cardiology

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hndrx1a

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Haven't really seen cardio mentioned in forum...is it becoming less appealing?Hence, fellowships easier to get into?

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Check some of the past posts -- there's been some discussion about Cards as well as GI, and other IM fellowships to a lesser extent. Cards is still extremely competitive, but if GI hasn't already surpassed it as the most competitive IM fellowship, it soon will. Two reasons: 1. Sheer numbers -- there are something like 650-700 Cards spots and 250-300 GI spots, and 2. Lifestyle -- both have nifty toys and procedures but you won't have to be up in the middle of the night nearly as much with GI as you would with Cards (unless you exclusively do something like EP or Echo -- but again, that would mainly depend on the practice you'd join and how the work was divvied up).

I think another factor is the number of years -- general Cards is 3-4 years after IM (research year) and then EP is another 1-2 (some places let you fold in the first EP year into the final year of general), Intervention is rapidly becoming 2 years at many places, ECHO is one-year, heart-failure/transplant is 1 year at least. All said and done, worst-case you could spend up to 5 years after IM residency doing fellowship. This is kind of ridiculous. Given the fact that other specialties are beginning to cut the number of years needed for training (look at CVTS, Plastics or Vascular where the number of required Gen Surg years is being/has been curtailed), I think (hope) you will soon see the same thing happen in these IM fellowhips that go past two years. If for any other reason, funding pressures will probably be the first impetus.
 
•••quote:•••Originally posted by hndrx1a:
•Haven't really seen cardio mentioned in forum...is it becoming less appealing?Hence, fellowships easier to get into?•••••As Text has stated, this topic has been covered, so you might want to utilize the search feature to glean more wisdom.

Cardiology remains one of the toughest specialties to match in. By the numbers, it is more difficult to get than derm. The same can be said of G.I., which is arguably more difficult, although the difference is somewhat cosmetic at this point in my opinion, as both are exceptionally difficult to obtain.
 
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Klebsiellia,

What the **** are you talking about???? As difficult as Derm? Ok dude. First of all, they can't even be compared since it is a fellowship vs. a hard to obtain residency. Now, last time I checked Cardio was 50% FMG, which means , no, it is not as difficult as DERM, if you could compare the two. Fellowships tend to be handed out to the residents' programs, they tend to take their own. Not to mention that all of the cardio fellows here at my school are Indian. Dont freak the guy out.

TT
 
Thanks for the insight guys...I thought it might be easier to get into because of amount of years fellowship requires- don't think you'd want to commit to that many years...na, touchdown, didn't freak me out, I for one believe Derm is in another league, as far as tough to get into; GI though, will always be tough:"scoping for dollars".
 
Touchdown,

I can and will compare anything I see fit. If you choose to ignore rational and well subtantiated opinions, thats your prerogative I suppose.

Your arguments are as hollow as they are meaningless. Citing FMG participation is a rather crude meter of a specialties' competitiveness. FMG entrance is easily accounted for by a number of reasons. Firstly, there are any number of programs that are filled with only FMG's. Since these programs will fill have the seats with their own, that means plenty of FMG's will get in. Additionally, FMG's in other more competitive programs are very often excellent, and an AMG in the same program is by no means guaranteed a slot. Obviously you have not spent any time at all pondering these things. There are numerous other reasons, like fully published and trained cardiologists in other countries who are admitted to fellowship here.

The fact remains that Cardiology is receiving far more applications per slot than derm. In this sense, it is more competitive.

You might have offered us a far more convincing argument, like derm recieves fewer applications because students select themselves out based on application numbers. But that would have required some real thought and analysis, something your reply is entirely devoid of.
 
hndrx,

You can continue to 'believe' whatever you want. Most of medical student belief is based on hyperbole and fear instilled by other applicants to a field. There is no denying that derm is tough to get into. This is because of the rather slim number of slots. But AMG's do get into it if they really really want it. Those who don't, are often scared away by other horror stories perpetuated by the likes of Mr. Touchdown.
 
