Texas Heart Institute

[wire]

I'm interested in cardiology and will most likely end up in private practice, likely interventional, but maybe ep (research bores me, with the exception of clinical/device trials). I know that Texas Heart is one of the best cardiology fellowships in the country and was wondering if there are any current/prior fellows who could shed some light on the program? I'm currently at a fairly malignant "top" program on the east coast and have had enough with eastcoasters. i'm looking forward to moving somewhere with a better lifestyle and with nice people.

Are the fellows happy at THI? Do the fellows have each others back or is everybody out for themselves, ie what's the comradery like? Are the attendings friendly and willing to teach? I've heard good things. Do you have any time for things outside the hospital (I have a family - ie: is it a repeat of residency where everything else has to be put off)? What's Houston like? Thanks and good luck to all applying this year (well kind of this year).

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[KRichards62]

I'm interested in cardiology and will most likely end up in private practice, likely interventional, but maybe ep (research bores me, with the exception of clinical/device trials). I know that Texas Heart is one of the best cardiology fellowships in the country and was wondering if there are any current/prior fellows who could shed some light on the program? I'm currently at a fairly malignant "top" program on the east coast and have had enough with eastcoasters. i'm looking forward to moving somewhere with a better lifestyle and with nice people.

Are the fellows happy at THI? Do the fellows have each others back or is everybody out for themselves, ie what's the comradery like? Are the attendings friendly and willing to teach? I've heard good things. Do you have any time for things outside the hospital (I have a family - ie: is it a repeat of residency where everything else has to be put off)? What's Houston like? Thanks and good luck to all applying this year (well kind of this year).

I'd also be interested to hear about the program...but I'm coming from the perspective of someone who may be interested in academics - clinical research and education.

 

[NDESTRUKT]

THI is an amazing place to train with great clinical exposure and research opportunities. Heavy hitter big names as faculty.

The work is intense though and you'll be doing a lot of scut work from what I gathered and from what a friend of mine who was there told me.

Otherwise, TX is a great state if you want a lower cost of living and overall nice people.

 

[wire]

THI is an amazing place to train with great clinical exposure and research opportunities. Heavy hitter big names as faculty.

The work is intense though and you'll be doing a lot of scut work from what I gathered and from what a friend of mine who was there told me.

Otherwise, TX is a great state if you want a lower cost of living and overall nice people.

Thanks NDestrukt. Can any fellows verify this? Is there really a lot of scutwork?

 

[punk]

Thanks NDestrukt. Can any fellows verify this? Is there really a lot of scutwork?

Rotated through Texas Heart as a resident, considered THI for fellowship. There are several pros and cons of THI fellowship.

Pros: excellent clinical training particularly cath numbers (place has 13 cath labs), if you want to do interventional, this is the place to go as it prefers its own candidates, dont recall any year in which they took anybody outside their program. Can also get Echo level III training using elective time in third year. Huge volume of LVAD/Cardiac transplant, so there is plenty of experience to be gained in this aspect too. If you want to go into private practice, THI is a great place to train. Fellows make lot of money too by easy moonlighting shifts, $100,000 is your salary with moonlighting money.

Cons: Fellows don't work with residents and therefore take primary call, see all patients by themselves, have to respond to nurses calls about potassium levels etc (that is why the scut work). They work quite hard. This is not the place to go if you harbor academic ambitions as meaningful research is hard to do.

Houston as a city does not have much to offer in terms of activities for kids (zoo and museum of natural history are the only two things that I can think). Not much outdoors as it is really hot and humid in summers. Houston in general is not pedestrian or bike friendly city which I would have preferred. Food is great but not too many options for vegetarian. However, its cheap and has affordable homes for sure.

 

[KRichards62]

It seems to me the lack of residents/medical students would in some ways make the work harder (more grunt work, etc) but in other ways make things more efficient (quick rounds with attending being able to skip the basics and spend time discussing nuances of cardiac care).

Can anybody comment on this?

 

[wire]

bump..

 

[Tius]

rotated as a resident here, considered and interviewed here for fellowship, rotated with Dr Wilson the fellowship program director for a month. THI is an amazing clinical program like everyone else has been mentioning. They do all kinds of interventional magic.

Pros:
- Complex PCI, percutaneous vads, pacemakers, ablations.
- You are not required to do research so you can actually achieve level 2 in everything with level 3 in certain things in 3 years.
- If you are a general fellow and desire to do PCI fellowship here, you basically get it guaranteed.
- Heart transplant/LVAD experience is amazing
- lots of ECMO experience
(caveat, unless you electively do more heart failure rotations or do a heart failure fellowship, you'll get to see a lot of LVAD's and ECMO but not necessarily manage them or place ECMO's)
- lots of very knowledgeable attendings, all friendly, always available

Cons:
- in-house call all 3 years, first year is quite a bit of call (caveat, 2nd and 3rd year, though you're required to do in-house call, you're backup to the 1st year fellow and automatically get paid moonlighting pay for call)
- no primary residents on ccu, you ARE the intern/resident/fellow/attending overnight, as a result, lots and lots of work/scut to do
- +/- con, depending on how you like things, you don't have dedicated cath or consult months, your consult month is your cath month, so you see consults, evaluate them and will cath and f/u post-cath.
- in the end, it is a private institution training fellows, so you will be doing a lot of scut work for the private attendings

 

[wire]

rotated as a resident here, considered and interviewed here for fellowship, rotated with Dr Wilson the fellowship program director for a month. THI is an amazing clinical program like everyone else has been mentioning. They do all kinds of interventional magic.

