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Pulmonary and Critical Care fellowship 2020/2021 cycle

Iyanu ah Shele

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Its that time of the year again. As ERAS is now open, i was hoping we could get some helpful discussions going here.

My credentials : IMG, No visa needed, average USMLE scores, Posters and Oral presentations, attended national conferences, popular university affiliated community hospital, gap year, plan to apply broadly.

Any advice from last years applicants would be appreciated especially with the virtual interview this year.

Good luck guys.
 

the argus

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Anyone else notice a large number of critical care medicine only options listed under the PCCM programs? Is that new this year?
According to the ACGME website there are currently 45 CCM-only programs offered through IM departments. These tend to be at big academic centers (with some exceptions). They are filled with people either adding a critical care year onto another IM fellowship (cards, nephro, ID, etc) or doing a stand alone 2 year CCM fellowship.

You'll also run into the 22 pulmonary-only programs which in contrast tend to be at smaller community hospitals (again, with some exceptions).

 
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Doctor Bob

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aPD perspective.

We have a CCM only program; 6 spots per year, total complement of 12... which is pretty big for a CCM-only program.
(coughcough orlandocriticalcare.com coughcough shamelessplug)

The reason that there aren't many CCM-only programs relative to the total number of PCCM programs has to do with a requirement of the ACGME for CCM program accreditation.

For an institution to apply to have a CCM fellowship, they already have to have an IM residency in place, as well as 3 other IM subspecialty fellowship programs. CCM is the only IM fellowship that has an accreditation requirement dependent on the presence of other fellowships. Now, pulmonary counts as one of those IM subspecialty programs you can have, and as a twist, if your institution only has two IM fellowships in place, you could apply for pulm and CCM combined at the same time.

That strict requirement is starting to loosen so I would expect to see a rise in CCM-only programs in the next few years.

Now, as for what you should apply for... pulm only, or CCM only, or PCCM... it's the age-old advice of "train in the field you want to practice in". If your plan is to do CCM only, then just do CCM. You will spend more time in the ICU as a CCM fellow than you will as a PCCM fellow. And if you want to have a clinic and never set foot in an ICU, then pulm alone is better than the combined track. PCCM is good if you want to do both (and not have one as a fallback 10 years down the road... if you don't practice in one for a decade then you aren't going to be able to pick it back up way down the road as a "retirement option") or if you want to do research.

If your goal is to do PCCM, my 2 cents is that it's better to not match into a combined program, than to try and do them piecemeal. While most CCM programs have a mechanism in place to accomodate someone who only needs to do 1 year, it messes up the acceptance plans. If I accept a 1yr person this year, then I have to accept another 1yr person next year or have an unfilled spot in the program. And maybe next year there won't be a good 1yr applicant. Personally, it doesn't factor into our point-structure for applicant ranking, but it does whisper in the back of our minds.

That's a lot of words that ultimately boils down to: it depends
 
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Breitenfeld31

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Hi all,

I am hoping for some insight into the clinical experience and training from PCCM at Dartmouth and VCU from anyone familiar with the programs. I have spent time reviewing their sites, but was hoping for feedback from people who may have been there or interviewed in person. Thanks in advance.
 

DDEA

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Its that time of the year again. As ERAS is now open, i was hoping we could get some helpful discussions going here.

My credentials : IMG, No visa needed, average USMLE scores, Posters and Oral presentations, attended national conferences, popular university affiliated community hospital, gap year, plan to apply broadly.

Any advice from last years applicants would be appreciated especially with the virtual interview this year.

Good luck guys.

Hi All,
I hope all of us to do well during this interview trail. My credentials : IMG on J1, USMLE Step 1 240's, Step 2 250's, Step 3 230's. >10 articles published in peer reviewed journals, > 15 posters. Coming from university program. Applying broadly.
 

Iyanu ah Shele

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Hi All,
I hope all of us to do well during this interview trail. My credentials : IMG on J1, USMLE Step 1 240's, Step 2 250's, Step 3 230's. >10 articles published in peer reviewed journals, > 15 posters. Coming from university program. Applying broadly.
Strong credentials, I think you should be good.

