MD Cardiology Fellowship

[Dino007]

Hey guys, so I'm starting medical school next January at St.George's and I'm almost 80% sure I want to be a cardiologist. I had a few questions regarding cardiology fellowships as I'm trying to get a better visual of how my life is going to look like the next 10 years or so lol ....

1- Do fellowship programs look at the medical school you came from even though at that point you should be done with 3 yrs of residency (asking because I'm going to a Caribbean school). If not, what makes you a good candidate for fellowship programs?
2-Are all cardiology fellowship programs 3 years long?
3- I know the pay in internal medicine residency is about 45-50K, so how much more does a fellow make?

Thanks in advance guys..

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[Tenk]

1: it is most certainly a factor but far less important than what residency you are from, board scores, research and connections. Keep in mind that your medical school will also influence all the things I mentioned above meaning you will have an incredible uphill battle coming from the Caribbean.

2: most are three. Some are even four. I think there are some integrated IM/cards that shave off a year.

3: varies on where you work. Can be 1.5x residency pay or even more than 2x.

 

[LebronManning]

1. At least you're going to the one school in the Carib that is reputable. Work hard there and get into an academic IM program, then you'll be able to get a Cards fellowship if you want it.
2. Yes, anyone you would want is 3.
3. Pay in big cities is closer to 60-80k, but yeah you get paid more as a cardiology fellow just because you're another year out of med school. Usually hospitals or academic systems pay a sliding scale increasing every PGY year. It's the same for any residency, so 4th year neurosurgery resident will make as 1st year cards fellow because both would be PGY-4

 

[GoSpursGo]

Mostly agree with above.

1) Name of your residency will be more important, as will board scores, though again those may be dependent on your medical school name. In addition to those factors, you will NEED to do research in residency to have a decent chance to match cardiology, so it's important for you to match to a residency that can support that.
2) Agree, mostly 3.
3) I think your number is a little outdated, more likely in the 50-55k range at a minimum and I've been more in the 55-65k range. In general fellows are paid on the same scale as residents--you're still considered "house staff," and you get a small bump for each PGY. So a PGY-4 fellow makes a few thousand more than a PGY-1 intern. That said, oftentimes the biggest difference is that as a fellow you can moonlight, and THAT may allow you to pull in ~20-30k extra per year.

 

[mrbreakfast]

Just some notes:

-As others said, your salary as a fellow is on the same sliding scale as every resident. As med students we were told things like "fellows make six figures", but I have yet to actually see a fellowship offering that. At my institution a PGY-6 senior cardiology fellow would make a little more than 20% more than an intern. You can make a week's salary in a day with moonlighting, but I'm not sure how much time a cardiology fellow would have to moonlight.

-The best thing you can do to become a cardiologist right now is to study your butt off so you can get into a decent residency, something that is absolutely not guaranteed to Caribbean students.

 

[Dino007]

Thanks for all these informative replies guys. I noticed a couple of comments made about Caribbean students trying to find a decent residency. I've applied to other U.S medical schools as well but since we are still in the beginning of the application cycle, I still haven't heard back yet. However, my grades and extracurricular activities aren't that great. That being said, the only reasonable U.S option I might possibly have is a D.O school. (and probably a D.O school that isn't too good either.) So I feel that going straight to a St.George's, which is an MD school, in January 2020 would be better than having to wait until an indecent D.O school accepts me, and I would have to start August 2020.
-Do you guys think I should just wait, or just go to St.George's in January? (keeping in mind that I want to do internal medicine and a cardiology fellowship)?
-Also, do you guys often see doctors coming from the Caribbean that go on to do fellowships after residency? If so, is that common?

