EP fellowship

[CanIMakeIt]

Hi,

I am a cards fellow looking at EP fellowship positions. I decided on EP late and I know most, if not all, programs are done with 2016 spots. I am looking for some information/help in deciding where to apply.

I know the top programs (hopefully still are) UPenn, Michigan, Brigham
Where do these programs fall in terms of procedural volume/reputation/good mixture of complex and simple ablations: Mayo (Rochester, Scottsdale), Indiana, Alabama, Duke, Hopkins, UCSF, Ohio state, UCLA, UCSD, BID, Vandy (recently lost 2 big names so I am not sure what shape the program is in), WashU, UW, UTSW

- Any other programs that I should consider?
- Filling out individual applications for the programs blows btw.

Thanks in advance for any help you guys can provide

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[CanIMakeIt]

Any insight is welcome!

 

[ahhndrew]

Hi,

I am a cards fellow looking at EP fellowship positions. I decided on EP late and I know most, if not all, programs are done with 2016 spots. I am looking for some information/help in deciding where to apply.

I know the top programs (hopefully still are) UPenn, Michigan, Brigham
Where do these programs fall in terms of procedural volume/reputation/good mixture of complex and simple ablations: Mayo (Rochester, Scottsdale), Indiana, Alabama, Duke, Hopkins, UCSF, Ohio state, UCLA, UCSD, BID, Vandy (recently lost 2 big names so I am not sure what shape the program is in), WashU, UW, UTSW

- Any other programs that I should consider?
- Filling out individual applications for the programs blows btw.

Thanks in advance for any help you guys can provide

With regards to top programs for EP, Hopkins is one of the best EP programs. I am applying cards this year and asking around, have heard Hopkins, Penn and Michigan as the best EP programs. While Brigham is obviously a great program in general, have not particularly heard about them as much specifically re: EP. From what I hear procedural volume is excellent at Hopkins, with afib/flutter ablations certainly common and VT ablations as well (not sure about every day on the latter). I hear Penn is an authority on VT ablations. UTSW EP program is not great at all at the moment. Duke is good but not close to Penn/Hopkins/Mich or even Brigham.

That's all I know for now.

 

[CanIMakeIt]

Thanks!

 

[ahhndrew]

To update, as I learn more: Brigham clinical EP program is quite good, though not sure about their basic science research. Out of the Harvard programs would say likely Brigham is best EP wise. I know BID has a particular big name there, but not much else there beyond him.

 

[oscillation]

Loyola in Chicago is one of the best place to train in EP . Tons of complex ablation because of David Wilber

 

[Tius]

I can only chime in on the programs I interviewed for - Kaiser LA, UCSD, Michigan, Ohio state.

In regards to outright volume, Ohio state I would say has some of the highest volume of probably any program. They are the land of the millionaire EP's. I felt they were a pretty cool program in the sense of you will get probably whatever volume you can handle. The majority of the staff there were a previous private practice group from Riverside who ended up becoming OSU staff. The funny thing is they were all Michigan trained so I would imagine they're all extremely competent technically and knowledge-wise. Probably the only drawbacks I see from that program are - Ohio, and I remember one of the attendings say they're so swamped with procedures that they're likely not able to walk you through all the nuances.

I interviewed at Michigan and had a friend who recently graduated from their EP program. I would say world class. I think from fib/flutter, SVT standpoint, you'll probably come out dominating. You have big-time names there ala Morady who's still clinically involved with the fellows ala procedures and conferences, Orale who's a big time fib guy, also you'll do procedures with him. Chugh there will probably extensively ablate a 4th time afib until you want to vomit. You also have Bogun inregards to their dedicated VT guy and I believe they regularly have VT's at least once a week - though that detail in regards to frequency I cannot be sure. I think the only drawback is, cold Michigan winters.

Kaiser Permanente in LA was a pretty awesome community program. Their volume is also crazy, especially since all the EP procedures from around the Kaiser clinics get brought back to main Kaiser where the fellowship is. Their volume is so insane that the fellows and attendings don't implant pacers (non-CRT), the surgeons do that. As a fellow you would only implant ICD's and CRT's inregards to devices. I think also a unique aspect of Kaiser is that unlike most academic programs where the case-load will be heavy afibs, redo-afibs, and structural VT if you have a HF program, Kaiser had a huge volume of SVT's, specifically pathways. One of their attendings, Wu is their VT guy and did an extra year of VT training at UCLA under Shivkumar. He had established their VT program there and was starting to do epicardial's. Drawbacks: lacks any big time names, but I don't think their training is any lesser because of that, and probably not as heavy on persistent afib volume. The impression I got seemed like they did mostly paroxysmal afib with maybe 30% persistent afibs.

UCSD isn't as highly touted as the heavy hitters ala UCSF, Michigan, Brighams, Upenn inregards to name but I feel they're training is pretty diverse with complex ablations. Afibs are a very regular procedure, 4/5 days a week with a good mix of afib. Their main guy is Greg Feld who is well touted in the world of flutters and ain't so bad himself in afibs. They do tons of lead extractions with average probably 2 a week, to sometimes 4 a week. Their previously big guy Narayan, who was a big proponent of rotors in afib left to go to Stanford. However, one of the other guys who also is a big rotor guy is still there, Krummen at the VA and is applying the concept to VF. I believe last year he ablated a guy with refractory VF targeting rotors. I think coming out of here afib skills will be up there with hands on training with rotor based ablation (whether you believe in the concept or not is another question), tons of lead extraction experience, and training from one of the seminal flutter guys. I would say the drawback from this program is that they lack in the VT department, specifically structural VT. They tend to be more conservative with ischemic/nonischemic VT's. On the other hand, normal structural VT - aka PVC's, Outflow tract VT's seemed fairly common in their case volume.

Some of the other things I heard about other programs on the interview trail/looked into while applying, but can't confirm first hand:
UCLA seems to have low volumes in most things except VT. Shivkumar there is a heavy hitter with VT so if that's your thing, maybe a good program. Upenn I feel is always regarded in the EP world as the top program if not near the top, but program culture in regards to malignancy maybe a question. Northeast programs tended to be heavy in VT so if that's an interest, something to consider. Strayed away from the Northeast due to location/weather/cost of living. UCSF is also big with Scheinman, I hear is one of the top if not top programs on the West Coast, but also with a heavier emphasis on research. Seemed like they did all the major ablations, just never got an interview there.

Hope this helps.

 

[CanIMakeIt]

Thank you so much for the info guys! So far very few programs currently have 2016 spots. But this will be so helpful for 2017 spots,