Good luck to all
 
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Doctor Bob

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This should not be taken as a discouragement to application, but so you are aware of something that is lingering in the back of PD's minds...

The US administration keeps making rumblings about limiting/denying visas (specifically the J1 and H1B that most applicants ask for). The worry for us would be that we would accept someone and then have our ability to onboard them blocked at levels that we can't do anything about.

The visa lawyers that our hospital uses (and I imagine most big places are the same) are pretty good at getting applications approved even when the process is limited because GME is a different kind of market. But... just something that all residency/fellowship PDs are keeping an eye on...
 

dooly

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Can anyone give some insight as to applying on July 1st and programs not viewing applications till Aug?

Should we still aim to apply tomorrow, I have an outstanding LoR and wondering if I should wait to submit my application? Or can the pending letter be submitted at a later time?
 

nola2016

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Can anyone give some insight as to applying on July 1st and programs not viewing applications till Aug?

Should we still aim to apply tomorrow, I have an outstanding LoR and wondering if I should wait to submit my application? Or can the pending letter be submitted at a later time?

From what I was told, because of the ongoing issues that is why they delayed it essentially a month. I was told by a colleague who spoke with a fellowship PD (non-Pulm Crit) that the applicants just submit when they're ready.

You can get the things in, but to create an even field for everyone (some states being in different phases of COVID), the scheduling issues, to help the PDs/programs plan how to interview, etc.
 

dooly

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From what I was told, because of the ongoing issues that is why they delayed it essentially a month. I was told by a colleague who spoke with a fellowship PD (non-Pulm Crit) that the applicants just submit when they're ready.

You can get the things in, but to create an even field for everyone (some states being in different phases of COVID), the scheduling issues, to help the PDs/programs plan how to interview, etc.


Makes sense, thank you!
 

the argus

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Can anyone give some insight as to applying on July 1st and programs not viewing applications till Aug?

Should we still aim to apply tomorrow, I have an outstanding LoR and wondering if I should wait to submit my application? Or can the pending letter be submitted at a later time?
From the front page of the ERAS website,

"ERAS 2021 July cycle fellowships are now open! Applicants may begin submitting applications to July cycle fellowship programs. Programs may begin reviewing applications on Wednesday, August 12 at 9 a.m. ET. Applications submitted on or before August 12 at 9 a.m. ET will display an application date of “August 12” to programs. Applications submitted after August 12 will be date-stamped in real-time."
 

zooplankton

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I graduated from a community (new medical school) program without in-house fellowship in 2018. I am an IMG on H1 visa. I am interested in Pulmonary and critical care fellowship. I only did posters during residency but have not published anything yet (working on two projects currently while working as a hospitalist). I passed CS only on my second attempt. My step 1 was high 250, ck high 260 and step 3 was 240. What are my chances for getting into fellowship? Will my CS-attempt filter my application out?
My biggest red flags are 1. IMG 2. H1 visa (limits me to only 20-30 programs all over the country) 3. CS attempt 4. Not a well known residency program 5. lack of research 6. 3 yr gap since graduating residency
Only plus points are 1. scores 2. passed critical care echo boards

I know the only thing I can work on right now is do more research and try to get many publications. I know I don't enjoy research as much as clinical medicine but will try my best to improve my CV.

What is your honest opinion considering my situation, should I even apply for fellowhip ?
 
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Iyanu ah Shele

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I graduated from a community (new medical school) program without in-house fellowship in 2018. I am an IMG on H1 visa. I am interested in Pulmonary and critical care fellowship. I only did posters during residency but have not published anything yet (working on two projects currently while working as a hospitalist). I passed CS only on my second attempt. My step 1 was high 250, ck high 260 and step 3 was 240. What are my chances for getting into fellowship? Will my CS-attempt filter my application out?
My biggest red flags are 1. IMG 2. H1 visa (limits me to only 20-30 programs all over the country) 3. CS attempt 4. Not a well known residency program 5. lack of research 6. 3 yr gap since graduating residency
Only plus points are 1. scores 2. passed critical care echo boards

I know the only thing I can work on right now is do more research and try to get many publications. I know I don't enjoy research as much as clinical medicine but will try my best to improve my CV.

