Pediatric Cardiology

Discussion in 'Pediatrics' started by sam1, Apr 28, 2007.

  1. sam1

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    I thought it would be nice to start this thread for Pediatric residents aspiring to pursue a career in Pediatric Cardiology. Please contribute.:)
     
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  3. sam1

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  4. oldbearprofessor

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    To the very best of my knowledge, there are no current pedi cardiology fellows or attendings who post on SDN. If there are...well, come out, come out, wherever you are.....

    So, first off, I would like to avoid adding any stickies to the pedi forum. These decrease ease of getting around the forum. If there are multiple threads on multiple specialties, I can add them to a single sticky or rename the pedi links one to make it clear where these are (e.g. create a table of contents sticky).

    Now then, lacking anyone to correct me, or perhaps as a way of "goading" someone to correct me :p , here's a bit about pedi cardiology from the perspective of someone who has worked with them on a daily basis for over 20 years, but isn't one...

    Pediatric cardiology is a pedi subspecialty and, like virtually all of them, requires a 3 year fellowship in which nearly2/3 of the time will be research. One matches into it as noted via the NRMP matching process with interviews conducted towards the middle of the PL-2 year.

    The match statistics http://www.nrmp.org/fellow/match_name/ped_card/stats.html

    as they often do, don't well reflect the competitiveness or lack of competitveness of the field. Although I'm sure all accredited programs are good, there are certainly 5-8 that are the best known with the highest volume and therefore are the most competitive. I'll leave it to others to name them. :rolleyes: .

    There are sub-sub specialties of pediatric cardiology that are accessed via an extra year of fellowship (selected by the institution - no match).

    http://pediatriccardiology.uchicago.edu/PCFellowship.htm

    is typical of programs I am familiar with and indicates that the two fields for the extra year of training are electophysiology and interventional (cardiac cath). Of course, all pedi cardiologists are trained in these, but in the largest children's hospitals there will be a separate EP and cath service.

    Lifestyle and salary are relatively similar to other critical care pediatric specialties (NICU and PICU). Private practice exists but not as widespread as NICU. Pediatrix, the private practice groups which manages a large number of neonatal practices is increasing buying up pediatric cardiology practices. Like NICU and PICU, at the largest children's hospitals, there is an increasing trend for 24 hour in-house coverage by attendings. We'll see how widespread this becomes.

    The day of a pediatric cardiologist is highly varied. There are clinics - follow-up of known congenital heart patients and evaluation of new consults. This includes a fair amount of playing with entirely well babies sent in due to a murmur that is benign. It also includes a bit of high drama. Several times, those same babies have turned out to have closing PDA's which protected their coarctation or other major defect and had to be "rushed" and I mean "rushed" to our NICU from the clinic...

    Inpatient consists of seeing pre-op patients, and seeing in-patients who are on the wards and in the NICU, of managing post-op patients in a cardiac or pediatric ICU and general floor duty for more stable patients.

    Research is highly varied - there is molecular research going on. For example,

    http://imgen.bcm.tmc.edu/molgen/facultyaz/towbin.html

    runs a large research program that is molecular oriented.

    There is also plenty of clinical research going on too.

    Increasingly there is interest in long-term follow-up, nutrition and social issues in children with congenital heart disease. In the right place, fellows could find projects in these areas as well.

    Hope this helps start some discussion.
     
  5. sam1

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    Thanks oldbearprofessor, lets keep the thread going!
     
  6. 14022

    14022 Unregistered Abuser
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    I agree with everything that OBP has posted. Peds cards is often mentioned in the same breath with NICU and PICU as specialties that attract people who like physiology, procedures, and high acuity. I think what makes peds cards much different from NICU and PICU is the how varied the job can be from day to day. This could be good or bad depending on how you look at it.

