I can chime in on Baylor experience and a little of THI experience. My background - baylor resident now baylor fellow. Aspirations - applying for a career of clinical ep.
First and foremost - in the last 4 1/2 years I've been at Baylor, I have not heard or known any fellow who was fired by our program director. Our director is an amazing person and has your back, probably to a fault. He has burned some bridges in past as far as affiliations due to protecting us. There have been fellows in the past who have had personal issues, have had to take extended leave and were able to return to training without retaliation. An honest, though probably biased opinion, of our program:
Strengths - volume. Though most our procedural vol is va and ben taub, There hasn't been an issue with numbers, especially cath. Our director is interventional and as a result, Ben Taub where he is at is geared towards that. Examples, when you're on cath at va, average 6 caths a day, intermittently up to 8 diagnostics. Ben Taub, Weds and Thurs are the heaviest from 8-12. Mon-Tues-Fri probably in the range of 6 on ave. Given we are 1 of 2 county hospitals in houston with LBJ having no interveentional capability, all cath patients and stemi's get shuttled to us. EP vol at VA has been sky rocketing in the last 1-2 years. Ave device implants 3-4 per day, except tues where we generally do a.fib ablations. SVT ablations probably ave 2/wk at the va. EP vol at Ben Taub, due to having 2 cath labs only, Tues are the main ep day with 4 sometimes 5 devices. Fridays are our secondary days with 1-2 devices. Ablations unfortunately are limited at ben taub, not due to vol but due to lab time given we have to share with interventional. Echo, ave inpatient echo vol both at va and ben taub probably 40 studies - tte's. Do you as the fellow read all of them? No, because the attendings don't wanna stay till 8 pm so they do chip in, which I feel is not a bad thing. As a second year, I am probably on ave reading myself 12 studies a day, in addition to performing TEE's and DSE's.
From my personal experience inregards to EP, i think from a general fellow, EP is wonderful for devices. Dr Makkar and Afshar allow us to implant. Just came off of EP Bentaub/St Lukes and by the end, I'm doing everything. Incision, extrathoracic excess, making pocket, cannulating CS os and feeding CS lead for BiV, suturing, the whole shabang. Ablation experience is not as robust.
Weaknesses - hightech stuff. We have limited impella support cases at the va, occasional tandem's. We have TAVR cases on thurs but as a diagnostic fellow, you basically just scrub in and not do much, given you have the CT surgeon, interventional fellow, at least 2 interventional attendings ahead of you. Hightech EP stuff - rare VT ablations, haven't heard of impella assisted vt ablations, vol of a.fib is not something like Michigan, UPenn where we ablate a.fib everyday.
Inregards to THI, our vol there is low given our baylor services include consult, cath and a hybrid rotation of BenTaub and Luke's Ep. Cath is low, probably 2 cases on ave. However, the situation is we're an academic group rotating in a 1) Private hospital with multiple private groups and 2) A hospital with it's own fellowship. As a result, we scrub in only on cases where Baylor consult or attendings have been seeing the patient. As a rule, our director has stated we don't jump into cases where THI fellows or attendings have been seeing the patient, and vice versa is true.
CT/MRI - very limited experience. 1 month for exposure. Given traditionally most of us are either interventional or ep bound, minority are noninvasive. The noninvasives who want CT/MRI experience will probably have to do an additional fellowship.
Call schedule - home call, resident see's CCU consult and admits. When you're on ccu as fellow, you have 1 resident, 3-4 interns. 1st year, 1-2 weekends/month on call, split holidays. 2nd year - 1 weekend a month, no holidays. 3rd year - no weekends and no holiday coverage.
Quick run down of our program - is everyone happy? heck yes. Most people who do interventional stay and basically get the spot. Most ep guys leave given they want to go to other programs and get more ablation experience. Previous EP matches - UCSD, Mass Gen, Beth Israel, Michigan, last year and this year's EP fellow are from here.