research experience. If you only plan on doing what's required to fulfill residency requirements then you best make sure the rest of your application is top notch and even then may want to focus on more community based programs as opposed to big name academic ones.

Yeah, generally speaking as someone who gets nauseated with the process of doing research and who went into medicine to take care of patients, I do think going through the process helped me understand some of the ways to at least analyze research papers even if I don’t want to do it in my career

There was a thread about this several months back, but this also emphasizes just how important it is to go to a cardiology program which fits with your career goals. The program mentioned above by Scottish seems like it demands more research productivity than many others I’ve seen... also the dig at trying to get level 2 in multiple modalities is a kind of silly - why shouldn’t you be able to? Sounds like I would have hated it at that program

 

[Happyfeet1234567890]

Thanks everyone for the replies! Very informative!

 

[Scope guy]

something that happens with competitive fellowships: applicants from big programs almost always match somewhere. The best applicants go to the big programs but even mediocre applicants match in mid tier programs which amazes me. Sort of match is related to where you are doing residency.

So try to go to the biggest IM program you can go to. LORs from there, few case reports, abstracts, can get you cards somewhere

 

[Dr27th]

This isn’t great advice.

I filtered the applications for our academic cardiology program over the last three years. This season, we had 554 applicants for five places. We only interviewed 60 people.

Here is what I do:
1. I look to see if the USMLEs were passed on the first attempt. It has little to do with how well someone will do in cardiology fellowship, but most programs are going to feel nervous about their statistics for fellows meeting board certification if there was an academic issue in medical school.

2. I next go to the scholarly activity section. Original research is far more meaningful than case reports or review articles. Same thing for first author publications. You’re in a medicine residency to become a great physician, not a researcher. We get that. BUT you absolutely MUST show something in the section. Believe it or not, there is a COCATS1 requirement in research for ACGME-accredited cardiology programs for an applicant to meet board eligibility. We won’t mess with the ACGME, and most of us are entirely too busy to police cardiology fellows who think they can get away with not satisfying this requirement. Most programs will expect 5 to 9 months of research (loosely defined). My own program has accepted cardiology fellows in the past who thought they could get away with avoiding research by trying to get level 2 in several areas instead, and it was an absolute nightmare to have to police. So, showing something on your ERAS application...anything is critical. If it is blank, you’re going to stand out as an outlier. We have interviewed some of our own medicine residents who showed nothing in that area, but I promise you this was out of courtesy and they were not ranked anywhere near the matchable range. There are just too many highly qualified applicants who (even if they are only playing the game) realize that believing they are entitled or special is not a desirable trait for a cardiology fellow. Those are the people that match. I’ve even had one or two people do a research rotation with me but blow it off. I still wrote them a warm letter of recommendation anyaway, but usually only if I’ve worked with them clinically. Guess what? They didn’t match anywhere.

** A special note about the comment regarding the lack of research not being a problem for community programs: we have a couple of those in our region, and guess what they use to select their applicants? Research. Residents and fellows who can do research give community programs a certain amount of prestige, and the more visibility they can get, the more patient referrals they get. You’re going to be judged by the same standard and they’re not going to look at you unless you check the research box.

3. What does the IM program director say? We all know that letters of recommendation pretty much are going to come from people who will say favorable things, so they have not as much impact. A medicine program director tends to be very straightforward. I will also add that it’s extremely obvious if the letter is written by somebody that doesn’t know you, or they are too busy to take their job as a letter writer seriously (usually write one or two paragraphs, often there are typos, and sometimes they even use the wrong name for the applicant). The best letters are two pages or more and really go on about how good the applicant is. Make sure this is somebody who really knows you.

4. Caliber of the residency program. This is important. If you think you want to do cardiology, do yourself a favor and try to match into the most competitive IM program you can. Again, I have seen a certain amount of entitlement from one or two of our local medical students who stayed at this institution for residency, and then thought that they were entitled to stay here for cardiology fellowship. IM residents who worked hard and checked all the boxes (including research) were fine. Those that didn’t were ranked nowhere close to the matchable range.

When at the interview, I really don’t look at the application again. I just want to see if this is somebody who’s going to be a good match. If there is any hint that the applicant is anything less than hard-working, or if there is any hint that the applicant might not play well in the sand box, they are not ranked in the matchable range.

Lastly, cardiology really isn’t that difficult. It’s only one organ system…. But that doesn’t mean you don’t have to play the game to get there.

I hope that helps.

Is there a filter that screens for where an applicant did residency? E.g by region and prestige? Or is it once the applicant passes the initial screens of visa requirement, steps on first attempt, that you open their application individually and check for what proram they’re coming from?
Do you have a minimum requirement for step scores? How relevant is each step and value of scores for each step?

 

[Scottish Chap]

Is there a filter that screens for where an applicant did residency? E.g by region and prestige? Or is it once the applicant passes the initial screens of visa requirement, steps on first attempt, that you open their application individually and check for what proram they’re coming from?
Do you have a minimum requirement for step scores? How relevant is each step and value of scores for each step?

No “filter” but it’s one of the first things we see when we open the file. You need to open the file to see anything. We had over 550 applications last year, so it’s a tremendous amount of work.

 

[Dr27th]

No “filter” but it’s one of the first things we see when we open the file. You need to open the file to see anything. We had over 550 applications last year, so it’s a tremendous amount of work.

Thanks.. although this doesn’t really answer any of my questions. Haha

 

[MyTachyBradyHeart]

Thanks.. although this doesn’t really answer any of my questions. Haha

Generally, the "filter" is a certain step 1 score (+ passing it on the first attempt), followed by residency/research/no obvious red flags in medical school (i.e. failing a course, etc). Different institutions of course will have different "filters" and "cutoffs", although this is fluid. Also, even a rejection doesn't always mean a rejection. For example, I got a big-fat rejection from an institution I was surprised to not even get an interview invite... then 1 email later, an interview invitation was offered right away...