Jan 24, 2021
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Any thoughts on what a "safe" number of interviews is? Sitting at about 10 (majority with >3-4 positions) and wondering should I keep scheduling if I get more? FWIW larger academic program, good scores throughout and letters
 
Jan 3, 2021
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Anyone heard from Columbia or other Boston programs?
Not yet. Waiting on those as well. Based on prior years, looks like MGH has sent out at end of January/early February. BWH may be slightly after that and given their technique of only 1 applicant per day is likely more variable.
 
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EYY

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This past week's been pretty quiet for me. I wonder when's a good time to start sending out letters of interest to programs that haven't heard from yet?
 

joker2400

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This past week's been pretty quiet for me. I wonder when's a good time to start sending out letters of interest to programs that haven't heard from yet?
Same here. Heard from UTSW Saturday, but silence otherwise.
 
Jan 27, 2021
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Hi All,

I'm a dual CCM-ACTA fellow at THI. I created this profile to give a bit of light about the CCM component or dual process (plenty of info about ACTA at THI out there). I used plenty of other people's wisdom while navigating the interview process, and my old residency program had a tradition of answering questions in SDN through a non-personal account. So I decided to pay it forward and give my 2 cents on THI CCM. I think that there are a couple of former THI fellows in this thread, so I expect that they will also add to anything discussed.
 
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Hi All,

I'm a dual CCM-ACTA fellow at THI. I created this profile to give a bit of light about the CCM component or dual process (plenty of info about ACTA at THI out there). I used plenty of other people's wisdom while navigating the interview process, and my old residency program had a tradition of answering questions in SDN through a non-personal account. So I decided to pay it forward and give my 2 cents on THI CCM. I think that there are a couple of former THI fellows in this thread, so I expect that they will also add to anything discussed.
Thanks for doing this? Can you give an insight into the CCM rotations, what ICUs, the faculty manning those ICUs. Thanks.
 

abolt18

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Thanks for doing this? Can you give an insight into the CCM rotations, what ICUs, the faculty manning those ICUs. Thanks.
Why not talk about CCM in a CCM thread?
 
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dchz

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Hi All,

I'm a dual CCM-ACTA fellow at THI. I created this profile to give a bit of light about the CCM component or dual process (plenty of info about ACTA at THI out there). I used plenty of other people's wisdom while navigating the interview process, and my old residency program had a tradition of answering questions in SDN through a non-personal account. So I decided to pay it forward and give my 2 cents on THI CCM. I think that there are a couple of former THI fellows in this thread, so I expect that they will also add to anything discussed.

How many heart transplants are yall doing per fellow per year? LVADS? last I heard the numbers were very low.
 
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Jan 27, 2021
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How many heart transplants are yall doing per fellow per year? LVADS? last I heard the numbers were very low.
Compared to historical numbers, it was low, 22 and 25 hearts for 2020 and 2019. The average is 16.8, that is, 3658 hearts among 217 registered centers. (OPTN database).

In 2018 CMS funding for hearts was cut, which is reinstated since Oct 2020. Reports go quarterly to OPTN, but I know last weekend there were 3 and this week 2 more. I'm on an elective, so those are the ones I know about. There is likely more.

LVAD wise, I don't think is low at all; there are always a couple of new names in the ICU list every week. Especially due to destination therapy use (no heart ttx listing, just LVAD). However, I don't have access to the Intermacs database, so I'll ask for some numbers and answer appropriately.
 

Hork Bajir

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Speaking of...

I have my doubts about this current trend of everyone and their mother doing dual cardiac and ICU training. For a select few with very specific career goals it makes a ton of sense- but judging from the experiences of my current cofellows who are looking for dual jobs right now, there just aren’t that many out there. Certainly if the current trend continues, the supply of dual trained folks is likely to outpace demand. Not to mention that finishing a year of fellowship, and then realizing that you have a full additional year of fellowship, really sucks big time.

My advice for the residents is to really think hard about whether you want to do dual training. If you can’t see yourself being happy doing anything but working in a high end CTICU taking care of MCS patients, then go for it. But based on my observations and conversations with a number of dual trained ppl, in most cases you’re probably better off just picking one
 
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Speaking of...

I have my doubts about this current trend of everyone and their mother doing dual cardiac and ICU training. For a select few with very specific career goals it makes a ton of sense- but judging from the experiences of my current cofellows who are looking for dual jobs right now, there just aren’t that many out there. Certainly if the current trend continues, the supply of dual trained folks is likely to outpace demand. Not to mention that finishing a year of fellowship, and then realizing that you have a full additional year of fellowship, really sucks big time.