What is your honest opinion considering my situation, should I even apply for fellowhip ?
I think the major red flag here is the H1 status. With the numerous changes being made, I don’t know how it’s going to affect sponsorship this year.
 

Doctor Bob

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Is this also going to affect international students currently studying in USA? Lot of my classmates are Canadians who'll be applying to residency hoping to be sponsored via J1/H1B.

It's not supposed to affect people already here on those visas. It's only supposed to affect new applications/reapplications.
But again... it's all speculation until there's actually official policy.
 

Doctor Bob

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Application submitted. Let the wait begin!!!!

This is bothersome to us on the other side of the applications as well...
I know they're in the system... electronically waiting... and I'm not allowed to see any of them until mid August...

But I know they're there.

Waiting.




Waiting...
 
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Critforlife

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I heard from a fellow that NY programs will be doing video interviews and I am guessing its gonna be the same all over. An other interesting thing I was thinking and had a discussion with my mentor too is, now that a lot of residents worked full time for almost 4 months in ICUs because of covid and a lot of talk regarding critical care, will it become more competitive?
Had to wait and see, what do you think guys!
 

Doctor Bob

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ACGME/AAMC sent a very nice email to all of the programs recommending they hold virtual interviews this year.
It isn't required but... it's likely to be the standard. You may find some places that offer both in-person and virtual but I would be surprised if there were any places doing only in-person interviews.

Here in Orlando we're only doing virtual interviews.
 
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Doctor Bob

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If a program just states 3 LOR required on their website (including PD letter) but don't specify they don't want any more--is it ok to send a 4th letter if we have it?

You are always free to do whatever you like, but it's best to follow the instructions.
Some programs may not care and will just shrug off the extra LOR (neutral outcome)
Some programs will only download the first 3 LORs and ignore the 4th (neutral to potentially negative outcome depending on which LOR is the 4th... maybe that was the best one you had...)
Some programs will look at it and think "well we specifically said we don't want more than 3 and this person can't follow instructions" (very negative outcome)

There really isn't a situation where sending 4 when 3 is the requested limit works out in your favor. I suppose if the 4th letter happened to come from someone who was good friends with a member of the selection committee then sure... but you should be asking your LOR writers if they know anyone at the programs you're applying to anyways, and preferentially sending their letter to a program they know people at...
 
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cafs1000

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Any thoughts regarding my profile?

I am IMG on H1b. Currently a resident in a community hospital on the east coast.
My scores are 240s-250s-230s, CS pass. All first attempt.

I am concerned because I was not a good student when I started medical school. In my country, you start Medical schools with basic sciences like math, chemistry, stuff like that and it was a complete mess at that time. So I have that awful record on the transcript (although I fix it and did very good in Medicine pre-clerkships and clerkships). I don´t know if this important but it is kind of embarrasing and it was when I initially applied to residency.

I have 8 posters (at least 3 presented in national meetings, probably 4), 1 publication, and 1 oral presentation.

I am applying to programs sponsoring H1b so I will end up applying to only 40 programs (another concern)

Do you know people who have matched in pulm/crit under these circumstances?
 

CriticalCareDoc7

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Any thoughts regarding my profile?

I am IMG on H1b. Currently a resident in a community hospital on the east coast.
My scores are 240s-250s-230s, CS pass. All first attempt.

I am concerned because I was not a good student when I started medical school. In my country, you start Medical schools with basic sciences like math, chemistry, stuff like that and it was a complete mess at that time. So I have that awful record on the transcript (although I fix it and did very good in Medicine pre-clerkships and clerkships). I don´t know if this important but it is kind of embarrasing and it was when I initially applied to residency.

I have 8 posters (at least 3 presented in national meetings, probably 4), 1 publication, and 1 oral presentation.