    What I mean by this is such. You cover every age of patient, from the fetus with fetal echo to the adult with congenital heart disease (which could even be an elderly person with a TIA from an ASD for which you close in the cath lab). You cover every level of acuity from the healthy child with an innocent murmur to a critically ill neonate with hypoplastic left heart. You can practice in almost every part of the hospital, from outpatient clinic, to the ER, to the inpatient wards, to the NICU/PICU. You can find jobs in both private practice and university hospitals. You can be a "radiologist" by doing echocardiograms and you can be a "surgeon" by doing interventional cardiac cath and EP. There are plenty of opportunities for basic science, translational, and clinical research.

    I am someone who can get bored pretty easily so subspecializing can be somewhat undesireable, but there is so much variety within the field of peds cards that I feel it would be a great specialty for someone like me.
     
  7. Reddpoint

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    One question I have had is about job availablity. I worry that unlike adult specialities, it might be difficult to have flexibilty in choosing a place to work. Any thoughts?
     
  8. 14022

    14022 Unregistered Abuser
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    Because the vast majority of kids are healthy, pediatric subspecialists can usually only practice in areas that have a dense population and can support a hospital that will see enough pathology that would support subspecialists. Obviously it will be hard to practice any peds subspecialty (with exception of NICU and PICU) in a rural area. So the majority of jobs are in academic medical centers in "large" cities. But "large city" is a pretty loose term since it can mean anything from New York City to Des Moines, Iowa.

    But in general, if you are well-trained and can offer a lot to a hospital, you can probably find a job fairly easily in any "large city," although it may not be for the salary you are hoping for. You run that risk, but if you truely love what you do, it is a risk worth taking.
     
  9. pedsresident

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    I'm glad someone started this thread. I am nearing the end of my intern year and looking at different Cards Fellowships. I've had a hard time finding a good source of information. I did come across the MUSC program. But from what I've been told the program is very malignant. Fellows are lazy, the attendings are almost psychotic, and the department tends to dissociate themselves from the rest of the pediatric department. I am clearly not interested in a program like this and will most likely stay away from MUSC but would like thoughts on other programs that might be more interesting and without these clear drawbacks.
     
  10. arydolphin

    arydolphin Member
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    I've been on the interview trail for Peds Cardiology in the past few months, and one thing that I've come across is that there is a great variety in terms of jobs that you can get in Peds Cardiology. While lots of programs are looking for people that will focus on the basic science research aspect of things, there are also a good amount of opportunities in the clinical science arena as well. Some programs are even diversifying into looking for some people to do more of the hopsitalist tasks while other practitioners are more based in the clinics and other outpatient areas. Like scholes, the field appeals to me because of the variety, and I'll be headed into fellowship with an open mind on what I'd want to go into after fellowship.
     
  11. Berkanita

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    Hi There!

    I am a newbie in this forum but I am glad to say that I liked most of these links you guys gave.

    :oops: cool!
     
  12. oldbearprofessor

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    Please remember that opinions, especially very negative ones, about a particular program are always best provided based on personal experience. Otherwise they are rumor and gossip which is not ideal as a means of communicating experiences.

    I recommend that in general, even with the level of anonymity that SDN provides, that people not discuss details of specific programs in a public forum. The world of pediatric specialty training is a very very small one compared to most other fields and folks know each other well.

    YMMV however, and unless it is grossly inappropriate, I won't delete anything in this regard unless it is about my program (j/k).
     
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  13. cardsurgguy

    cardsurgguy Senior Member
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    A few years ago prior to starting med school when I was working at my job, I overheard a pediatric cardiologist talking to a med student telling him that the market was excellent for peds cardiologists.

    In this particular year, he mentioned there were 200 positions open for pediatric cardiologists with only 60 coming out of fellowship. In other words, the salaries were good and you could go whereever you wanted to no questions asked.

    Is this still the way it is now or was he even right in the first place?
     
  14. GAdoc

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    I'd just like to get an idea for what you think made you a successful applicant for ped cards. Did you know going into your pediatric residency that you would ultimately pursue a fellowship? Did it scare you that you might not obtain a fellowship spot? What would you have done/do if you don't obtain a slot?
     
  15. Complications

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    So ... what are the best programs? Child mag has a ranking ... for what that's worth ... but what do you guys think?

