How bad is to get into Cardiology fellowship?

Discussion in 'Clinical Rotations' started by chury, Jan 7, 2002.

  1. chury

    chury Member

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    Hi

    I am only a third year but I am already thinking about my career path.

    My question is how competative is to get into Cardiology fellowship? I am in NYC so which Internal Medicine residencies are the best in order to get into cardio? I assume the university based IM programs are better but I am not sure. Is there are big difference reputationwise between programs at NYU, Cornell, Columbia, Einstein, M. Sinai?
    Does reputation of your medical school matter when applying for fellowship?


    My second question is the salary. I will end up with 200K in debt and with my fellowship salary of 40K I would barely survive here in NYC. Is fellowship intense like residency (hours-wise) and is it possible to do something on the side as an MD while doing your fellowship?

    Thanks a lot

    Chury MS-3 AECOM
     
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  3. Goofy

    Goofy Senior Member

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  4. Dr JPH

    Dr JPH Banned
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    Do you need to do research in medical school to do Cardiology?

    Can you go through medical school as a reasonably good student, competitive boards, and kick butt during your early IM residency and get into cardio?

    Also...how many years of IM do you need to do before a cardio fellow?
     
  5. Goofy

    Goofy Senior Member

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  6. chury

    chury Member

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    Thanks Kleb!

    As I said I attend Einstein med. Since they have 4 cardio fellowship programs: Beth Israel, Long Island Jewish, plus 2 different ones at Albert Einstein/Montefiore, do you think it is a good idea to stick with Einstein with my Internal Medicine residency as well?
     
  7. Goofy

    Goofy Senior Member

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  8. Goofy

    Goofy Senior Member

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  9. task

    task Senior Member

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    Both Cardiology and GI have evolved into the most competitive IM subspecialty fellowships. There are approx. 650-700 Cards spots available in the US, and something like 250-300 GI spots. Because of the sheer need of Cardiologists by the marketplace, there is talk of increasing the number of spots of Cards fellowships. GI seems to be holding the line where they are. I think part of this thinking is related to the scare that GI had a few years ago, when the word on the street was that there were too many GIs out there and not enough work, so the # of people applying dropped like crazy and GI programs couldn't fill. Now that the demand for GI docs is out of control, the same fellowship programs are living high, taking their pick. If they're smart, they'll play the game like ENT or GU, keeping the # of spots small and stable so that there will always be a strong demand for the field, jobs aplenty, and the caliber of applicants high.

    But I digress. Onto Cards. Cardiology is very competitive, probably still slightly more than GI for right now, but there are more spots so I think it evens out a bit. And while there are greater numbers of people applying for Cards, you can pretty much separate out the IMG appplicants from US applicants (except for the truly stellar IMGs), and then separate out socially-challenged US applicants from normal ones, and then separate out those US applicants from top IM programs from average ones. So the numbers do reduce themselves. Having said that, there are some facts/tips to keep in mind to make sure you've done all you can to enhance your chances of matching in Cards. I cannot stress enough to you the importance of going to the best name/reputation IM program you can get into. As Klebsiella touched on, what matters to fellowship programs is what you did just before applying to them. Coming out of a highly regarded IM program puts in you in a higher echelon of consideration, in that they (fellowhip PDs) already know you had the numbers to go to a reputed IM program. Everything I'm going to say now relates to the reputation of the IM program. As a general rule, the highly regarded IM programs will usually have highly regarded Cards programs, which means they will have highly regarded Cardiologists on faculty. These are the faculty you want writing your letters because they are buddies with and trained with all the other Cardiologists at fellowship programs. The world of academic cards is small, and all these faculty know each other pretty well, so a letter from a buddy is immeasurably more valuable than one from a stranger.

    As a general rule, I think you do have your best chance at fellowship where you train in IM, for obvious reasons. I think notable exceptions would be places like the Cleveland Clinic, where the repuation of Cardiology training far outshines the general medicine program. That's why these people who think going there for IM with the intention of gunning for fellowship are in for a rude awakening. CCF takes their pick, and except for may one or two a year from their own IM program, they pick from top IM programs exclusively.

    It sounds like you have your heart set on metro NYC programs. That's fine and good, and definitely focus your efforts on getting to know faculty and doing research with them with the object of staying in NYC. From my residency applying days, I seem to recall that Cornell, Columbia, NYU and Mt. Sinai were uniformly considered the top IM programs in the City.

    But, if you want to do cards more than anything, you need to look past Eastern Pennsylvania and apply far and wide across the US, both for IM and subsequently for fellowship. I believe that if you left NYC and went to a top IM program away from NYC, then appying to fellowship programs in NY would be more advantageous than staying at an middle-rep program in NYC just to stay in NYC.

    So, yeah, for IM, academic top-name places are your best bet. For fellowship, I honestly don't think it matters unless you're going into academia. My goal is the private world, and while I'd like to get into a top Cards programs, honestly my more important focus is to go to a volume program where they do tons of procedures and see lots of patients so that proficiency is not an issue. Along those lines, private places like Cedars-Sinai or Cleveland Clinic are places to look at because they have a lot of private-insurance and big $$ patients who can afford all those procedures.
    With regards to $$, I really wouldn't worry. While deferring loans isn't a great way to start "real" life, you will have moonlighting opps in residency that will help pay off some bills. As for life after fellowship, that's even less worrisome. Cardiologists, even ones who do no intervention, do better than about 90% of other medical or surgical subspecialists in terms of earnings. So $$ should not be a worry.

