Official Pulmonary Critical Care 2017-2018 Thread

[Cincylung]

Eras opens tomorrow. Might as well get it started so we can assist each other when filing out? Yes I'm getting anxious! Can we make it a sticky?

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[tartesos]

By the time you finish, median salary will be +400k.
Good luck!


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[MedicinalTofu]

Hello everyone. Is this a WAMC thread?

- US Citizen
- Went to an academic university medical center (in mid to high tier) for Internal Medicine
- Graduated at top resident ranking (does this matter?)
- AMG school, a recently established (within last 10 years) allopathic medical school
- Graduated AOA
- Step 1 255 Step 2 270

- Took time off to make some money and pay off loans as a hospitalist and with a side gig as PMD (private practice with a good side gig on my days off)
- Graduated residency in 2016. Worked 14 hospitalist shifts a month and 12 PMD shifts a month (only 4 days off a month). Entering current cycle to try to get in for 2018-2019 academic year. Working residency hours and loving it. Work hard and play hard right? (or perhaps hardly playing)

Research:
Published:
- Review article in major ICU journal indexed in Pubmed
- Letters to editor x 2 in major ICU journal indexed in Pubmed
- updated book chapters on Lung Ultrasound and listed as an editor
- listed as author on a medscape article for a pulmonary topic
- publishing a lung US and dialysis manuscript in a renal journal.

Also CHEST abstract posters x 2 on various ICU topics , case report manuscript on ECMO use

(all done in current academic year; no real pulmCC oriented research in residency as was not focused on that earlier)

pending other projects with PEs but unlikely to get published before current interview season

- Letters:
Will get from pulmCC and PD from home institution.

Not interested in being full academic bench work. happy to go to any institution that has point of care US as a focus of teaching.


Of note, is it true that community programs, those that look to take their own, will actively ignore external candidiates as part of their mantra to take their own? Maybe its hard to tell as generalization?

Thanks

 

[maverickdoc]

Hello everyone. Is this a WAMC thread?

- US Citizen
- Went to an academic university medical center (in mid to high tier) for Internal Medicine
- Graduated at top resident ranking (does this matter?)
- AMG school, a recently established (within last 10 years) allopathic medical school
- Graduated AOA
- Step 1 255 Step 2 270

- Took time off to make some money and pay off loans as a hospitalist and with a side gig as PMD (private practice with a good side gig on my days off)
- Graduated residency in 2016. Worked 14 hospitalist shifts a month and 12 PMD shifts a month (only 4 days off a month). Entering current cycle to try to get in for 2018-2019 academic year. Working residency hours and loving it. Work hard and play hard right? (or perhaps hardly playing)

Research:
Published:
- Review article in major ICU journal indexed in Pubmed
- Letters to editor x 2 in major ICU journal indexed in Pubmed
- updated book chapters on Lung Ultrasound and listed as an editor
- listed as author on a medscape article for a pulmonary topic
- publishing a lung US and dialysis manuscript in a renal journal.

Also CHEST abstract posters x 2 on various ICU topics , case report manuscript on ECMO use

(all done in current academic year; no real pulmCC oriented research in residency as was not focused on that earlier)

pending other projects with PEs but unlikely to get published before current interview season

- Letters:
Will get from pulmCC and PD from home institution.

Not interested in being full academic bench work. happy to go to any institution that has point of care US as a focus of teaching.


Of note, is it true that community programs, those that look to take their own, will actively ignore external candidiates as part of their mantra to take their own? Maybe its hard to tell as generalization?

Thanks

Outside of the top 10-15 programs, you should get interviews from most others. Have a convincing explanation for your gap years . Good luck

 

[RememberWhen]

Outside of the top 10-15 programs, you should get interviews from most others. Have a convincing explanation for your gap years . Good luck

And which programs are considered the top 10-15?

 

[maverickdoc]

And which programs are considered the top 10-15?

The usual : UPMC, National Jewish, Mayo , Vandy, Duke, MGH,HUP etc etc etc

 

[MedicinalTofu]

Thank you for your advice.