    Cardiac Care
    1. Children's Hospital Boston: The hospital is conducting 74 cardiac-related studies, among the most in our survey. Among its research accomplishments: the development of innovative tissue engineering techniques to avoid the need for pacemakers and artificial heart valves.

    2. The Children's Hospital of Philadelphia: In addition to performing more than 375 complex cardiac surgeries in-house in 2005, the hospital sent a team of heart specialists to nearby facilities to operate at the bedsides of nearly 100 premature infants with Patent Ductus Arteriosus, a condition in which the vessel that allows blood to bypass the baby's lungs before birth fails to close normally.

    3. Children's Healthcare of Atlanta: The facility is a leader in the field of cardiac genetics, conducting research to help explain the development of congenital heart disease and identify genotypes in patients with certain heart conditions. This will enable doctors to predict whether patients are at a greater risk of death or more likely to require a heart transplant, knowledge that will facilitate their care.

    4. Texas Children's Hospital, Houston: In 2004 and 2005, its heart surgeons performed 83 extremely risky operations -- and only three patients died, one of the best survival rates of our survey.

    5. The Children's Hospital, Denver: The hospital is a leader in pediatric heart transplants, with three-year survival rates around 85% and shorter-than-average patient stays.

    Runners-Up: 6. Morgan Stanley Children's Hospital of NewYork-Presbyterian in New York City; 7. University of Michigan C.S. Mott Children's Hospital in Ann Arbor; 8. Children's Hospital Wisconsin; 9. Cincinnati Children's Hospital Medical Center; and 10. Children's Medical Center Dallas
     
  16. arydolphin

    arydolphin Member
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    I'll get back to you in a week, Match Day is June 13, so basically I'm on pins and needles right now wondering what I'll find out on that day.
     
  17. wex

    wex New Member

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    arydolphin,

    what were your feelings about the programs? did you go to the big powerhouses? What are you hoping for next week?

    Good luck!
    -wex
     
  18. drbon

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    i was just wondering how competitive peds cardio spots are....there seems to be very few programs out there (only 4 in the whole NYC/NJ metro area that take like 1-2 ppl per year). any advice on how to be a good candidate?
     
  19. jowell

    jowell Junior Member
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    Good luck to all of you matching today in Pediatric Cardiology!
    I hope you all end up happy!
     
  20. meconiumdelee

    meconiumdelee Yellow Fellow
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    I take that ranking with a grain of salt. It's CHILD magazine. It's written with the perspective of parents....it may be a great place to be a patient, but there is a lot more than what makes a program "great." What is important varies depending on what role you play. A great place to be a patient doesn't always mean the best place to be a fellow or a resident.

    Just my 0.02

    Anyone match today?
     
  21. 14022

    14022 Unregistered Abuser
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    I hear what you are saying, but if you look at the methodology of the rankings, the Child magazine rankings are much much much more legitimate than the worthless US News and World Report rankings for children's hospitals. US News relies ONLY on hospital reputation, which they obtain from surveys of a bunch of doctor's throughout the country. From US News website..."Ranked only by reputation, each hospital was recommended by at least 3 percent of responding board-certified physicians surveyed in their specialty by U.S. News in 2004, 2005, and 2006." This is very political and subjective.

    Child magazine uses actual data and information about the hospitals themselves. Although it has its limitations, it is more objective than US News. From Child Magazine website...."Our comprehensive 247-question survey, guided by leading pediatric experts (listed on page 12 of this article), examines vital medical information including survival rates, the number of complex procedures and intricate surgeries conducted, volume of research studies, efforts to reduce medical errors, and the quality and training of the doctors and nurses -- as well as child-friendliness, support for families, and community involvement. It was sent to the 116 full members of the National Association of Children's Hospitals and Related Institutions last August. Seventy-six hospitals completed the survey. The responses were graded to determine the best hospitals overall and the leaders in six pediatric subspecialty areas."

    But I agree that neither is perfect and neither really indicates the better training programs.
     
  22. Complications

    Complications Member
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    To the root of the question ... what are the top places if they are not on that list ...
     
