Cardiology program impressions 2019

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blackhat2

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Hi all,

I saw a thread from a few years ago where people posted their program impressions after going on the interview trail, and thought it'd be a good idea to resurrect it for the 2019-2010 application season. I interviewed fairly broadly so can speak to a number of places, starting with below and will add more further down the thread. Obvious caveat is that these are my subjective impressions and heavily subject to bias!

Northwestern
Pros:
  • High clinical volume
  • Strong clinical + basic research, note they have some in-built databases that the fellows can access to pursue outcomes research (this is more specific for me but is relevant to others who have this interest)
  • Frontloaded schedule--busy first year but lots of flex time later
  • PD is a new young guy who trained at NW but seems supportive and excited to grow the program (I think this is his first year)
  • Faculty very friendly/approachable, which is the whole vibe of the program
  • Nice facilities
Cons:
  • Very private practice focused population so may miss diveristy
  • Located in a nicer part of Chicago (on Michigan Ave)-->expensive to live nearby and if you’re into urban diversity may be a downside for you
  • Aggressively expanding their research department, and I got the sense there’s some pressure on the fellows to go into academics
  • Didn’t see a lot of female leaders in the department
  • “Prestige”--Northwestern has a big name but perhaps not quite as much the heavyweight as MGH/UCSF/Hopkins/etc...
  • Almost all their fellows last year came from Northwestern--apparently this was a fluke of having a lot of chiefs + short-trackers applying that year but something to note

BIDMC
Pros:
  • Very strong outcomes research infrastructure with the Smith Center
  • The Division Chief (though he's relatively new) and other higher up faculty seem very invested in the fellows/program
  • Whole division has a medium-sized feel so got a strong sense of camaraderie among the faculty, though I didn't have a chance to talk to many of the felows
  • Very supportive of flex time/electives/research in fellowship, though first year is very frontloaded.
  • Seems to have more clinical volume than the other Boston programs esp their CCU, though they don't have heart transplant yet (maybe next few years as some hospital mergers are happening)
  • I got the sense that this program is growing/upward trajectory (also building new tower)
  • Fairly strong IM residency (though weaker compared to BWH/MGH)
  • EP seems strong here
  • Supportive of women in cardiology
  • Harvard affilitation
  • You do some rotations at BWH/other Boston places
Cons:
  • Extremely frontloaded-no research elective time at all the first year which could be an issue for some
  • No VA or county hospital
  • Had a hard time getting of sense of what the fellows are like--can confirm that they work hard but they seem a little awkward around each other/the faculty
  • Surrounded by the other Harvard-affiliated programs--I liked this program more than BWH/MGH but the prestige factor still favors those two.
  • Boston overall is pretty inbred, most fellows come from Boston and stay there after so not sure how easy it is to leave here after training


Brigham Women’s Hospital
Pros:
  • The PD Donna Polk is very approachable and really seems to go to bat for the fellows.
  • Nice, modern facilities
  • Very basic science heavy, but you have access to research at other Boston institutions
  • Fellows seemed pretty friendly/happy
  • Support for women in the program
  • Higher leadership seem invested in the program--they had a strong turnout on interview day which made an impression on me. Though they could be making up for their rep of not filling in past years (apparently in years past their interview days were much more intense/research focused which put some people off)
  • Strong affiliated IM residency
  • Harvard affiliation
  • VA affiliation
  • They have a new program to support the transition from fellow to faculty if that matters to you (but brand new so who knows how it'll work out)
Cons:
  • Limited clinical experience--they really tried to highlight what they do do during the presentation but limited TEE, not sure about COCATS leveling. Either way this is not the place for you if you want to do PP--I couldn't find any fellows who switched to PP though I'm sure they're out there.
  • What actually happens if transition to faculty? They are trying to increase support for this, but the rumors about hordes of underpaid 'clinical instructors' in Boston are still going around
  • Not sure about the strength of their clinical research programs
  • De facto 4 years (I'm sure you could escape this if you tried but seemed to be expected)



MGH
Pros:
  • Famous name--likely carries some weight on your CV if you remain in academics
  • Strong clinical + basic science research
  • The fellows had a lot of camaraderie amongst themselves and with the faculty, which was a nice surprise as I wasn't expecting this from the Harvard affiliated programs
  • Very strong IM residency
  • The PD seemed approachable and invested in the program, same with upper leadership though less so than BIDMC or BWH
  • The fellows do some rotations at BWH and vice versa
Cons:
  • Still limited clinical work--TEE is still not a thing here for fellows which I found a little disturbing. Not sure about the volumes but seems weaker than the other Boston programs.
  • Vast majority of fellows are pursuing traditional academics, but it's not clear what happens if they switch to clinician-educator tracks (one of the fellows is pursuing medical education but he's definitely an exception to the rule) or how well they support the transition to faculty (again rumors about how tough this is in Boston)
  • Older facilities
  • Overall I wouldn't consider this fellowship on par with the residency



More pending. Appreciate others' input with their own interview impressions--can add to the my ones and/or add your own. This thread will be the most helpful if more people contribute!

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At most of the Harvard programs you can get COCATS 2 in one thing. They want you to work in a lab and do research for your career even if you subspecialize. Just to make that clear. They are not very supportive of going into private practice or clinical career. And yes expect to do 4-5 years.

If you’re absolutely sure you want your future job to be heavily research based then MGH and BWH are prob good bets. Otherwise you’re better off at a Texas Heart or Cleveland Clinic or Columbia or something of that nature if you give a **** about prestige but want good clinical volume. I’ve seen more than one fellow express regret because they decided to go for the “name” and realized that coming out into PP most people don’t care how many papers you published.

That being said you’re worried that NW is not as “prestigious” as the Harvard programs... to which I say that’s a first world problem of the tallest order and on par with saying “I have a Yale, Harvard, and Columbia acceptance, but really, how bad would it look if my diploma didn’t say Hahhhvuhd on it”
 
At most of the Harvard programs you can get COCATS 2 in one thing. They want you to work in a lab and do research for your career even if you subspecialize. Just to make that clear. They are not very supportive of going into private practice or clinical career. And yes expect to do 4-5 years.

If you’re absolutely sure you want your future job to be heavily research based then MGH and BWH are prob good bets. Otherwise you’re better off at a Texas Heart or Cleveland Clinic or Columbia or something of that nature if you give a **** about prestige but want good clinical volume. I’ve seen more than one fellow express regret because they decided to go for the “name” and realized that coming out into PP most people don’t care how many papers you published.

That being said you’re worried that NW is not as “prestigious” as the Harvard programs... to which I say that’s a first world problem of the tallest order and on par with saying “I have a Yale, Harvard, and Columbia acceptance, but really, how bad would it look if my diploma didn’t say Hahhhvuhd on it”

To add on this, our graduating fellows are looking for jobs. Two fellows have signed on for 400k+ jobs in PP in our 1 million+ city. Two others want to do academics, but now having to see what academics looks like (no protected research time x3 years, mostly clinical work, can buy down clinical time after 3 years, salary ~175k on the East Coast), they are having second thoughts. One is a true believer, so I think they will end up in academics, but the other has a family to help support and trading >200k is putting things into perspective.

When I was looking at programs, there were a few things I wanted. A good advanced heart failure program (lots of sick hearts, lots of imaging/procedures/referrals), and lots of elective time to get as much COCATS 2 certifications as possible. Research is worthless to me; this isn't undergrad or even residency, no one has to play the game anymore. 99% of it is garbage and people stake their careers on finding useless, clinically meaningless, prognosticators or useless echo findings that no one does in real life because of difficulty or variability.
 
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