As for gap year reason, is "I did not previously apply to PCCM and don't have any failed match history I just really was in a bind and needed to pay off loans ASAP" okay? A more eloquent version of this of course? followed up by why I want to do it etc..

 

[deleted856465]

Thank you for your advice.

As for gap year reason, is "I did not previously apply to PCCM and don't have any failed match history I just really was in a bind and needed to pay off loans ASAP" okay? A more eloquent version of this of course? followed up by why I want to do it etc..

Gap years are completely normal. People only really wonder if you're several years out and this is a legit career change.

When youre looking at programs, try to keep in mind what kind of career you might want and what kinds of careers you absolutely do not want. Some of the "best" programs are very research heavy. As a result, fellows are well-poised to getting a K grant after finishing but might have less than 30 intubations in 4 years and barely make their bronchoscopy numbers. Whereas if youre at a clinically heavy community or academic program, you might be doing an insane number of procedures but you will have less exposure to weird diseases, limited pulm subspecialty exposure and will have much weaker research opportunities. Every program will downplay the importance of what theyre lacking so you just have to make your own decisions.

 

[lovestosurf]

Excited the application season is starting!
Think I know the answer to this but... for fellowship do we need an LOR from "Department Chair where I completed my clerkship training"? I'm assuming no, that they only want a letter from our residency PD correct?

 

[MedicinalTofu]

any general personal statement pearls/pitfalls? I have a fairly standard PS in that I outline what I bring to the table, what attracts me to this field, what I hope to get out of it, and future career plans. No "touchy feely" stuff or anecdotes like a medical student PS.

 

[bri2015]

looking at the eras application now. some programs are listed as not participating in match? What does that mean?

 

[Cincylung]

looking at the eras application now. some programs are listed as not participating in match? What does that mean?

Some programs haven't completed the process to participate in the match. Doesn't mean they aren't participating just means they haven't submitted to Eras. Most do by June 30th and almost all do by application time. Just check back. My home institution is one of the programs listed as not participating but they clearly are from our talks.

 

[Cincylung]

What about Chest abstracts that haven't been accepted yet?? How do I list those? And any idea when Chest usually gets back to us about submissions?(those of you who've submitted in the past)

 

[deleted856465]

any general personal statement pearls/pitfalls? I have a fairly standard PS in that I outline what I bring to the table, what attracts me to this field, what I hope to get out of it, and future career plans. No "touchy feely" stuff or anecdotes like a medical student PS.

That's fine. Career goals is probably most important. Everyone brings the same stuff to the table for the most part. Unless you have a really unique life story, keep the PS bland and forgettable. Let your CV and letter of recs earn the interview

 

[deleted856465]

What about Chest abstracts that haven't been accepted yet?? How do I list those? And any idea when Chest usually gets back to us about submissions?(those of you who've submitted in the past)

Youcan list it as "in submission". The bar is so low for conference abstract acceptance that the distinction doesn't matter that much. What's more important is the actual research you did and whether the PD will be impressed (depends on their own research background).

 

[Torsades42]

Youcan list it as "in submission". The bar is so low for conference abstract acceptance that the distinction doesn't matter that much. What's more important is the actual research you did and whether the PD will be impressed (depends on their own research background).

For the last two years, Chest abstract decisions have come out before the application submission deadline. I'm not sure if this is intentional or just a coincidence. I doubt one abstract will make or break anyone's application, but it is worth noting.

 

[HelpPleaseMD]

Youcan list it as "in submission". The bar is so low for conference abstract acceptance that the distinction doesn't matter that much. What's more important is the actual research you did and whether the PD will be impressed (depends on their own research background).

last year it came out 7/13

 

[CriticalCareDoc7]

Hi guys!
I'm a Caribbean grad from a internal medicine community program. US citizen.
No research. Our program was really geared towards producing hospitalists. Very few
people per year go on to fellowship. I really fell in love with critical care during my residency and not looking for a research
heavy program. Would like to just be a plain 'ole intensivist ~ most likely locum tenens.
I need to be near a metropolitan city and at the very least an international airport.
I was only planning on applying to PCC & CC on the west coast and east coast and
skip everything in between. Looking at community based fellowship programs.
Right now I have about 50 programs in my saved program list.