 

[Dwan]

Thanks for all these informative replies guys. I noticed a couple of comments made about Caribbean students trying to find a decent residency. I've applied to other U.S medical schools as well but since we are still in the beginning of the application cycle, I still haven't heard back yet. However, my grades and extracurricular activities aren't that great. That being said, the only reasonable U.S option I might possibly have is a D.O school. (and probably a D.O school that isn't too good either.) So I feel that going straight to a St.George's, which is an MD school, in January 2020 would be better than having to wait until an indecent D.O school accepts me, and I would have to start August 2020.
-Do you guys think I should just wait, or just go to St.George's in January? (keeping in mind that I want to do internal medicine and a cardiology fellowship)?
-Also, do you guys often see doctors coming from the Caribbean that go on to do fellowships after residency? If so, is that common?

DO school will make it a lot easier to get into a decent academic residency program that can match into competitive fellowships, particularly those in less desirable locations. The prestige of the DO school doesn't matter much as they are all viewed the same to good residency programs, although the curriculum differences may be significant. While it's possible to get into Cardiology from a Caribbean school, it's hard to ensure that you'd be a top student (you'd want board scores equivalent to top MDs to get into a decent IM program). Also, while you think you are likely interested in Cardiology, the chances your interests change are quite high. I'm in IM residency already and even at this stage, many change their original interests.

 

[studentdocftw]

1. Probably, but they care more about where you completed your IM training...so if you are St. George's, kill the boards and stand out from the rest of your class to match at the best IM program you can. Good candidate for fellowship has great IM residency performance, solid LORs, good research output and checking the boxes (good board scores, clinical performance, etc.)
2. From my understanding, yes. 3 years for general cards..4 years for interventional..5 years for EP.
3. Not much more. Probably in the 60 to 70s...at least that's what a cursory google search showed.

Also remember to keep your mind open...you are just starting medical school. Consider all of medicine and start narrowing your options during your 3rd year. Caveat is if you settle on a very competitive specialty..then you want to get started early..especially coming from the Caribbean.

 

[mrbreakfast]

Do you guys think I should just wait, or just go to St.George's in January? (keeping in mind that I want to do internal medicine and a cardiology fellowship)?

It probably doesn't matter too much, thought for IM in particular, a Caribbean (do these count as US-IMG?) MD is probably slightly more desirable than a DO. This is hotly discussed on SDN, but the fact remains that having "DO" after your name closes a few doors in academics.

Here's the take-home message: the (major) issue with Caribbean/DO programs isn't that the programs are bad, but rather that they accept students who shouldn't be in med school. If you are indeed a student who belongs in med school and who was overlooked by the admissions process, you'll be fine. I have met very skilled residents/attendings who went to the Caribbean. There were attendings at my med school who did their med school on some tiny island and ended up doing fellowships at huge names. But understand that you are going to a place where, for multiple reasons, few emerge with the academic residency spot you will likely need.

This isn't to scare you. It's to keep you off the beach and focused.

 

[LebronManning]

DO school will make it a lot easier to get into a decent academic residency program that can match into competitive fellowships, particularly those in less desirable locations. The prestige of the DO school doesn't matter much as they are all viewed the same to good residency programs, although the curriculum differences may be significant. While it's possible to get into Cardiology from a Caribbean school, it's hard to ensure that you'd be a top student (you'd want board scores equivalent to top MDs to get into a decent IM program). Also, while you think you are likely interested in Cardiology, the chances your interests change are quite high. I'm in IM residency already and even at this stage, many change their original interests.

St. George's has actually done better in the match than many DO schools from what I've heard.

And generally the one place where MD (even carib) holds weight over DO is IM subspecialties especially. Lots of anti-DO stigma in Cards but not really IMG considering it seems like half of Cardiologists are foreign born.

 

[Dwan]

St. George's has actually done better in the match than many DO schools from what I've heard.

And generally the one place where MD (even carib) holds weight over DO is IM subspecialties especially. Lots of anti-DO stigma in Cards but not really IMG considering it seems like half of Cardiologists are foreign born.

IMGs perform better than DOs in terms of being able to get into the very top tier IM programs with a stellar app. There are no Carrib-IMGs at any of these, which is a key distinction.

