Cardiology.......

Discussion in 'Clinical Rotations' started by MD2b06, Aug 24, 2002.

  1. MD2b06

    MD2b06 Senior Member

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    Ok, I need some help here. I am really, really interested in cardiology, but I also have some concerns. First and foremost, the hours turn me off. Is there anyway to have some semblance of a normal family life as a cardiologist? An interventional cardiologist I shadowed is telling me to go into non-invasive cardiology (says that's pretty much the only way I can work 40 hrs a week in the field). I'm not sure how much this would appeal to me as I prefer procedure oriented specialties, but it's definitely an option. I guess what I'm trying to get at is whether or not it's possible to be an interventional cardiologist and still work normal hours? Perhaps in an academic setting? One other question. Is it true that most academic medical centers lock in their fellowship positions early with their own residents? My good friend is a PGY-2 and says he'll have his cardiology fellowship by the end of this year, which I thought was strange. In other words, should you try to obtain residency at the same institution where you'd like to do your fellowship? Thanks.
     
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  3. Castro Viejo

    Castro Viejo Papa Clot Buster

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    As in much of medicine the hours you work as an interventional cardiologist depends on your practice situation. If you are an interventionalist in a large group practice with a lot of interventionalists, then I doubt you'll be working as hard as a guy in a smaller practice. The thing about being an interventionalist is there are frequent emergencies and when you're on call you can expect to be working at odd hours of the night.

    Common wisdom passed from generation to generation of med students dictates that one should attempt to snag a medicine residency at a place where they offer the desired fellowship. So, yes, you heard right. If you want to be a Harvard-trained cardiologist it's best to get into a Harvard-affiliates medicine residency. That doesn't mean, of course, that all of Harvard's cardiology fellows come from a Harvard-affiliate, but that it would be somewhat easier for you, as a Harvard medicine resident, to make the in-roads and connections necessary to guarantee yourself a fellowship spot.

    The match for fellowships takes place EARLY in your PGY2 year, so your friend, the PGY2, is probably in the process of applying and hopefully he'll match at the end of this calendar year (not the academic year).

    Good luck.
     
  4. droliver

    Moderator Emeritus

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    I would be stunned if there was any interventional cardiologist who could limit their work to 40 hrs/week. Between their clinic hours, their cath lab time, the consults, and the inpatient services many of them work hrs. similar to the busiest surgeons. The same obligations exist for non-interventional ones(minus the cath lab), who I see @ the hospital all night long seeing consults.
     
  5. MD2b06

    MD2b06 Senior Member

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    That's the problem that I'm seeing. All the cardiologists that I know personally, at least half a dozen or so, work crazy hours. I'd say 80 hrs a week easy. They do cross coverage on the weekends though, so at least they get some time off every month. Anyways, the interventional cardiologist I was talking to said that since his practice is a referral based practice, he can't really cut his hours too much, or else he'll lose business. If someone puts in a consult for him, he has no choice but to go see the patient or else he can be virtually assured of never getting another referral from that physician again.

    I still got time to figure all this out I suppose. I'm only a first year. I suppose I won't know for sure what I want to do until till I hit the wards.

    PS: Anyone know if there are any fast track IM/Cards programs out there? Thanks.
     
  6. task

    task Senior Member

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    droliver and the rest are correct. While it's always nice to say that "lifestyle is what you make of it", Interventional Cards is one of those fields where you just can't. First, and foremost, the usual scenario in private practice is that say in a group of 10 or 12 there are 3 or 4 guys who do intervention, while the rest do nothing in the cath lab (non-invasive/non-interventional) or just do diagnostic cath (invasive/non-interventional). You also usually have one or two EP guys in the group (though this will change rapidly given the indications for bi-vent pacing in pt with LVEF<30% -- another screening colonoscopy scenario that's already happening). So if you're one of only three or four who do intervention, you are essentially q3-4 in your practice. Now, given that you do intervention, you probably do proportionately less clinic or taking care of Unit players than your partners do (from a time and equity standpoint) but don't worry, there will be ways to fill the time:laugh:

    I had written something a long time ago about fast tracking in IM. Bottom line -- fast-tracking only works if you can substantiate plans for a academic/research career that means you're spending 2-3 years of fellowship doing research alone, separate from the clinical years. The point is that they'll let you save a year of Medicine because you're spending more time in fellowship than a more "traditional route". Also, the only fellowships I see people fast-tracking into are ones that are traditionally reasearch heavy like ID, Heme-Onc, Endocrine, Renal. These are ones that are not nearly as competitive as ones like GI or Cards. People fast-track into these but it is as rare as hens teeth.

    Hope this helps.
     
  7. MD2b06

    MD2b06 Senior Member

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    I guess fast tracking is out of the question as I have zero interest in research. I hear a lot of interventional programs are now 2 years in length as well. So that means 3 years IM Residency, 3 Years Cardiology Fellowship, 2 years Interventional. Hmm... 8 years is a bit excessive if you ask me. I'd almost rather do interventional radiology, only 6 years of training I believe.
     
  8. southerndoc

    southerndoc life is good
    Physician Moderator Emeritus Lifetime Donor Classifieds Approved

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    Sometimes the road getting there is the better than the destination.

    If you truly love cardiology, then you won't mind the 8 years of training.
     
  9. MD2b06

    MD2b06 Senior Member

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    It's not the 8 years of training that I'm really worried about, although it is somewhat of a factor. It's moreso the inability to have any semblance of a family life that truly disturbs me about interventional cardiology. I kinda felt bad for the cardiologist I shadowed because he has a gorgeous wife and two really awesome kids, but he's never around to see them. If he gets home by 9, he's early. I can see doing that for a year or two, but knowing what I know about myself, I know I couldn't maintain that for over a 20-25 year period. Unless something changes, I'll probably just go with non-invasive cardiology. Fewer hours, less stress, much more time for family and outside interests. :D
     

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