Imaging fellowship pros/cons

[mayn]

I am currently a first year cardiology fellow trying to figure out the pros and cons of pursuing a imaging fellowship Vs stopping at general cardiology. It is an extra 1 to 2 years of training which can be substantial to tag on after back to back residency and gen cards fellowship.

1) How significantly does an imaging fellowship affect your day to day? Is this highly variable depending on your contract? (do you by default read more echos/CT/TEEs Vs someone without additional training?)
2) Are you setting yourself up for a career restricted to academia or academic centers with fairly robust imaging modalities?
3) Is there a financial incentive to pursue an imaging fellowship? i.e does it add to your salary, or just make you a slightly more competitive applicant for a non-invasive job
4) How competitive are imaging fellowships at relatively big name places
5) Any tips/advice from senior fellows or new graduates who went for an imaging fellowship

Thanks guys!

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[nlax30]

Do you want to go into academics or traditional “private practice”?

Do you want to potentially be an imaging dept director?

If you really enjoy those modalities or have a “passion” for imaging then the extra year could be worth it from a professional satisfaction standpoint. If looking to do academics or if you want to make imaging a big part of your practice then I think that’s where it could be helpful. Otherwise if you're more interested in private practice then I don't think it adds a whole lot besides MAYBE a little something extra if that group/hospital is looking for those skills.

Financially I don't think it would make a big difference. Reimbursement for cardiac MRI and CT is still behind nuclear imaging. Though it could mean a little extra in terms of administration pay if you get a imaging dept chair spot or something similar.

All that to say it depends..... I briefly considered doing 1 year imaging fellowship (before my current spot worked out) and ultimately decided against it mainly because I was already echo/nuc boarded and didn't want to pursue a more imaging focused academic career.

 

[cards67]

Agree completely with above post. If you're interested in it and want it to be part of your career, then go for it. Otherwise probably not worth it.

 

[SwanGanzHeretic]

If you want to stay in academics and want to pursue funded research and I mean you need a plan then imaging fellowship is worth it. That is imaging in CT or cardiac MRI is your academic niche. In private, Echoes and nucs is all anyone cares for and it is not worth it.

 

[IMreshopeful]

If you want to stay in academics and want to pursue funded research and I mean you need a plan then imaging fellowship is worth it. That is imaging in CT or cardiac MRI is your academic niche. In private, Echoes and nucs is all anyone cares for and it is not worth it.

I would agree, although there is a niche in PP for cardiac CT some places
CMR not so much

 

[IMreshopeful]

I think IC, EP and heart failure are definitely valuable fellowships for both academic and PP jobs
Imaging is one of those which I think primarily thrives in an academic setting. Usually the folks I see going PP post imaging fellowship don’t use their skills all that much - end up reading nucs and echo and doing TEE most of the time with occasionally being the curbside guy for a CMRI or cardiac CT.
For ACHD suspect this is a similar issue - can’t imagine there’s a lot of PP jobs where you need a guy dedicated to looking after repaired ToF, Tga, truncus, VSD patients

 

[nlax30]

Also certainly some places where cardiac CT and MR are controlled more by radiology which introduces even more uncertainty.

 

[mayn]

Interesting.

I personally was leaning towards a private practice career, maybe focused on echo. For example getting involved with an institution's structural heart program doing a ton of intra-op TEEs (if this sort of gig even exists).

However, the impression I am getting seems to be that the extra year (or two) of training might not be worth it - unless one goes for it mainly for a professional satisfaction and/or wanting to stay in academics.

 

[IMreshopeful]

Interesting.

I personally was leaning towards a private practice career, maybe focused on echo. For example getting involved with an institution's structural heart program doing a ton of intra-op TEEs (if this sort of gig even exists).

However, the impression I am getting seems to be that the extra year (or two) of training might not be worth it - unless one goes for it mainly for a professional satisfaction and/or wanting to stay in academics.

If you are interested in doing a lot of TEE image guidance for TAVR, Mitraclip, Watchman, unless you do a lot of TEE guidance in general fellowship you may or may not want to do the extra year if they offer more training. This is admittedly something I don’t know about. It’s very much a niche

 

[mayn]

Would still greatly love to hear from people who have finished or are in an imaging fellowship - particularly regarding what kind of jobs they are looking at or currently working in.

 

[nlax30]

Interesting.

I personally was leaning towards a private practice career, maybe focused on echo. For example getting involved with an institution's structural heart program doing a ton of intra-op TEEs (if this sort of gig even exists).

However, the impression I am getting seems to be that the extra year (or two) of training might not be worth it - unless one goes for it mainly for a professional satisfaction and/or wanting to stay in academics.

Doing this in PP without an imaging fellowship is certainly feasible if you get enough exposure during your general fellowship and sit for the echo boards. I guess always the possibility that the extra imaging year could make your CV slightly stand out when time comes for the job search compared to someone to who didn’t do the year..... but I would say the biggest factor is going to be your interview and if you can show them you have whatever skill they are looking for.

 

[cards67]

Interesting.

I personally was leaning towards a private practice career, maybe focused on echo. For example getting involved with an institution's structural heart program doing a ton of intra-op TEEs (if this sort of gig even exists).

However, the impression I am getting seems to be that the extra year (or two) of training might not be worth it - unless one goes for it mainly for a professional satisfaction and/or wanting to stay in academics.

Depends how interested you are in echo and how badly you want that type of job. It's mostly major centers doing tavrs and stuff, which will limit your job options a bit, and they'd probably prefer a level 3 person with intra-op experience. Though I'm sure there are exceptions. Certainly some of these places are hardcore academic centers, but not all of them. You could always throw out feelers to potential employers and see what they're looking for.