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Hi all! Can't seem to find a thread for this years ACTA yet. Thought we could share our experiences.
Anyone here applying?
Is it normal for some programs to not answer emails? Bad sign?
 

drsamzie

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Things normally slow down around this time due to the holidays and New Year. It's a typical pattern to see invites pick up early to mid January. Not sure how it will change as programs are doing Zoom/Skype interviews but I don't predict it will be too different.
 
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EYY

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Applying this cycle as well. Hope it all goes well! 😊
 
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Nivens

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A piece of unsolicited advice: try and ignore the “prestige” labels when selecting programs. All that glitters isn’t gold. Make this year count and don’t overthink it: you need a good volume of a wide breadth of cases. Bonus points if it’s in the region you want to end up. Everything else is gravy.
 
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Are a lot of people in y'all's residency applying hearts this year? The few in my class who were leaning more towards it ended up switching gears to pain.
 
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Applied a few days after app opening. So far three interview invites
Are a lot of people in y'all's residency applying hearts this year? The few in my class who were leaning more towards it ended up switching gears to pain.
started out with three now down to me haha. one is team private practice and one is doing regional.
 
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Are a lot of people in y'all's residency applying hearts this year? The few in my class who were leaning more towards it ended up switching gears to pain.

Job market wasn't so great last year and who knows with covid
 

Drangue

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Is OHSU not participating in the match this year? I don't seem them in the the SFmatch and I don't see any updates on their website.
 
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Hork Bajir

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While I understand the motivation for programs to fill internally, especially in 2020 (risk mitigation), it’s kind of lousy to not even consider any outside candidates
 
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A piece of unsolicited advice: try and ignore the “prestige” labels when selecting programs. All that glitters isn’t gold. Make this year count and don’t overthink it: you need a good volume of a wide breadth of cases. Bonus points if it’s in the region you want to end up. Everything else is gravy.

What are some of the well rounded programs out there?
 
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Nivens

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What are some of the well rounded programs out there?

Hard for me to say- I only know other places by reputation, which sort of reinforces my point. The rough “ranking” of programs that exists in these threads is largely based on history and hearsay. If I could do it again, I would make sure to ask the fellows specifically about the number of pump cases per week and how it breaks down into bread and butter vs more complex referral-center stuff, as well as solo vs supervised. You need at least 2 cases a day, give or take, with a good mix of complexity and solo/supervising. Programs that don’t have the volume or complexity are going to blow smoke about other stuff (cath lab, ep, echo specific education, etc etc), but without a solid backbone of core cases, you’re wasting your time.
 
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drsamzie

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What are some of the well rounded programs out there?
Not going to name places specifically, but my take on an effective program:
-Doing mostly your own cases (Like 85-99% your own, not the pop-in-do some TEE imaging-and-leave supervisory fellowships)
-Highly complex as well as bread and butter cases (Even if you do PP community anesthesia, you'll be glad you did a handful of DHCA cases in the rare event you need to go that direction)
-Transplant and mechanical support
-A mix of cath lab and structural heart
-TEE teaching is a focus and not an afterthought
-Faculty that is supportive (might be hard to figure out during interviews, so get candid feedback from current fellows)
-A program that ensures their fellows are protected from doing general cases that need coverage - it happens out there
 
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Hard for me to say- I only know other places by reputation, which sort of reinforces my point. The rough “ranking” of programs that exists in these threads is largely based on history and hearsay. If I could do it again, I would make sure to ask the fellows specifically about the number of pump cases per week and how it breaks down into bread and butter vs more complex referral-center stuff, as well as solo vs supervised. You need at least 2 cases a day, give or take, with a good mix of complexity and solo/supervising. Programs that don’t have the volume or complexity are going to blow smoke about other stuff (cath lab, ep, echo specific education, etc etc), but without a solid backbone of core cases, you’re wasting your time.

And doesn't farm out your procedures to srnas like a certain boston hospital
 
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Can we give examples of the good ones, even if we don’t list the nit so good ones, so it can guide us in our choices as interviews are virtual this year so not much information can be gotten.

Not going to name places specifically, but my take on an effective program:
-Doing mostly your own cases (Like 85-99% your own, not the pop-in-do some TEE imaging-and-leave supervisory fellowships)
-Highly complex as well as bread and butter cases (Even if you do PP community anesthesia, you'll be glad you did a handful of DHCA cases in the rare event you need to go that direction)
-Transplant and mechanical support
-A mix of cath lab and structural heart
-TEE teaching is a focus and not an afterthought
-Faculty that is supportive (might be hard to figure out during interviews, so get candid feedback from current fellows)
-A program that ensures their fellows are protected from doing general cases that need coverage - it happens out there
 
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Guillemot

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I have toyed with the idea of going back to fellowship from PP. CT was always fun in residency, but it has been a long time since I've done cardiac. I feel like I'd be really behind. Would they want to see someone like that get testamur status or something as a reassurance?