  23. 14022

    14022 Unregistered Abuser
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    That's the thing, those are considered among the top programs, maybe with the exception of denver. The top programs (in no particular order) are boston, chop, michigan, and baylor. right behind are places like atlanta, stanford, ucla, cincinatti, milwaukee, columbia, and others.
     
  24. azure251

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    Hi everyone,

    I am a 3rd year medical student (for the next 2 weeks :) ), who will be starting off her 4th year with a Pediatric Cardiology elective. I was wondering if you had any advice on any good references I should consider purchasing that would be helpful for me through out my rotation. I know I want to do peds, but I am still uncertain if I will want to specialize. Any suggestions are Greatly! appreciated.

    Lisa :)
     
  25. UVa2005

    UVa2005 Junior Member
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    Just wanted to state that CHILD magazine rankings, like US News, are also not great since they do not include hospitals/programs that are not a part of a "children's hospital". Therefore, there are some great programs out there that are not ranked because they are not stand alone hospitals.
     
  26. arydolphin

    arydolphin Member
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    Quick update, since I'm on PICU call and a kid is coming in soon: I didn't match yesterday. I'm still in flux at the moment about all of it, but honestly, I wasn't super-confident going into the match since I had heard all throughout interview season that this year was really competitive. The stats that the NRMP put out yesterday validated that. Here are the bare-bones numbers: 170 certified applicants for 108 spots, and 101 matched. That leaves 69 people that didn't match and only 7 unfilled positions. In other words, 41% of the applicants didn't match, so it's not like I didn't have some company in not matching. Anyways, I still definitely want to go into Peds Cards, I just have to figure out a way to give myself a better shot next year. If anyone wants me to post the full stats, like US grads vs. foreign grads and such, just let me know.
     
  27. arydolphin

    arydolphin Member
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    The Pediatric Cardiology Handbook by Myung Park is a nice little resource to have. It's a good review book that covers all of the major topics in peds cardiology, and it's a fairly easy read. Plus, it'll fit nicely into one of the pockets on your white coat, so you can have easy access to it throughout your rotation. You could also look into a book on EKGs so that you'll be able to interpret EKGs on your rotation. I like the Dubin book on EKGs, but there may be some other books that others like. Best of luck with your rotation!
     
  28. oldbearprofessor

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    bummer...sorry to hear this. Let us know how things work out.
     
  29. azure251

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    Thanks so much!
     
  30. ZekeMD

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    Hey Arydolphin,

    What kinds of things go into the peds cardio fellowship application? Do they look at board scores, med school grades, or just residency stuff and letters from the residency program? Thanks

    Zeke
     
  31. 14022

    14022 Unregistered Abuser
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    I haven't yet applied but I will tell you what my chief residents told me, who both recently matched into cardiology.

    First, and hopefully this will soon change, there is no consolidated application service, like ERAS for residency, AMCAS for medical school, etc. You need to go to each website and download the individual application for each program. Each program requires different information. Some want things like medical school transcripts and/or dean's letter, some want USMLE scores, some want a personal statement. All want letters of recommendation, at least 3, and some want more.

    The LOR's are arguably among the most important, especially if from well-known people. Most programs want 1 or 2 letters from a cardiologist. All want one from your PD, some specifically want a non-cards letter.

    If you have an idea of where you may want to apply, just go to their website and see if they have the application available to download. You can see for yourself what those specific programs want.
     
  32. idealist22

    idealist22 Junior Member
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    hi there, i'm a 2nd year resident who matched in peds cardiology last week. i had applied to boston, chop, ucsf, texas children's, and columbia. i received interviews at all of them but turned down baylor (they do a 2-day interview and i just couldn't find time in my busy junior year call schedule to go down there). chop was my favorite program, but i loved columbia as well. all of the programs offered great training opportunities, i felt, especially for those planning on academic careers. i chose new york for relationship and family reasons, and i was thrilled to match there last week. if anyone has any questions about any of these programs, please feel free to email me.
    arydolphin, sorry to hear about your match day. the number of applications really shot up this year... last year only about 140 applied. it was definitely a tough year. i wish you the best of luck for next year.
     
