Extra year CHIP fellowships in my opinion is silly. STEMI's are all CHIP. To dedicate a year is just a plain waste of time.
Yes, there are CTO techniques, complex LM and stuff. It should all be incorporated into your 1 year fellowship. People will say 1 year is not enough to gain enough experience. It is not now anymore, because of these stupid advanced training (i.e. CHIP, structural) that devalues the 1 year IC training.
I am a strong advocate that if a program is efficient, and does not scut a fellow out, and have operators that are trained in CTO and structural, and have the volume, 1 year is plenty of time for structural, CTO, peripherals and CHIP.
To be in a IC fellowship and when you do a diagnostic, and it turns out to be a "CHIP" case, and you step aside for the CHIP fellow, it is a complete waste of your time and effort as a IC fellow. It clearly devalues the ACGME IC fellows experience, and I feel ACGME should really crack down on this.