Is this a poor strategy? Or should I be applying really broadly?

 

[tartesos]

Hi guys!
I'm a Caribbean grad from a internal medicine community program. US citizen.
No research. Our program was really geared towards producing hospitalists. Very few
people per year go on to fellowship. I really fell in love with critical care during my residency and not looking for a research
heavy program. Would like to just be a plain 'ole intensivist ~ most likely locum tenens.

Step 1: 233
Step 2: 242
Step 3: 230

I need to be near a metropolitan city and at the very least an international airport.
I was only planning on applying to PCC & CC on the west coast and east coast and
skip everything in between. Looking at community based fellowship programs.
Right now I have about 50 programs in my saved program list.

Is this a poor strategy? Or should I be applying really broadly?

Really broadly specially in between the coasts will improve your chances greatly.
Good luck!



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[MedicinalTofu]

how important is USMLE scores for fellowship anyway? It's probably way down the list right? Maybe just used a tiebreaker for another comparable candidate if similar in every other facet? This would probably only be important for super research candidates vying for the top of the top position then right?

 

[kjamess]

how important is USMLE scores for fellowship anyway? It's probably way down the list right? Maybe just used a tiebreaker for another comparable candidate if similar in every other facet? This would probably only be important for super research candidates vying for the top of the top position then right?

it matters, but the tier of the program will determine how much (speaking in generalities)

 

[gutonc]

how important is USMLE scores for fellowship anyway? It's probably way down the list right? Maybe just used a tiebreaker for another comparable candidate if similar in every other facet? This would probably only be important for super research candidates vying for the top of the top position then right?

As with residency apps, it's generally used as a screening tool.

My (not PCCM) fellowship program scored applicants on 6 (or 7...it's been a few years since I was on the committee) aspects of the their application (1-5 on each). Step scores was both a screening tool for interview invites and one of those aspects on the final score.

Every program will do things differently. Don't make yourself crazy trying to figure out which ones do what. You have the scores you have. Move on.

 

[fel4pccm]

Hi guys!
I'm a Caribbean grad from a internal medicine community program. US citizen.
No research. Our program was really geared towards producing hospitalists. Very few
people per year go on to fellowship. I really fell in love with critical care during my residency and not looking for a research
heavy program. Would like to just be a plain 'ole intensivist ~ most likely locum tenens.

Step 1: 233
Step 2: 242
Step 3: 230

I need to be near a metropolitan city and at the very least an international airport.
I was only planning on applying to PCC & CC on the west coast and east coast and
skip everything in between. Looking at community based fellowship programs.
Right now I have about 50 programs in my saved program list.

Is this a poor strategy? Or should I be applying really broadly?

I went through match last year and was fortunate to get in. Similar credentials, carib grad, us perm resident with research and publications. I applied to about 80 programs.

For any IMGs my suggestion is to apply to as many programs as you can. Research the programs you're applying to; see if you can find out if they have interviewed IMGs in the past or have IMG fellows. Be realistic and cast a wider net if you can afford to

All the best!

 

[Cincylung]

I went through match last year and was fortunate to get in. Similar credentials, carib grad, us perm resident with research and publications. I applied to about 80 programs.

For any IMGs my suggestion is to apply to as many programs as you can. Research the programs you're applying to; see if you can find out if they have interviewed IMGs in the past or have IMG fellows. Be realistic and cast a wider net if you can afford to

All the best!

How many interviews did you get/actually go to after applying to 80?

 

[fel4pccm]

How many interviews did you get/actually go to after applying to 80?

I got invited to 15, went to 10 interviews. Matched into #2 on my list.

Hindsight is 20/20 - and if I were to do it again, I would definitely apply to programs after doing some research - see who current fellows are, who was invited in the past. To some programs I applied a bit late, absolutely a bad idea. I got few interviews late in the cycle due to cancellations but you have to take them with a bag of salt.