  33. TexasRose

    TexasRose Gotta run
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    bump for interest
     
  34. yaypoker1

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    hi everyone,

    im a MS3 and interested in learning more about peds cardiology, specifically:

    what are the hours like?
    do you get to do any procedures?
    how would you describe your work environment? (stressful, colleagues)
    what is the average compensation?
    is malpractice/lawsuits high?

    Thanks very much!
     
  35. ZekeMD

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    It really depends on what area of cardiology you do. You can do interventional and then there are lots of procedures. You could also do electrophysiology, echo, etc etc etc. Salary varies based on location and whether you are in academics or private practice. My guess is that average is around $200K. But like I said, this can be highly variable. Hours also depend on what you do. You can tailor your practice to work as little or as much as you like.
     
  36. medpedsdoc

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    does anybody has any experience of pediatric cardiology interview at memphis tennesee, if so please share your experience.
     
  37. Prop

    Prop New Member
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    Hi all.

    I were just looking at this thread, and thought I'd post a few questions of my own.
    I'm a FMG, who have been set on IM and then a fellowship in cardiology for quite a while, but after doing my core rotation in pediatrics, I completely fell in love with it.

    Do You think research in adult cardiology will be considered as good as research in pediatric cardiology when applying for fellowship?
    Is pediatric cardiology as hard in hours etc as adult cardiology? (I understand that the adult cardiologists generally work very hard etc, but I'm not sure I'd want to live like that, having kids and all).
    How is the job outlook? Are there enough jobs to go around?

    On a side note, I'm also very interested in Neonatology, so if OBP (or any other neonatologist) is looking, maybe You could answer. How do You think Neo compares to ped cardiology in hours, competitiveness, job outlook etc?

    Thanks,
    Prop
     
  38. oldbearprofessor

    Administrator Rocket Scientist Physician Faculty SDN Advisor 10+ Year Member

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    There are plenty of jobs for all pedi subspecialists. The shortage is substantial for all, with some variability by sub-specialty.

    Comparing neo to cards - similar hours, neo fellowship is less competitive to get, especially if you aren't targeting a large center. Job outlook is good for both, although there are more neos and more jobs for neos in more places. But there are still a wide range of places and jobs for pedi cards.
     
  39. Prop

    Prop New Member
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    Thank You so much for the answer. When You say similar hours, how much is that? (I know it's different in different places, but an estimate would be great).
    I looked at the thread about how to become a neo, but I'm still not sure about how much You work. I understand that being in-house for 24 hours at a time is common, and that's what I'm expecting to do... but how many hours do You work in average each week? Is it 45-50 hours, or is it more like 70-80 hours?

    Thanks again,
    Prop
     
  40. bigtymer

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    How competitive is a pediatric cardiology fellowship compared to a general cardiology fellowship coming off of IM?
     
  41. Socrates25

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    Med-peds resident here. My thoughts are that adult cardiology is much more competitive than peds cardiology in terms of match.

    The post from 07 above includes only aggregate numbers with IMGs, which greatly dilutes the statistics.

    The peds cardiology match rate for american medical grads is around 75%, the lowest of any peds subspecialty but still much better than adult cards or adult GI.
     
  42. Tootsies

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    Does anyone have a recommendation for a book to read for a pediatric cardiology rotation? I only have 1 month, so it can't be too detailed, but I want to show that I'm at least reading...
    Thanks!
     
  43. J-Rad

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    This one for super-quick read (i.e. could be read a few days before the rotation):
    http://www.amazon.com/Fundamentals-Pediatric-Cardiology-David-Driscoll/dp/0781785006/ref=sr_1_9?ie=UTF8&s=books&qid=1277222011&sr=8-9

    This one for a more in depth (but, 4th-yr.-med-stud appropriate) reviews for things you see as you go along.

    http://www.amazon.com/Pediatric-Cardiology-Practitioners-Myung-Park/dp/0323046363/ref=sr_1_1?ie=UTF8&s=books&qid=1277222011&sr=8-1

    Read the EKG chapter before the rotation. The line drawings in the echo chapter will be helpful when you are looking at an echo.