My advice for the residents is to really think hard about whether you want to do dual training. If you can’t see yourself being happy doing anything but working in a high end CTICU taking care of MCS patients, then go for it. But based on my observations and conversations with a number of dual trained ppl, in most cases you’re probably better off just picking one
That is a great point, but there also is a large pool of applicants that choose to do duel for the competitive advantage for matching into a better cardiac program if they can stomach an year of ICU. I've noticed that people who are truly passionate about ICU end up pursuing 1 year CCM fellowship. Not saying that people who are dual trained are not passionate about ICU. I am sure many of them are.
 
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Jan 27, 2021
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Thanks for doing this? Can you give an insight into the CCM rotations, what ICUs, the faculty manning those ICUs. Thanks.
Rotation = 1 month. 9 ICU rotations and 3 electives (Research, TTE, Perfusion medicine, etc). My schedule: Neuro ICU, CV surg ICU, CV mechanical support ICU, MICU, Perfusion medicine, Research, TTE, SICU, CV mechanical support ICU, CV surg ICU, Thoracic ICU, Texas Children CV mechanical support ICU.

Our fellowship is under the cardiac anesthesia division that belongs to Texas Heart. The Baylor anesthesia department works in parallel in the non-cardiac ORs. We have mostly anesthesia ccm or dual-trained attendings plus 3 pulm crits, 1 cv surgeon (only does ICU) and 1 cardiologist (also CCM trained). I like the multidisciplinary flavor.

This year the new PD Diaz-Gomez has made emphasis on ASE TTE Critical Care Echocardiography certification i.e CCeExam. He is a big proponent of US in ICU and is part of the group that wrote book and created the board certification. So we took the board exam in January and are working on getting the number of echo studies needed for certification.
 
Jan 27, 2021
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Speaking of...

I have my doubts about this current trend of everyone and their mother doing dual cardiac and ICU training. For a select few with very specific career goals it makes a ton of sense- but judging from the experiences of my current cofellows who are looking for dual jobs right now, there just aren’t that many out there. Certainly if the current trend continues, the supply of dual trained folks is likely to outpace demand. Not to mention that finishing a year of fellowship, and then realizing that you have a full additional year of fellowship, really sucks big time.

My advice for the residents is to really think hard about whether you want to do dual training. If you can’t see yourself being happy doing anything but working in a high end CTICU taking care of MCS patients, then go for it. But based on my observations and conversations with a number of dual trained ppl, in most cases you’re probably better off just picking one
I agree that is definitely not a convenient thing (extra training, delaying attending life, etc) and likely a poor financial decision thinking on the extra year of training. Job wise there seems to be an appetite for dual trainees for now.
 

dchz

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Speaking of...

I have my doubts about this current trend of everyone and their mother doing dual cardiac and ICU training. For a select few with very specific career goals it makes a ton of sense- but judging from the experiences of my current cofellows who are looking for dual jobs right now, there just aren’t that many out there. Certainly if the current trend continues, the supply of dual trained folks is likely to outpace demand. Not to mention that finishing a year of fellowship, and then realizing that you have a full additional year of fellowship, really sucks big time.

My advice for the residents is to really think hard about whether you want to do dual training. If you can’t see yourself being happy doing anything but working in a high end CTICU taking care of MCS patients, then go for it. But based on my observations and conversations with a number of dual trained ppl, in most cases you’re probably better off just picking one
I want to ECHO this, roping the candidate into an extra year of ICU servitude has very high opportunity costs involved for the candidate.

I've considered a dual fellowship once up on a time. I'm sure @THIFellow loves ICU as it is. But doing ICU at St. Luke does not seem fun to me. But it's easier said than done @Hork Bajir , I remember myself willing to do a year of ICU just to do hearts. Glad I didn't take that route, but let's not dismiss how hard it is to get into a decent ACTA fellowship.

Compared to historical numbers, it was low, 22 and 25 hearts for 2020 and 2019. The average is 16.8.
Yeah but the average place doesn't have 8 fellows per year. 4 heart transplants per fellow is enough to realize you don't want to do it regularly!

This year the new PD Diaz-Gomez has made emphasis on ASE TTE Critical Care Echocardiography certification i.e CCeExam. He is a big proponent of US in ICU and is part of the group that wrote book and created the board certification. So we took the board exam in January and are working on getting the number of echo studies needed for certification.
This is awesome. I love the initiative it's about time we picked up the TTE. Again, not to dismiss your ICU year, but one does not need to stomach the ICU year to do this. I took extra elective months in TTE during fellowship and went around and did TTEs with the techs. Was able to put an awake pt on ECMO with my TTE guidance (not a big deal, but to me it was a test of my competence). Nonetheless, this was a very valuable skill later in practice as I feel comfortable looking up the TTE images and interpreting for myself before I took them to the OR. Kudos to your PD for doing this for yall.
 
