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AequaMD

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For those interested in interventional, what are the actual numbers for diagnostic, PCI and complex interventions (talking to fellows etc.) at the programs you visited?

I'll start with UCSD.
Diagnostic (PGY 4-6): ~300
PCI (PGY 7): ~300-350
Complex (PGY 8): there is a dedicated year of interventional for those interested

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For those interested in interventional, what are the actual numbers for diagnostic, PCI and complex interventions (talking to fellows etc.) at the programs you visited?

I'll start with UCSD.
Diagnostic (PGY 4-6): ~300
PCI (PGY 7): ~300-350
Complex (PGY 8): there is a dedicated year of interventional for those interested

Didn't bother with counting diagnostic but over 1000 from pgy 4-7
Pci pgy 6&7: 560
Didn't count complex pci separately, but no advanced fellow to compete with
Peripheral interventions: 60 (could have done more but didn't have strong interest)
Tavr: 90 as primary operator
Watchman: 30
Clip: 17 (we started half way through the year)
Pfo/asd: 25
Cooper
 
This is a small specialty and I’d rather not post publicly for the sake of maintaining anonymity, but happy to answer questions via PM
 
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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.
 
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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.

CTO is also something you can learn and get proctored after finishing fellowship... not necessary to learn everything in one year. Plus it’s such a specific field and a niche that in truth, when you’re in practice, the vast majority of IC docs won’t do them. It is helpful to see these procedures and have exposure to the techniques used etc as it gets you familiar with catheters, wires, etc. To be honest, I will feel comfortable with these things as an IC fellow because of how complex the stuff we do at our program is, but I won’t come out trained independently as a CTO operator. And in practice I will probably still refer them unless I end up in a job where I can have the luxury of a low reimbursement, long hours, high risk intervention.

Otherwise I generally agree with you. CHIP training years are yet another nonsensical way to lengthen our fellowship training time and dilute out quality of training.
 
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