Bottom line - IMGs (Carib grads even more so) should have their ducks in a row. Apply to as many programs, try to get the apps in at once vs. waiting to see what the responses are like and then reapplying. I know of some that applied late to some programs; didn't pan out that well.

HTH and good luck to everyone!

 

[meedu]

Is it smart to apply both critical care and pulmonary critical care? I am an IMG as well, currently have a list to apply to 80 programs including critical care programs

 

[BeeBee-8]

Is it smart to apply both critical care and pulmonary critical care? I am an IMG as well, currently have a list to apply to 80 programs including critical care programs

I think so. I am planning on doing the same; mostly PCCM but I will apply to some CCM only programs. The places which have both PCCM and CCM, will you apply to both or only one of them?

 

[meedu]

I think so. I am planning on doing the same; mostly PCCM but I will apply to some CCM only programs. The places which have both PCCM and CCM, will you apply to both or only one of them?

I am thinking both. I guess there would be one interview though. Not quiet sure!

 

[meedu]

I am also wondering how people are picking the program they should apply to? What criterias are you using?

 

[Histiocytosis XYZ]

I know it's not easy to generalize, but when applying to both PCCM and CCM-- do you guys recommend "cutting out" the pulmonary components out of your PS and focusing on just critical care. Or do you think the CCM programs really couldn't care less. Thanks

 

[BeeBee-8]

I know it's not easy to generalize, but when applying to both PCCM and CCM-- do you guys recommend "cutting out" the pulmonary components out of your PS and focusing on just critical care. Or do you think the CCM programs really couldn't care less. Thanks

I am planning to cut out the pulmonary components for CCM programs.

 

[NewYorkDoctors]

I have an accepted publication but I may not receive the proofs or the Pubmed Indexing before July 15th. If that happens, do I just leave as provisionally accepted and then have to explain it later on at a potential interview?

 

[deleted547339]

I have an accepted publication but I may not receive the proofs or the Pubmed Indexing before July 15th. If that happens, do I just leave as provisionally accepted and then have to explain it later on at a potential interview?

"In press"

 

[MedicinalTofu]

I just received an invitation to be a reviewer for a major Crit Care journal.
A) Is this a "big deal" for a fellowship applicant for the PDs?
B) Does this go in Experience or Extracurriculars?

 

[maverickdoc]

I just received an invitation to be a reviewer for a major Crit Care journal.
A) Is this a "big deal" for a fellowship applicant for the PDs?
B) Does this go in Experience or Extracurriculars?

Not a big deal. There are hundreds of journals out there and they need thousands of reviewers

Also pccm >>> ccm imho ( recent graduate very familiar with the job market )

 

[CCM-MD]

Not a big deal. There are hundreds of journals out there and they need thousands of reviewers

Also pccm >>> ccm imho ( recent graduate very familiar with the job market )

Don't know where you were looking for jobs but the CCM market is hot. Which is why you can find so many pulmonary/cc guys working as pure intensivists.

 

[maverickdoc]

Don't know where you were looking for jobs but the CCM market is hot. Which is why you can find so many pulmonary/cc guys working as pure intensivists.

But it is harder work and gets monotonous after a while .
And it is much easier to get a job as a pccm doctor especially in private practice
P.S. there is a reason why Pitt/ Mayo give away their ccm spots like candy while it is almost impossible to even get an interview for the pulmonary spot

 

[deleted547339]

But it is harder work and gets monotonous after a while .
And it is much easier to get a job as a pccm doctor especially in private practice
P.S. there is a reason why Pitt/ Mayo give away their ccm spots like candy while it is almost impossible to even get an interview for the pulmonary spot

Ummmm. Pitt gives away their CCM spots like candy?

 

[CCM-MD]

But it is harder work and gets monotonous after a while .
And it is much easier to get a job as a pccm doctor especially in private practice
P.S. there is a reason why Pitt/ Mayo give away their ccm spots like candy while it is almost impossible to even get an interview for the pulmonary spot

This post shows your ignorance.