Amen Klebsiella.

Furthermore, why is it not valid to compare Derm and Cards because one is a residency and one is a fellowship? They both involve an application process and rely on interviews, LoR, etc. etc.

And to echo Klebsiella, if I understand him/her correctly, why does the fact that FMGs (by the way that term is considered old-school, the new term is IMG) apply to and obtain spots in Cards make Cards less competitive? What you ought to consider is the caliber of the IMG applying to fellowship. Yeah, where I went to med school all the Cards fellows were Indian, but they were also all freakin' amazing clinicians. So what's your point? That's in the context of an overall amazingly competitive group of people who apply to Cards in general. Remember, a good number of the people applying to Cards come from top IM programs, meaning that they probably had the numbers to match into one of the so-called "competitive" residencies out of med school if they had applied/wanted to. So this impacts the applicant pool as well.
 
Klebsiella is right. Cardiology and even more specifically Interventional Cardiology are incredibly difficult to get spots in (~700 for cards and ~70 for interventional). The FMG factor is not comparable to Derm since.....all FMGs applying for Cards must have completed an ACGME certified domestic IM program....without any exception that I can think of. The competition and demand for Cards is so stiff now that word is that they may up the funding for more fellowship spots (ironically after cutting funding a while back). Thats good for aspiring Cardiologists. As for interventional.....I don't know....but either expect to have your nose in many unsavory places....or get religion....cuz you'll need all the help you can get.
 
I have another question, I am a first year at DMU and I am also interested in cards. When the time comes, should I try for a MD residency or DO? Also, I have heard that anyone with a pulse can get an IM residency, but what about the cards fellowship? Do they look at grades and board scores for the fellowship or is it based more on working your a$$ off during residency? Thanks all!
 
IM programs are easy to match in, however the more competitive academic IM programs are not. Generally, to secure fellowships in GI and Cards, one's chances are better if he or she did their training at an academic IM residency program...namely one with an active division of Cardiology, GI, etc. Some academic medicine programs have lost their specialty divisions, thus having to outsource the specialty work to outside group practices. That is not ideal if you are interested in one of those specialties.

I applied for IM, mostly medium sized academic programs with a tentative plan to go into Critical Care or Cardiology. One of the things I noted on my interviews were the relative representation of such specialties and the success applicants had in securing fellowship spots. Subtle things...but most IM programs...that are adequately strong...will not hesitate to show the details of who went where.

Making important connections in your desired field is imperative....so doing a bit of research and getting to know your chairs are worthwhile.
 
I would recommend you try to obtain a medicine slot in an MD program. These are generally of higher quality leading to more opportunities. While there are enough medicine program slots to go around, the very best spots are not as abundant. Your best chances for securing top fellowships are to go to the best program possible. Top scores on your boards will become meaningless once you apply for fellowship. The only thing that will matter is how well you perform in actual clinical setting along with research. Being able to score highly on a multi choice exam is very different from running a Micu competently, and program directors understand this quite well.
 
I touched on this in a post on another thread sometime ago -- the question had to do with going to a middle tier IM program with a "promise" from the PD there that the said applicant would get a GI fellowship there unless some unforseen disaster took place vs. applying to and going to the best IM program you can get into. As touched on previously, IM is easy to match into except for the top tier programs. Bottom line, if you want to do something like Cards (or GI, and soon Allergy/Immunology) in my opinion you should go to the best IM program you can get into. Fellowship PDs want Medicine docs from the places that are known to really train good IM docs. As a general rule, these are the programs acknowledged as the top IM programs. Better IM programs tend to have more well known faculty in subspecialties, and all those guys trained with each other (in a given field) so they know each other. Getting letters from those faculty and doing research with them opens the doors you need opened to get fellowship, bottom line. Reputation breeds the name and the name breeds the contacts to get you into fellowship.

To my knowledge, only allopathic programs will set you up in the way I described. So go to the best MD IM program you can get into.
 
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