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Looking back at my last year's emails, although the bulk of the interview invitations came in January, there were a few that came in February. My last interview invitation was on 2/28, so there still is time.
 
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I interviewed at most programs in northeast (total overkill in retrospect). If you are interested, PM me and I would be happy to share what I thought after my interviews last year.
 
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dchz

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I don't know anything about Monte, thought of as a good NYC program or is it one of the lower tier ones?

Talking "tiers" clouds the conversation a lot and gives some programs undue praise while unnecessarily making other programs seem worse.

How bad of a fellowship is monte? It's better in training than a program like cooper, where they don't have heart failure. You probably do more cases than one would at NYU. But they aren't going to give you 8 weeks of vacation and average a 40 hour work week. Monte does have the downside where if you're the fellow on call you might have to drive across town in the snow to relieve someone for 1 hour.

On the other hand programs like columbia has very good education and fellow lectures with the godfather of TEE himself, but it's unlikely you will do a subclavian central line by landmark there.

How much better is columbia better than monte? Probably a good amount in terms fellowship recognition, alumni network and such. But to say they are different "tiers" would be giving too much credit to Columbia, both would produce trainees that have done tons of heart failure and would be heads and shoulder above a place like cooper.
 
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Nivens

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Talking "tiers" clouds the conversation a lot and gives some programs undue praise while unnecessarily making other programs seem worse.

How bad of a fellowship is monte? It's better in training than a program like cooper, where they don't have heart failure. You probably do more cases than one would at NYU. But they aren't going to give you 8 weeks of vacation and average a 40 hour work week. Monte does have the downside where if you're the fellow on call you might have to drive across town in the snow to relieve someone for 1 hour.

On the other hand programs like columbia has very good education and fellow lectures with the godfather of TEE himself, but it's unlikely you will do a subclavian central line by landmark there.

How much better is columbia better than monte? Probably a good amount in terms fellowship recognition, alumni network and such. But to say they are different "tiers" would be giving too much credit to Columbia, both would produce trainees that have done tons of heart failure and would be heads and shoulder above a place like cooper.

Agree the “tiers” thing is super misleading, though I’ve certainly benefited from it. Programs change a lot from year to year and decade to decade: anesthesia faculty come and go, surgeons come and go, hospital leadership changes, etc, but if you’ve noticed, the list of “top” programs has remained relatively fixed for a long time.
 
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anaesthetic

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Talking "tiers" clouds the conversation a lot and gives some programs undue praise while unnecessarily making other programs seem worse.

How bad of a fellowship is monte? It's better in training than a program like cooper, where they don't have heart failure. You probably do more cases than one would at NYU. But they aren't going to give you 8 weeks of vacation and average a 40 hour work week. Monte does have the downside where if you're the fellow on call you might have to drive across town in the snow to relieve someone for 1 hour.

On the other hand programs like columbia has very good education and fellow lectures with the godfather of TEE himself, but it's unlikely you will do a subclavian central line by landmark there.

How much better is columbia better than monte? Probably a good amount in terms fellowship recognition, alumni network and such. But to say they are different "tiers" would be giving too much credit to Columbia, both would produce trainees that have done tons of heart failure and would be heads and shoulder above a place like cooper.

Agreed. I turned down some “name brand”programs (i.e., “top 3”) for a smaller program purely because of gut instinct, and it was one of the best decisions I’ve ever made. I had an awesome year, learned a ton, worked a ton, saw some crazy stuff, and had fun doing all of it. Who knows if I would have been better off being one of sixteen fellows churning out cases for a year, but I have no regrets at all.

Also, I had great TEE education during fellowship, but the surgeons here only want to hear about relevant echo findings in a three second window during time out. It’s been worth the training but kind of funny to think about.
 
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Hork Bajir

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Brigham is a great program, but they recently lost a few surgeons and their volume is way down. I would be sure to get a sense of what kind of numbers their current fellows are posting before you rank them (of course they’re going to tell you that they’re hiring someone new, their numbers are recovering, etc.… but they told me the same thing when I interviewed there, and from what I hear the volume is still waydown. You only have one year of fellowship, don’t shoot yourself in the foot by going to a program which won’t expose you to enough cases)

Don’t get me wrong, obviously it’s a great program with world-class faculty, and a super choice if you have any ambitions of staying in academia given how connected they are to the SCA. I’m just suggesting that you really kick the tires before accepting the shiny propaganda that they’ll try to sell you
 
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