CCM is probably harder work, but pays better than pulm and shift work is quite awesome. What speaks for itself is that there are many pulm/cc trained folk working as pure intensivists. I can speak for my large midwestern city: most hospitals have employed intensivists and combined pulm/cc gigs are few.

 

[maverickdoc]

This post shows your ignorance.

CCM is probably harder work, but pays better than pulm and shift work is quite awesome. What speaks for itself is that there are many pulm/cc trained folk working as pure intensivists. I can speak for my large midwestern city: most hospitals have employed intensivists and combined pulm/cc gigs are few.

I am not trying to pick up a fight , we are on the same team . Just giving my two cents . When I applied 4 yrs ago , I got a pre match at Pitt/ Mayo and I was an average candidate . Mayo was not even going into match . Same with Mt Sinai I think .

 

[CCM-MD]

I am not trying to pick up a fight , we are on the same team . Just giving my two cents . When I applied 4 yrs ago , I got a pre match at Pitt/ Mayo and I was an average candidate . Mayo was not even going into match . Same with Mt Sinai I think .

There is no match for CCM.

 

[NewYorkDoctors]

So are Pulm/CC jobs pretty much a packaged deal? A Pulm/CC fellow who just graduates cannot realistically expect to do all pulm because the employers would want ICU coverage then? We have already explored doing all CCM in the earlier posts.

 

[maverickdoc]

So are Pulm/CC jobs pretty much a packaged deal? A Pulm/CC fellow who just graduates cannot realistically expect to do all pulm because the employers would want ICU coverage then? We have already explored doing all CCM in the earlier posts.

There are all sorts of jobs that I get recruiter emails for .
Most are pulm plus ccm.
But there are pulm only ( mostly outpt ),
Ccm only ( bigger hospitals ) and even pulm sleep
Obviously in academics it is more focused

 

[tartesos]

So are Pulm/CC jobs pretty much a packaged deal? A Pulm/CC fellow who just graduates cannot realistically expect to do all pulm because the employers would want ICU coverage then? We have already explored doing all CCM in the earlier posts.

You can do pulm only almost anywhere, just don't expect the same pay.


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[PulmDr]

I have been practicing pulm only (inpatient and outpatient at a large practice in the northeast). Now I am mostly inpatient and outpatient pulmonary and barely do ccm. I'm rvu based and wouldn't have it any other way. Find a rvu based practice and you'll feel rewarded regardless and will have more autonomy over when your days begin and finish.

 

[Histiocytosis XYZ]

Assuming I'm just waiting on my PD to upload his letter, but have 3 other letters uploaded and ready to go- whats the best strat here? Send out the app and assign his letter later or send everything at once? Last year's thread mentions something about the letters being available immediately to programs after they are uploaded now. Can anyone confirm?

 

[NewYorkDoctors]

Assuming I'm just waiting on my PD to upload his letter, but have 3 other letters uploaded and ready to go- whats the best strat here? Send out the app and assign his letter later or send everything at once? Last year's thread mentions something about the letters being available immediately to programs after they are uploaded now. Can anyone confirm?

Similar scenario as above I am wondering about.

3 out of 4 letters are ready (PD one in my case is ready)

The fourth letter is a prominent faculty member whose word will go a long way. But will likely not make the 7/15 cutoff (maybe upload week after and then plus the EDFO processing time)

Should I sit on it and wait or just submit with 3?

 

[gutonc]

I'll never understand why these questions get asked for fellowship apps. It's exactly the same as it was 3 years ago folks (except that apps no longer get downloaded, they just exist online, which makes holding out even dumber). Just submit.

 

[Histiocytosis XYZ]

I'll never understand why these questions get asked for fellowship apps. It's exactly the same as it was 3 years ago folks (except that apps no longer get downloaded, they just exist online, which makes holding out even dumber). Just submit.

I suppose because i did not have this problem three years ago, and therefore did not delve into the answer. The last 2 words of your post were helpful, thanks

 

[MedicinalTofu]

So in that above scenario, if a program requests 4 LOR but only 3 are in at the time of submission on 7/15 with a fourth one pending, does that application get screened and turned down in that case?