Pediatric Cardiology Fellowship

[StarboardMD]

I just did my cards rotation last month and I think I found my calling. It caught me off-guard because I thought I hated cardiology until I realized that it's all very logical. Is anyone else on here going to apply in the spring match or anyone have any recommendations? I'm from a small program and I want to stay in my general region, so I won't be applying to a ton of places, which I realize is going to make getting a spot kind of a challenge. Hopefully it's not too competitive this year!

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[JMMH]

If cardiology is your calling I would apply to more places than you think initially. Fellowship is only three years, so it may be worth looking at more places to secure a spot. Compared to residency, I applied to much more geographically diverse places. I ended up doing fellowship in another part of the country I had never been, and it worked out great. I would much rather go straight through fellowship then miss out on a spot because I was too picky on location.

I was from a small program as well but my attendings were very supportive of my application. Good luck!

 

[StarboardMD]

Thanks for the advice! Did you do an away rotation prior to applying? I really think I need to, since we don't have a CICU or do very many procedures at my program, and that's kind of a big part of cardiology. Who knows, I might hate it! But the few programs I've contacted so far about an away have said that they don't do them any more because the ACGME has made it prohibitive.

 

[SurfingDoctor]

Thanks for the advice! Did you do an away rotation prior to applying? I really think I need to, since we don't have a CICU or do very many procedures at my program, and that's kind of a big part of cardiology. Who knows, I might hate it! But the few programs I've contacted so far about an away have said that they don't do them any more because the ACGME has made it prohibitive.

My advice is to never do an away rotation as a resident or fellow or whatever at another hospital unless you are mandated to. You will be at such a disadvantage compared to the physicians in the program, mostly with just system issues, that you will be perceived as slow and inefficient, which you will be because you don't know how the hospital runs. Despite thinking you may get "face time" or a letter or whatever from it, it typically doesn't work that way. For medical students, the issue is different because showing enthusiasm and having face time lead to recognition and that's enough as you have residents to help manage the work in an unfamiliar system. But as a resident, if your work is slower than other residents around you because of unfamiliarity with a system, no one is going to pick up the slack and your face time and enthusiasm will not matter. There also issues with credentialing, malpractice, etc. which are paperwork hurdles, but the work flow issue will be more of a hindrance.

 

[RySerr21]

My advice is to never do an away rotation as a resident or fellow or whatever at another hospital unless you are mandated to. You will be at such a disadvantage compared to the physicians in the program, mostly with just system issues, that you will be perceived as slow and inefficient, which you will be because you don't know how the hospital runs. Despite thinking you may get "face time" or a letter or whatever from it, it typically doesn't work that way. For medical students, the issue is different because showing enthusiasm and having face time lead to recognition and that's enough as you have residents to help manage the work in an unfamiliar system. But as a resident, if your work is slower than other residents around you because of unfamiliarity with a system, no one is going to pick up the slack and your face time and enthusiasm will not matter. There also issues with credentialing, malpractice, etc. which are paperwork hurdles, but the work flow issue will be more of a hindrance.

I disagree with this whole heartedly....of course you are not going to be as fast and efficient as the people who are IN the program. Why would they even make that comparison or have that expectation be any different? I did a peds cards away as a med student and as a resident and had great experiences both times. They aren't expecting you to show up on day one and be efficient and know where everything is. Yes, its a hassle to have to learn things, but it isn't SO bad that it renders you completely useless. If you are so far behind you literally can't get your work done and other people are having to step in and do it for you, its not bc you are new to the system - its bc you arent a good resident. It IS about showing up and being enthusiastic, and being a team player, getting along with the nurses and other house staff and having strong work ethic, a passion for the subject, and showing off whatever knowledge you have, etc. So what if it takes you a little bit longer to figure out how to get the echo lab, or to write a note. No one is timing those things. What it does mean is that you will just have to work a little harder. Come in earlier, stay later, whatever you have to do to get the job done. People will notice that, and instead of "this resident is not as fast and efficient" it becoems " man this resident is working his ass off and doing whatever he needs to do to get his work done and take care of his patients...oh and on top of that he is super cool."

So, while there are risks with an away, i believe they can be extremely helpful IF you are a good resident. Thats a big IF, if you are socially awkward or dont get along with people or dont have a good work ethic then best to try and trick them with your paper application. I had a lot of support from the program and received a letter as well. Its also a great opportunity for you to see how a program with a fellowship works, especially if you come from a smaller program. Where i trained, doing aways seemed pretty common and everyone seemed to have a positive experience. I agree that the paperwork to get their is a huge pain in the ass, but its 100% worth it.

 

[SurfingDoctor]

I disagree with this whole heartedly....of course you are not going to be as fast and efficient as the people who are IN the program. Why would they even make that comparison or have that expectation be any different? I did a peds cards away as a med student and as a resident and had great experiences both times. They aren't expecting you to show up on day one and be efficient and know where everything is. Yes, its a hassle to have to learn things, but it isn't SO bad that it renders you completely useless. If you are so far behind you literally can't get your work done and other people are having to step in and do it for you, its not bc you are new to the system - its bc you arent a good resident. It IS about showing up and being enthusiastic, and being a team player, getting along with the nurses and other house staff and having strong work ethic, a passion for the subject, and showing off whatever knowledge you have, etc. So what if it takes you a little bit longer to figure out how to get the echo lab, or to write a note. No one is timing those things. What it does mean is that you will just have to work a little harder. Come in earlier, stay later, whatever you have to do to get the job done. People will notice that, and instead of "this resident is not as fast and efficient" it becoems " man this resident is working his ass off and doing whatever he needs to do to get his work done and take care of his patients...oh and on top of that he is super cool."