 

[PhillyMed777]

One interesting thing I will add is that the sliding scale for pgy training pay does always increase yearly at a given institution, but isnt standardized across them. It is possible to make less as a pgy4 cards fellow than a pgy3 resident depending on where you move and where you came from.

Agree with lots of the above advice. I'm assuming there are reasons that put u in the carribean. Fix that from here on out to obtain the best results. You won't be on even ground but can't expect to be. Make every day count. Compete hard.

 

[Coltuna]

St. George's has actually done better in the match than many DO schools from what I've heard.

And generally the one place where MD (even carib) holds weight over DO is IM subspecialties especially. Lots of anti-DO stigma in Cards but not really IMG considering it seems like half of Cardiologists are foreign born.

I've actually heard that after IM residency, no one really cares about the initials behind your name. The reason there is a "bias" against DO students in fellowships is because the average DO student doesn't match into the same caliber of IM residency that an average MD student does.

 

[PhillyMed777]

dc

I've actually heard that after IM residency, no one really cares about the initials behind your name. The reason there is a "bias" against DO students in fellowships is because the average DO student doesn't match into the same caliber of IM residency that an average MD student does.

You cannot blanket statement anything.
Of course there are some cardiologists who dont like DOs just baseline. Ive met one. I do agree that residency caliber does play a larger role. Anyways, this does not apply to OP.

 

[LebronManning]

IMGs perform better than DOs in terms of being able to get into the very top tier IM programs with a stellar app. There are no Carrib-IMGs at any of these, which is a key distinction.

There are very few but your point is generally true. Someone from SGU matched at Mt. Sinai (main campus) a few years ago

 

[Dino007]

IMGs perform better than DOs in terms of being able to get into the very top tier IM programs with a stellar app. There are no Carrib-IMGs at any of these, which is a key distinction.

Do you mean that the IMGs that get the better IM programs are not from the carib, but from other countries in general?

 

[cptsam]

It probably doesn't matter too much, thought for IM in particular, a Caribbean (do these count as US-IMG?) MD is probably slightly more desirable than a DO. This is hotly discussed on SDN, but the fact remains that having "DO" after your name closes a few doors in academics.

I thought that DO>>>>Caribbean in almost all categories. At least, that’s what the general consensus is based on what I’ve read around here.

 

[mrbreakfast]

I thought that DO>>>>Caribbean in almost all categories. At least, that’s what the general consensus is based on what I’ve read around here.

From an academic residency perspective, I think they're pretty much equivalent. I will say at the three institutions I've been at I have met exactly zero DO fellows/attendings, and I have heard many grumblings from DOs here that they are blackballed by certain academic programs; there's a thread that talks about this topic on the first page of this sub-forum.

I think the DO>Caribbean view is derived from there being more "decent" DO programs than Caribbean programs, which matters for educational purposes. You'll have to ask actual DOs/Caribbean grads though.

 

[Dwan]

Do you mean that the IMGs that get the better IM programs are not from the carib, but from other countries in general?

Yeah, they were always top students unlike Carrib-IMGs.

 

[Dwan]

From an academic residency perspective, I think they're pretty much equivalent. I will say at the three institutions I've been at I have met exactly zero DO fellows/attendings, and I have heard many grumblings from DOs here that they are blackballed by certain academic programs; there's a thread that talks about this topic on the first page of this sub-forum.

I think the DO>Caribbean view is derived from there being more "decent" DO programs than Caribbean programs, which matters for educational purposes. You'll have to ask actual DOs/Caribbean grads though.

DOs have gotten into a few high ranked IM programs that carribs have never touched, and many solid mid-upper tier institutions that don't take Carribeans. For most of the top 20 though, it's going to be near impossible for both.

 

[cptsam]

DOs have gotten into a few high ranked IM programs that carribs have never touched, and many solid mid-upper tier institutions that don't take Carribeans. For most of the top 20 though, it's going to be near impossible for both.

Isn’t the top 20 extremely difficult to get even if you come from an allopathic school?

 

[Dwan]

Isn’t the top 20 extremely difficult to get even if you come from an allopathic school?

