Critical Care fellowship with TEE emphasis or CC/ Card combined

[Makis]

Hi guys,

For those of you applying now for a CC fellowship starting in 2010, do you guys know which fellowship offer a strong emphasis on TEE? A lot of fellowships advertise that, but the reality is that is pretty difficult to get your numbers for certification in just 2-3 months of electives. Also, for the people who graduated after 2009, TEE certification can only be obtained via Cardiac fellowship pathway.

http://www.echoboards.org/certification/pte/documents/PTE-FINAL.pdf
On page 10, it clearly states "the practice experience pathway will not be available to those finishing core residency training after June 30, 2009"

My question is should I still go for a fellowship that offers some TEE training or or just do my CC fellowship and do Cardiac later or try to find a combined CC/ cardiac.

Thanks for any comments/ suggestions.

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[bullard]

Yeah, you have to do cardiac fellowship now to get TEE-certified, no way around it. You can still take the test after doing some TEE in a CC fellowship and get "testamur" status, whatever that the f that is, but full certification now requires fellowship.

Which fellowship to do? Depends on your goals/future. Private practice? Both make you more marketable -- I'd argue that cardiac is more marketable since very few anesthesiologists do critical care in private practice, but many do hearts. I have no idea what private practice groups think of "testamurs".

Academics? Either one -- critical care probably more in demand, and certainly a way better lifestyle. The cardiac attendings work pretty hard at my residency, alway getting called in for heart and liver transplants and bringbacks, whereas the critical care guys sleep at home on call because they have the ICU fellow to take phone calls from the CA1s in the unit.

Take this with a grain of salt because I'm doing a cardiac fellowship in 2010. But I thought long and hard about doing critical care. Hope that helps.

Hi guys,

For those of you applying now for a CC fellowship starting in 2010, do you guys know which fellowship offer a strong emphasis on TEE? A lot of fellowships advertise that, but the reality is that is pretty difficult to get your numbers for certification in just 2-3 months of electives. Also, for the people who graduated after 2009, TEE certification can only be obtained via Cardiac fellowship pathway.

http://www.echoboards.org/certification/pte/documents/PTE-FINAL.pdf
On page 10, it clearly states "the practice experience pathway will not be available to those finishing core residency training after June 30, 2009"

My question is should I still go for a fellowship that offers some TEE training or or just do my CC fellowship and do Cardiac later or try to find a combined CC/ cardiac.

Thanks for any comments/ suggestions.

 

[RussianJoo]

there are combined cc/cards fellowships? does anyone know which programs have them?

 

[ProRealDoc]

there are combined cc/cards fellowships? does anyone know which programs have them?

No more. You have to do each individually.

 

[August_Bier]

Why would TEE training obtained during an ICU fellowship not count towards this requirement - has anyone looked into this, e.g. asked the National Board of Echocardiography, Inc.?


On page 10 of


http://www.echoboards.org/certification/pte/documents/PTE-FINAL.pdf


"For applicants finishing their core residency after June 30, 2009, fellowship
training must be obtained in an ACGME accredited fellowship
program."

"A copy of a certificate of successful completion of fellowship training
dedicated to the perioperative care of surgical patients with Cardiovascular
Disease."

 

[RussianJoo]

No more. You have to do each individually.

thanks for the reply.

 

[proman]

The issue will be getting 150 personally performed echos to qualify (plus the 150 reviewed-that should be easy). I know Duke's CCM provides the numbers (according to their info).

 

[bigdan]

The issue will be getting 150 personally performed echos to qualify (plus the 150 reviewed-that should be easy). I know Duke's CCM provides the numbers (according to their info).

...wow. Good call, proman.

http://anesthesiology.duke.edu/wysiwyg/downloads/CCMFellowship7-2009.pdf

 

[sevoflurane]

If you plan on doing serious hearts after residency I would be leary about doing CC + TEE. I would value the experience of providing complete care for lvad, rvad, bivad, heart transplant, pedi hearts, dissections and helping surgeons place catheters via TEE over CC medicine. If you are doing B and B CABG/valves I'd go either way. That's just me.

 

[Makis]

Thanks for your replies, guys.

 

[bubalus]

Here's what you need to remember about TEE "Certification." The National Board of Echocardiography is not a part of the American Board of Medical Specialties, so in my mind, TEE "Certification" doesn't mean near what board certification in anesthesiology does. A testamur is someone who has taken the exam but hasn't submitted the paperwork for "certification." That doesn't mean they don't know what they are doing, and private practice groups are more concerned with what you can do. At least mine is.

If you're concerned about prejudice against a testamur, look up some big names in echo and see what they are. Albert Perrino, author of A Practical Approach to Transesophageal Echocardiography is a testamur. Sidebotham, another author of another widely used book is also a testamur. Glen Gravlee was a testamur for 6 years before becoming certified, but his lapsed 6/30/09 and wasn't renewed, though he may be retaking the next test. I couldn't find an entry for Catherine Otto. Anyone doubt her knowledge of echo?

In addition to giving the TEE boards, the NBE also gives the adult comprehensive boards that some cardiologists take. Want an interesting exercise? Get a list of all the cardiologists who read echoes in your institution and see which of them have taken the ASC, which are diplomates vs testamurs. There are a lot of cardiologists out there reading echoes who have not even testamurs of the ASC exam.

When you decide CC vs CT, think about what you want to do later. If your goal is to do hearts, then do a CT fellowship. You can do your electives in the ICU if you want more ICU experience.