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Discussion in 'Cardiology' started by joti, Mar 27, 2007.

  1. joti

    joti Junior Member 7+ Year Member

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    Mar 7, 2006
    In the ACC Presidential speech in annual convocation, Steve Nissen ( Immediate Past President) mentioned it is high time for Cardiology to separate from Internal Medicine. The advances in Cards is very dynamic and explosive so that training has to be extended at the same time it needs the freedom as Derm and Neurology. He suggested ACC should work for changing Cards into an independant speciality with 5 years of training. Any thoughts?

    COURAGE trial was the highlights of this ACC. However the editors of NEJM and JAMA claimed more negative trials came out because of the new clinical trials registration policy.
     
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  3. nutcancer

    nutcancer 2+ Year Member

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    Dec 20, 2006
    let me put it this way..if cards had its own match straight out of medical school, i would seriously re-think my decision not to pursue it. and you better bet there would be serious response from other medical students as well. having to go through IM is the biggest turn off for me about cardiology. too many cardiologists have told me they forget their IM training down the road anyway.
     
  4. IceMan0824

    IceMan0824 Holy crip, he's a crapple 5+ Year Member

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    Dec 7, 2006
    True, true. As much as I recognize that IM does help expand the knowledge and experience of a cardiology training, I just really do not want to end up in IM. No offense to the IM crowd, but I'm more technique oriented and I know day to day patient care only will wear my patience thin.
     
  5. nutcancer

    nutcancer 2+ Year Member

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    Dec 20, 2006
    What career are you considering if you don't mind me asking?
     
  6. IceMan0824

    IceMan0824 Holy crip, he's a crapple 5+ Year Member

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    Dec 7, 2006
    This is all still preliminary as I'm still MS-0, but CT (which brought me to cardiology(interventional), NSG, or maybe PRS. I am sure board scores, and many other factors might just have a hand in what I ultimately end up in.
     
  7. Big Ben

    Big Ben 2+ Year Member

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    Nov 19, 2006
    I think Nissen is off base her and don't see this happening in a million years. When you finish your IM program, you realize why you need this background. I'm not sure how much medicine you actually need (I think 2 years potentially could work) but undergoing dedicated IM training is a necessary evil. The majority of cardiologists in the US will not be heading large RCTs. They will be seeing referrals and consults for patients with multiple comorbidities and are as likely to see a patient in their clinic with atypical chest pain from GERD as they are someone with a severe cardiomyopathy.

    It's easy as a med student to look and say you don't need IM to practice cardiology. The fact of the matter is if you don't think IM is for you, you're probably not that well suited for cardiology and would be better off in a field like radiology (i.e. IR).
     
  8. IceMan0824

    IceMan0824 Holy crip, he's a crapple 5+ Year Member

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    Dec 7, 2006
    And you see, I agree with you. I do realize it is a necessary evil, but with the limited experience I do have with IM, I do know it is definitely a factor (right now) that's hindering my enthusiasm for the field. If, theoretically speaking, there was a way to educate a cardiologist without IM, I would be on board. Till then, I weigh my other options.

    But I do agree with you. I do believe IM contributes much to the field of cardiology and I cannot see how cardiology might manage without it, but then again, my knowledge is limited. So who knows...who knows...
     
  9. IM person

    IM person 2+ Year Member

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    Dec 3, 2006
    I think calling IM a necessary evil is very short sighted. Doing a IM residency means learning critical skills such as triage, chronic management, etc. The majority of patients with cardiology issues need chronic management, not a one time referal to a subspecialist.

    Doing a cardiology subspeciality without IM is like the blind leading the blind. I'm very surprised S Nissen made that statement, I would love to hear his thoughts...unfortunately I'm not at the ACC...
     
  10. whatsdown

    whatsdown 2+ Year Member

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    Dec 19, 2006
    There is something to be said for the very long training times with doing cardiology. I think a 5 year program is a great idea if its done right, with the second year still having a heavy internal medicine component. The idea is part of a growing trend to allow hospitalists to manage virtually all patients in the hospital, and GI, Cards, Surgery etc becoming entirely consultants.
     
  11. JoBlo

    JoBlo 2+ Year Member

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    Sep 30, 2006
    Great, more pigeon hole medicine where the true internist is the only one that has a perspective on the entire patient and all organ systems.

    There are enough times already where neurologist recommendations conflict with cardiology recommendations which conflict with nephrology recommendations, where everyone is neglecting other organ systems. Sound like these changes will just make that worse
     

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