It's easy if from a top school. From a bottom-mid tier it's not uncommon (will see multiple at every decent sized MD allopathic), but you usually need to be a top student. I do believe allo MD is another big jump from DO for IM, as not only do you open up the top 20 wherever you are, but the solid mid tier programs that take top DOs will take mediocre MDs. You don't need a top 20 for cardiology fellowship, though, that's why I think going DO is a strong advantage over the Caribbean. There are very strong non-elite programs such as OHSU (which match really well even into prestigious fellowships) that regularly take DOs but never a Caribbean. A few other examples of great programs that have taken DOs but will never take Carrib-IMGs: U-Washington, Pitt, UCSD, BU, Case western.

 

[Splenda88]

The prevailing sentiment here is that DO >>>>> Caribbean. Everyone enters med school thinking they are going to be the top dog and yet very few of us come out with stellar credentials. You are basically screwed if, for instance, you fail a class or got low step1/2 score coming from SGU. On the other hand, FM/IM/Neurology/Path/Peds are still wide for DO students with these 'issues'.

When you are gambling with $400k, make sure you spread the risk...

 

[PorkChopsOG]

I think the DO>Caribbean view is derived from there being more "decent" DO programs than Caribbean programs, which matters for educational purposes. You'll have to ask actual DOs/Caribbean grads though.

No, not derived just because there are more decent programs (whatever that means). DO>>>>>Caribbean in every regard other than the letters behind the degree. I cannot believe people on SDN are not immediately shooting down the thought of going to a Caribbean school over a DO school. One of the BIGGEST benefits of going DO school is they actually care about their students and want them to match. Caribbean schools actively take in more students than they have clinical spots and cull them throughout the first 2 years to get them down to the appropriate size. All of these schools touting insanely high match rates are messing with their numbers and not including the 2/3 of the class they previously failed or people they didn't allow to take boards because they were a failure risk.

Just the numbers alone speak for themselves. There is a 59% chance to match as a US-IMG and a SOAP success rate of 3%. So let's say you make it through med school with no red flags. You have a 41% chance of NOT MATCHING. You've worked your ass off to have that high of a chance to not match? And if you don't match? 3% chance of successfully SOAPing. DO's have an overall much higher match rate at 84% with a SOAP success rate at 31% and I believe a placement rate in the 90's when you account for the now defunct AOA match. (compared to USMD 94% match and 34% SOAP success rate). The fact is, DO's have a more successful match numbers wise. And at the end of medical school, your goal should be to have a job so you can pay off the multiple hundreds of thousands of dollars in debt you just accumulated.

Are there some programs that don't interview DO's? Sure are. That's the name of the game and that's the caveat with going to a DO school. Don't like it? Should've done better in undergrad. But you still will be a physician in the US.

If your goal is to be a physician in the US, you have a much higher chance to do that at a DO school. The numbers do not lie. If all you care about is the letters behind the name, then you'll be better off at a Caribbean school.

 

[AnatomyGrey12]

Thanks for all these informative replies guys. I noticed a couple of comments made about Caribbean students trying to find a decent residency. I've applied to other U.S medical schools as well but since we are still in the beginning of the application cycle, I still haven't heard back yet. However, my grades and extracurricular activities aren't that great. That being said, the only reasonable U.S option I might possibly have is a D.O school. (and probably a D.O school that isn't too good either.) So I feel that going straight to a St.George's, which is an MD school, in January 2020 would be better than having to wait until an indecent D.O school accepts me, and I would have to start August 2020.
-Do you guys think I should just wait, or just go to St.George's in January? (keeping in mind that I want to do internal medicine and a cardiology fellowship)?
-Also, do you guys often see doctors coming from the Caribbean that go on to do fellowships after residency? If so, is that common?

I would wait for a DO acceptance.

St. George's has actually done better in the match than many DO schools from what I've heard.

Nope.

 

[deleted600623]

What caliber of IM program does one need to match in order to open doors to a Cards fellowship?