I am applying to programs sponsoring H1b so I will end up applying to only 40 programs (another concern)

Do you know people who have matched in pulm/crit under these circumstances?

Just apply broadly my friend and see what happens. For sure people with your stats have matched in the past.
I'm just unsure how competitive it is these days. I'm finishing up fellowship this year as a chief and so curious how the interview
season will go with tele - interviews.
 
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BigGAC1

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Question for any PDs/APDs out there: I submitted my application on ERAS today, but 2 of my letter writers only submitted their letters to ERAS/EFDO yesterday afternoon (one of which is my PD letter). Given the (up to) 5 day processing time, how will this affect my application (if at all)?
 

Doc_Slytherin

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Question for any PDs/APDs out there: I submitted my application on ERAS today, but 2 of my letter writers only submitted their letters to ERAS/EFDO yesterday afternoon (one of which is my PD letter). Given the (up to) 5 day processing time, how will this affect my application (if at all)?

I'm in the same boat as you! Here's hoping it won't be a red flag against us!
 
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Doctor Bob

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Question for any PDs/APDs out there: I submitted my application on ERAS today, but 2 of my letter writers only submitted their letters to ERAS/EFDO yesterday afternoon (one of which is my PD letter). Given the (up to) 5 day processing time, how will this affect my application (if at all)?

Not much. The application won't be considered complete until all of the letters are there, and programs may not look for updated complete applications every single day. But the PDWS (program directors workstation) has a button where I can view applications that have become complete since the last time I logged in. So it will be dependent on how often the program sweeps for new applications. That happens fairly frequently in the first week.

I'm in the same boat as you! Here's hoping it won't be a red flag against us!

Red flag? No. Just as mentioned programs may not choose to look at the application until it's complete. A few days after the initial wave won't be a problem. A few weeks... erm... well, that might be more problematic.

USMLE score release is pending still, is that going to be an issue?

Is it that you've requested a transcript to be released and NBME hasn't processed the request yet? Or NBME has sent it and ERAS isn't showing it as received? Or you've taken the test and still waiting for it to be scored?
 
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Light Squared Bishop

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I have been told that some programs have received so many applications that their interview invites may be delayed. Most of these rumors have come from a friend of a friend conversations. Anyone with more direct contact with programs have any news to share?
 

Doctor Bob

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I have been told that some programs have received so many applications that their interview invites may be delayed. Most of these rumors have come from a friend of a friend conversations. Anyone with more direct contact with programs have any news to share?

When I opened the PDWS yesterday there were >250 applications sitting there waiting. More have come in since.
I am not expecting to send out the first of the interview invites until some time early next week.
 
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SHB26

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Hey everyone!
I really prefer CC over of Pulm Crit, mainly because I do not enjoy being in clinic to the extent that I would like to avoid it at all costs. I applied to broadly to CC programs.

Does anyone know how long after an interview an offer is usually extended?
Thanks!
 
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walkitoff

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what is everyones thoughts on applying to pulm crit/care as well as crit care programs from the same institutions? Do you think this will hinder you from receiving interviews or offers in any way if they know that you have applied to both?
 

Doctor Bob

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Does anyone know how long after an interview an offer is usually extended?
Thanks!

This is very program dependent. Some will interview a large number before offering spots to anyone. Some will offer spots on a rolling basis. So there's no good answer here.

what is everyones thoughts on applying to pulm crit/care as well as crit care programs from the same institutions? Do you think this will hinder you from receiving interviews or offers in any way if they know that you have applied to both?

Well it won't affect the CCM program; applying to both says "I know I want to do critical care in some form". Where it might have an effect is on the PCCM side. You'll have to have an answer about how seriously you're interested in pulm.
 

Breitenfeld31

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Hi Everyone, I received a survery from MCW PCCM program. Did anyone else get it?
I got the same survey, yep. The only other message I have gotten is from UC-Davis saying they received >50% more apps than in previous cycles which seems to be a recurring theme. See how things go, but I'm cautiously optimistic haha.
 
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