    Many Cards fellows I know moonlight. As discussed previously, fellowships vary greatly in terms of how hard fellows work, the amount of night call, etc. You just play it by ear, and moonlight more during lighter months (ECHO or a reseach month) than on your CCU months.

    Oh, one thing about research. IF you've been working on something from med school days and can build on that during residency, that's cool -- the basic work is done, you're just looking at the data to make different arguements. I think if you're hoping to start some kind of a project in residency, it might be wise to start working on something from scratch with a faculty member at the end of your intern year or beginning of your second year. You're just not going to have the time or energy to do something worthwhile/meet deadlines as a intern, so all you'll end up doing is looking irresponsible to the faculty you're working with and delaying the research more. So only make the time when you know you can, which will be after intern year when your schedule frees up a bit. Just an opinion though.

    Hope this helped a little.
     
  10. chury

    chury Member

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    Thank you both so much for your replies.

    I appreciate it.

    PS. I do know that ther is a world-known cardio guy in my school (and Monty). His name is Sonnenblick. (he gave us 4-5 lectures in our 1st and 2nd year) But I did not know that Einstein/Monty cardio dept. has high reputation outside of NYC.
     
  11. chury

    chury Member

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    so if it says"Long Island Jewish Medical Center
    Program best described as Community-based university affiliated hospital" it still counts as only community-based program. Is that correct?
     
  12. chury

    chury Member

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    ok. I looked for IM programs.
    This is what I found for NYC:


    New York Presbyterian Hospital (Columbia Campus) Program
    New York , NY 140-35-11-297

    New York Presbyterian Hospital (Cornell Campus) Program
    New York , NY 140-35-21-270

    New York University Medical Center Program
    New York , NY 140-35-21-292

    Albert Einstein College of Medicine (Montefiore) Program
    Bronx , NY 140-35-21-287

    Albert Einstein College of Medicine (Jacobi) Program
    Bronx , NY 140-35-31-521

    Albert Einstein College of Medicine at Beth Israel Medical Center Program

    New Hyde Park, NY 140-35-21-281
    SUNY at Stony Brook Program
    Stony Brook , NY 140-35-21-315

    Mount Sinai School of Medicine (Bronx) Program
    Bronx , NY 140-35-31-517

    Mount Sinai School of Medicine Program
    New York , NY 140-35-31-288

    SUNY Health Science Center at Brooklyn Program
    Brooklyn , NY 140-35-21-305

    Staten Island University Hospital Program
    Staten Island, NY 140-35-11-304

    I found 11 programs. Is that enough? Can it happen that I do not match and to how many programs do people usually apply?

    Kleb, do you know anything about Jacobi/Einstein program? Is it good?

    Is they any programon this list you would not recommend?

    Thanks a lot
     
  13. Goofy

    Goofy Senior Member

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  14. taurces

    taurces New Member

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    I'm also a medical student (4th year) and while I was interviewing I also inquired about the whole cardio rat race. While it is true that you must go to a university-based IM program, the reputation of the school and maybe more significantly, the reputation (and connections of) the program director are equally important. I've been told numerous times that obtaining a cardio spot is more about "who ya know" rather than board scores and grades.

    With that in mind, it seems possible to go to a well-known or should I say well-affiliated program like Johns Hopkins Bayview or Pennsylvania Hospital (affiliated with UPENN)and still obtain a cardio spot without much difficulty.

    In the end, you should know how to play the game because like all of you said, cardio is very competitive.

    Just my thoughts...

    Taurces
     
  15. chury

    chury Member

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    Is 11 applications enough, too much...? To how many programs people usually send their applications ?
     
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  17. nyskindr

    nyskindr Senior Member

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    If you want to stay in the NYC area, then there are a number of community university affiliated internal medicine programs all of which have cardiology fellowship programs and in some cases very good ones,examples are Beth Israel,Lenox Hill,St Vincents in Manhattan,Staten Island and Maimonides in Brooklyn. LIJ also has one.These are not very difficult categorical positions to obtain.I would check into the fellowships their residents get at graduation.
     
  18. chury

    chury Member

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    beth israel is university-based one.
     
  19. Soupbone

    Soupbone Member
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    How good is the training at these fellowship programs at these community programs?

    It community trained GI or Cards guy from one of these programs(St. Vincents, Beth Isreal, etc.) at a disadvantage.


    thanks,
    S0upb0ne
     
  20. nyskindr

    nyskindr Senior Member

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    I know of quite a number of subspecialists who have completed the above noted programs in GI,Cardiology and Pulmonary, they are doing very well in practice and feel they have had solid training.It is important to remember that when using the term "community hospitals" in New York City that these hospitals are very large 500-600 beds with major med school affiliations, many residency and fellowship programs and very busy cardiac surgey programs in most cases.I believe Maimonides is among the larger private hospitals in the US,and Staten Island hospital has established a busy regional cardiac center.Some of these places are busier than many primary unversity hospitals.
    Another hospital in this category would be St-Lukes-Roosevelt Hospital -a Columbia affiliate .I dont think you must go to Penn,Cornell and NYU internal medicine to get a cardiology fellowship.............. but of course it cant hurt!
     
  21. Soupbone

    Soupbone Member
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    nyskindr,

    I see you are in NYC. I have gotten opinions on the 'big name' programs in NY, but getting info on the other programs in the city is a little harder. It appears that you have some pretty good insight into the Manhatten programs down here in the South.

    If possible, give me your opinions on Beth Isreal, St Vincents, Mt. Sinai-Cabrini, Maimmodes, and NY Methodist. Any insight would be helpful (atmosphere, training, housing, etc.)

    thanks in advance,
    S0upb0ne
    MS-IV UAB
     

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