    Alternatively, if you want a little more depth in fairly digestible chunks:
    http://www.amazon.com/Nadas-Pediatric-Cardiology-Barry-Keane/dp/1416023909/ref=sr_1_6?ie=UTF8&s=books&qid=1277222011&sr=8-6
    (But still read Park's EKG chapter).
     
  44. RySerr21

    RySerr21 i aint kinda hot Im sauna
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    how necessary do you guys think it is to attend a residency that has a peds cards fellowship? will it make your life that much easiser?
     
  45. michigangirl

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    Ryserr 21-- the peds cards folks will have a clear opinion on this, but in the general sense, it can be helpful in two ways-- you have an in with the fellowship program of the place you're at in case you want to stay, and you will get to know peds cards faculty that inevitably know other peds cards faculty at other places and can vouch for you. Not that this is not possible without a fellowship program, but having a fellowship means larger program, more faculty-- more connections.
     
  46. LionInTheDark

    10+ Year Member

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    I came from a program without a peds cards fellowship program, matched very well into fellowship, and can offer a few thoughts:

    1) I had no option of matching into my home program, which takes away your safety net and pretty much necessitates a move after residency (unless you are at St. Christopher's in Philly for example and want to go to CHOP...).

    2) Less cards research going on, although this didn't really seem to affect application. I did have other previous research experience though.

    3) I got the idea that the fellowship programs overall looked favorably on residents that trained without fellows, since as one faculty pointed out, you sort of "serve the role of fellow" in many situations as a resident, and get good preparation/more direct responsibility. Overall, I can't imagine it makes too big a difference in matching though.

    4) We did have a pretty involved ICU experience too, which programs seemed to look favorably upon.

    5) Without the fellows, you just work directly with the faculty, and the faculty are used to this, so it really isn't intimidating. On those services with fellows, we worked more closely with the fellows than the attendings.

    I doted over this quite a bit when making my residency rank list. The Chiefs at my program reassured me a lot during the final ranking process, and the fact that they had matched four people into pediatric cardiology the previous year, to Michigan, Denver, Cincinnati, and Stanford no less, went a long way to making me comfortable with my decision. Go somewhere where you will be happy, where you will be in the trenches, see alot of variety, and be given as much responsibility as you can handle. That will make you a good physician and set you up for success in pediatric cardiology.
     
  47. chocorocky

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    hi i am participating in ped. residency match 2012, and am yet to start residency, i am very interested in pediatric cardiology, can any of u tell me , out the following programs which ped residency is good if i want to do a ped. cardiology fellowship in a prestigious program like CHOP and Boston

    1. cleveland clinic
    2. SUNY downstate
    3. Albert einstein, PA
    4. St.John, detroit
    5. Texas tech elpaso
    6. Woodhull NY
     
  48. happyfeet814

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    Any thoughts on Children's Hospital of Wisconsin? Thank you so much
     
  49. J-Rad

    Physician Moderator Emeritus 15+ Year Member

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    Great program from what I've heard.
     
  50. JMMH

    JMMH Waddles, MD
    Physician Faculty 7+ Year Member

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    Agree very strong program. Never interviewed there but have met some of the faculty and have come away impressed with their description of the program and fellowship.
     
  51. Michelle McGee

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    Hello. I am in the process of selecting a residency program for the sole purpose of pursuing cardiology fellowship. I am here for advice because I have loved many programs and can not get a clear picture of the importance of program prestige when applying for fellowship.

    So, When selecting a residency, would I necessarily be better off at a program such as BCRP/CHOP/Northwestern (which have top programs in all subspecialties) when compared to a place like Michigan (seems like a great residency program, clearly a great cardiology center).
    Above all, when applying for fellowship I want flexibility in selecting a cardiology program anywhere in the country.

    Would appreciate feedback from anybody who has experience with the cardio match. Thank you.
     

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