Pros:
- Complex PCI, percutaneous vads, pacemakers, ablations.
- You are not required to do research so you can actually achieve level 2 in everything with level 3 in certain things in 3 years.
- If you are a general fellow and desire to do PCI fellowship here, you basically get it guaranteed.
- Heart transplant/LVAD experience is amazing
- lots of ECMO experience
(caveat, unless you electively do more heart failure rotations or do a heart failure fellowship, you'll get to see a lot of LVAD's and ECMO but not necessarily manage them or place ECMO's)
- lots of very knowledgeable attendings, all friendly, always available

Cons:
- in-house call all 3 years, first year is quite a bit of call (caveat, 2nd and 3rd year, though you're required to do in-house call, you're backup to the 1st year fellow and automatically get paid moonlighting pay for call)
- no primary residents on ccu, you ARE the intern/resident/fellow/attending overnight, as a result, lots and lots of work/scut to do
- +/- con, depending on how you like things, you don't have dedicated cath or consult months, your consult month is your cath month, so you see consults, evaluate them and will cath and f/u post-cath.
- in the end, it is a private institution training fellows, so you will be doing a lot of scut work for the private attendings

Thanks Tius. I spoke with somebody from my residency program who interviewed there and he mentioned that he got the vibe that the place would function just fine without fellows - aka the fellows get the weekends off when they aren't on call and they get a lot of holidays off. I know it's a minor detail, but if you're working hard it's nice to know you get some time to spend with your family. Is this true?

 

[dragonfly99]

uhhh...you better investigate that. Without residents to do the H and P and discharge summaries, would think that the fellows would get LESS time off, not more. Somebody has to do all that scut and paperwork.

 

[Tius]

actually what dragonfly states is true. I remember on the interview trail, the program director at university jacksonville florida said a statement to me that basically sums up our current training system. he said, "when you're a resident, you want to train at a resident run hospital. when you're a fellow, you want to train at a fellow run hospital". at this point, i only agree with half of it.

Personally, I felt residency should be hard, you get scutted out, you do all the patient care, but that's where you form your foundation of knowledge. As a fellow, I'm not so sure i want to be in a fellow run a.k.a fellow as the scut monkey program.

I have respect for all the fellows at THI and their program. Fewer folks I know work harder than the fellows at THI. However, the reality is, THI is a private hospital with fellows doing the scut. Its just plain and simple. Will you get excellent training, of course. Will you be writing a crap load of h&p's, discharge summaries, progress notes, heck yea.

As for weekends off, I'm not so sure, probably not as a first year. Maybe as a second year fellow. For example, in the "classical" academic ccu setting you have residents and interns writing h&p's, daily progress notes, discharge summaries, fielding pages from nurses about tylenol and colace. The fellow is allowed to make the important decisions, like when to cath, when to echo, how to interpret these studies and make therapeautic decisions, put lines, balloon pumps if needed be. The fellow doesn't write notes and deal with the scut pages. On the contrary, at THI, the ccu fellow IS the one who writes all the notes, h&p's, discharges, fields pages about patients not wanting to take plavix after des.

I think THI is a stylistic decision in the end as far as your learning and what you want to see. If you like to be in control of all aspects of patient care, are willing to deal with scut work, but get in return complex cases, manage severe and complicated cases of CAD, heart failure, transplant and LVADS, it may be a great place for you to learn. For me, i was tired of the scut work from residency and wanted to take a more back seat approach as a fellow and thus strayed away from THI. I hope this helps.

 

[wire]

bump, anyone else have anything to offer?

 

[Laplace]

Hoping to receive this thread to see if the THI fellowship has changed in recent years. I'm mainly wondering if it's still scut-heavy, otherwise sold on the program.

 

[cardsguy2017]

Interviewed at THI, a fellow gave me scoops. This scut work concern is overblown, multiple fellows told me it's not a big deal. Everyone seems to be pretty happy with the program and seem to have a good lifestyle. CCU is covered 24/7 by a first year fellow and they are the resident/fellow, that's the worst it gets. It's a private hospital with private attendings that are capable of handling their own patients, fellows are there to help but the place really could run without them. Fellows write notes, maybe do an admission or discharge once in awhile, but midlevels, hospitalists and even the attendings do this as well. Fellows aren't responsible for all patients in the hospital 24/7 or have to do everything, the attendings take on a lot of responsibility. If you never want to write a note or admit again, then you're likely not interested in private practice which the program is more geared for anyway. As far as I’m aware this is how thi has always been, some of the above comments are simply incorrect. Compare this to the typical University hospital where fellows get scutted by the hospital to do endless consults or attendings can lean heavily on residents/fellows to do everything (don't forget other services as well, ccu/consults only makeup a relatively small portion of fellowship training).