Last Ditch Effort/Advice requested

[DrGMW]

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This question is posted mostly for cardiology program directors (PD)or fellows with similar circumstances who have successfully obtained a cardiology fellowship:

I am a US medical graduate with descent step 1 and step 2 scores and did residency at a fairly strong academic institution. However, in my pursuit of cardiology, I made some big mistakes during my residency and failed to make friends in the department of medicine. With exception of third year, my in-training exam scores were not something to be proud of either and....in short, my IM PD is not supportive of my application to cardiology. When I applied for the first and last time, if it were not for my IM PD, I would have had the position at my institution. They know and like me there. While I am trying to talk my self out of cardiology, I miss it terribly, and am ready to work for free for a while to get into a fellowship. Does anyone have an idea how to overcome such obstacle. How about echo and CHF fellowships? Or do you have another suggestion to strengthen my candidacy?
I would greatly appreciate any help.

 

[dragonfly99]

If you are that set on doing cardiology, and your board scores are OK, then doing a CHF fellowship or something might help. At least then you'd be getting paid. However, at this point in the year it would be pretty hard to scramble into one, likely. The other option would be to find a research fellowship for the next 1.5-2 years. However, if your IM program director was the problem, then this may not be the best strategy. If you had an additional letter or two stating how good you are clinically, and that you get along well with people, that might help more.

Incidentally, the in training exam scores are not supposed to be used against you in the fellowship selection process, and nobody is supposed to be telling anyone what those were. I had a bit similar experience with my IM PD, although I don't think he did anything to actively oppose my application I also know he didn't try to help. In the end, you probably only need him to be neutral, but then need several strong LOR's and something extra (like CHF fellowship or research project) to set you apart.

If you are an IMG or FMG that throws another monkey wrench in this, and you may not be able to overcome your PD's lack of support for your candidacy. If you only tried x one, though, I would think about trying again if you got any interviews at all. Nothing ventured, nothing gained. Just be ready for all outcomes, including another rejection. You may want to have a backup plan, like becoming a hospitalist or another specialty. Many hospitals now employ hospitalist or IM docs for their chest pain ER's, which isn't exactly being a cardiologist but it's actually kind of close.