I probably wont ever pursue this avenue, but anyone with insight just humor me.
 

vector2

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I have toyed with the idea of going back to fellowship from PP. CT was always fun in residency, but it has been a long time since I've done cardiac. I feel like I'd be really behind. Would they want to see someone like that get testamur status or something as a reassurance?

I probably wont ever pursue this avenue, but anyone with insight just humor me.
No, you do not need to get testamur to be a serious applicant. @pgg went back for CT after being out for awhile so he can tell you what he did regarding letters of rec and such
 
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pgg

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I have toyed with the idea of going back to fellowship from PP. CT was always fun in residency, but it has been a long time since I've done cardiac. I feel like I'd be really behind. Would they want to see someone like that get testamur status or something as a reassurance?

I probably wont ever pursue this avenue, but anyone with insight just humor me.
No, you do not need to get testamur to be a serious applicant. @pgg went back for CT after being out for awhile so he can tell you what he did regarding letters of rec and such

I went back for CT fellowship 7 years after finishing residency. I did exactly no hearts in those 7 years, and had barely touched a TEE probe. I did feel behind when I started, compared to my fellowship classmates who were straight out of residency, who had all done a bunch of hearts in the previous year. I definitely was not as smooth with TEE, getting people off bypass, etc. But it worked out fine.

The program assumed we all were completely ignorant about TEE and started with the basics. Our PD explicitly told me that since the program takes people from lots of residency programs, with extremely variable TEE curricula, that they don't assume any baseline level of competence. Honestly, there's such a huge gulf between a graduating resident who's "good" with TEE and the level of skill expected of an ACTA grad, that small gaps between the new fellows' TEE knowledge are just noise.

There are some advantages to going back to fellowship late. Experience and comfort practicing independently is worth something. You're already board certified, so while your co-fellows have to devote time and energy to oral board study and practice, you don't.

I can see the pay cut being a big dissuading issue for people. I went to fellowship funded by my employer (the USN) so I took no pay cut, and kept accruing benefits like vacation time and pension credit. Win all around.

LORs were easy enough - my old PD wrote one for me. I was the assistant PD / ed coordinator for a residency program at the time, and the PD was a cardiac guy who wrote one for me too. We'd spent ~7 months together deployed to a trauma center in Afghanistan a few years before I applied.

When interviewing, every program asked me how I'd handle going back to being in a subordinate role with an attending telling me what to do. I thought it was an easy question. I think anyone who's ever practiced independently and been bottom-line responsible for taking care of sick and complex patients, who isn't a narcissistic fool, ought to be glad to have a smart, qualified, experienced person around to offer guidance and backup. But I guess they get some fools who walk in thinking they're too good to be taught anything, else they wouldn't ask.

And of course, there's the (unspoken) obvious mundane truth that they had something I wanted: a new skill set from their cardiac case load and teaching, and a certificate that was going to open lots of doors and make me eligible for echo board certification. I would have put up with a lot more than the occasional attending ego or power game to get those things. Every one of us has eaten crap and tolerated abuse and delayed gratification to get into training, and through it. How would I handle being a trainee again? Like an adult, how else?

I did have a handful of altercations with surgeons, however, that in retrospect I should have avoided as a trainee. :) It's hard to listen to bull**** though and just smile and nod, after years of not feeling obligated to indulge such bull****. A couple of similar encounters with OR staff that again, I should have just let go. Oh well. In retrospect, even those are basically happy memories.

I'm glad I went back and did it. I'm now a few years out of fellowship, still love doing hearts. Love the cases, the sick patients, the small teams ... even the cardiac surgeons. Well, almost all of them. And I wouldn't be doing hearts at all, if I hadn't spent that year as a fellow.
 
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Can we give examples of the good ones, even if we don’t list the nit so good ones, so it can guide us in our choices as interviews are virtual this year so not much information can be gotten.
Read ACTA fellowship threads from prior years. There is a lot of information on those threads. I went through the cycle last year, and I chimed in too when programs were fresh in my head. Take whatever I wrote with a grain of salt though. I ended up at a program I was very happy to match at based on my virtual interview day experience, but maybe all I saw on my interview day was glitters... I am still very excited to start the fellowship... only time will tell... :shrug:
 
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EYY

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Well, I hope that my application is just at the bottom of the pile since I submitted in mid December....

One can hope.
I’m sure! I submitted in November. I think it’s still too early.
 
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Hi Everyone- new member here applying this cycle. I applied right around Thanksgiving and so far have heard back from Sinai, Cornell, CC, BIDMC and Emory so far. Appreciate the updates from everyone and good luck!
 
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EYY

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Michigan and THI also sent invites
 
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T-burglar

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What are some of the well rounded programs out there?
Anything accredited should be fine . There is years and years of material and mastery remaining even after you graduate, so in terms of your clinical ability , where you train matters way less than your commitment to continuously learn and improve and question whether you know something as well as you think.

If you want something specific like a position at a major research institution then perhaps where you do fellowship will matter a bit more
 

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