So, while there are risks with an away, i believe they can be extremely helpful IF you are a good resident. Thats a big IF, if you are socially awkward or dont get along with people or dont have a good work ethic then best to try and trick them with your paper application. I had a lot of support from the program and received a letter as well. Its also a great opportunity for you to see how a program with a fellowship works, especially if you come from a smaller program. Where i trained, doing aways seemed pretty common and everyone seemed to have a positive experience. I agree that the paperwork to get their is a huge pain in the ass, but its 100% worth it.

Fair enough, people can have different experiences. I wouldn't doubt that if a resident did an away outpatient rotation or maybe even a ward rotation, it could be okay. But this was in reference to CVICU. One, residents don't typically rotate in CVICUs and two, to be a outsider to the system in a high acuity environment, well I don't see it going well.

 

[RySerr21]

Fair enough, people can have different experiences. I wouldn't doubt that if a resident did an away outpatient rotation or maybe even a ward rotation, it could be okay. But this was in reference to CVICU. One, residents don't typically rotate in CVICUs and two, to be a outsider to the system in a high acuity environment, well I don't see it going well.

Ahh. It seemed like more of a general discussion on doing an away rotation. I would agree that doing a CVICU specific away rotation as someone interested in a peds cards fellowship would not be as advisable, but more so bc you'd be getting more exposure the ICU department than the cards department. i think whether or not residents go through cvicu is also variable - we had it as an elective option and also just as part of the required picu experience.

 

[StarboardMD]

Thanks for all the input. Makes a lot of sense. I guess my biggest concern is that my home program is so small, and anything with significant acuity simply bypasses us, so I feel like I'm not getting a realistic representation of what a lot of cardiologists do. I would hate to go to all the trouble of getting into a fellowship only to realize that I don't enjoy it.

Maybe I should try to get an away at a program I'm not that interested in, since I really just want exposure. I have a pretty good personality and I'm easy to work with, but my knowledge base is pretty significantly lacking, since I only recently realized that I am interested in it, and everyone else I've talked to knew they wanted to do cards from the time they could walk...

 

[JMMH]

I did an away rotation as a 4th year medical student hoping to land a residency, and it didn't work out. I wouldn't recommend it as I think it can only hurt you rather than help. With that much face time you can blow people away for 99% of the time you are there, but if you do one thing that annoys one person, it can torpedo your chances.

As a resident I wouldn't worry about your exposure to various things, that's what fellowship is for.

 

[dr.peds]

Hey future pediatric cardiologists... I am from a small program and nobody has been able to answer this question. How many programs should I apply to be "safe"?

 

[StarboardMD]

Bump...I'm curious what people think about how many programs to apply to...

 

[dr.peds]

Bump...I'm curious what people think about how many programs to apply to...

I've been asking and most people have told me they applied to no more than 10 programs... I haven't seen any stats about that in particular...

 

[Step Up]

I've been asking and most people have told me they applied to no more than 10 programs... I haven't seen any stats about that in particular...

Applied?! I think "most people" mean they interviewed at no more than 10 programs! I would apply to more than that if you are not significantly geographically restricted. Pediatric cardiology match is very competitive unless you are an outstanding candidate. You don't have to accept all of the interview offers.

 

[dr.peds]

Applied?! I think "most people" mean they interviewed at no more than 10 programs! I would apply to more than that if you are not significantly geographically restricted. Pediatric cardiology match is very competitive unless you are an outstanding candidate. You don't have to accept all of the interview offers.

Yes, applied... that's what they have told me, but maybe it was not as competitive 5-10 years ago as it is now... I will apply to 25 programs at least...

 

[ElliotReid]

Whoa. Yeah, ten is a lot less than what I was assuming. I'm pretty limited geographically, so I won't be applying to that many, but I'm aware that I might be comprimising my chances of matching...

 

[Jkaur]

Hi everyone,
This is question for current or future pediatric cardiologists.
I am currently second year pediatric resident and planning to apply for Peds cardiology. I want to know what is the nature of the fellowship, work/life balance and any wise suggestions/opinions are most welcome.
Thank you.

 

[BigRedBeta]

Hi everyone,
This is question for current or future pediatric cardiologists.
I am currently second year pediatric resident and planning to apply for Peds cardiology. I want to know what is the nature of the fellowship, work/life balance and any wise suggestions/opinions are most welcome.
Thank you.

No doubt cardiology is a demanding fellowship. I think this is enhanced by the number of 4th year fellowships coming out of the general fellowship - imaging, EP, transplant, CICU, interventional, adult congenital. You end up with a lot of extra expertise amongst the faculty and that likely increases the expectations. Depending on how heavy your ICU call is, you may have an extremely rigorous 3 years of fellowship that goes beyond any other pediatric subspecialty field. Depending on how you define and prioritize that work/life balance, you may find a number of programs that will stretch you further than you want.

That said, work/life balance is a funny thing and can be manifested a lot of different ways. As a PICU attending, I much prefer my shift work style schedule that allows me to leave the hospital at the end of my shift without any major worry that I'll have to return. I like being able to turn off my phone to work calls at a certain time. Other people would find my 5-6 weeks of nights in-house unacceptable and prefer to be at home, even if it means the phone calls may come at all hours of the night.