Thoughts on Cardiology / Crit care?

[SpartanStrong]

Hey all, I'm a PGY-1 at a decent MD-IM residency that historically has great placement of its grads into cards fellowships.

That said, I love cardiology, but I also really really enjoy the MICU. I also like spending time in the CICU, and my CICU director mentioned that Cards/crit is an emerging field, but he's also a little biased (he's gen cards trained purely) and doesn't have CCM boarding.

Would it be possible to get a job with a gen-cards practice and simultaneously get a job with a CCM group such that I could alternate my time with the gen cards group and pickup shifts occasionally at the MICU? Or the SICU?

Or would I simply be overtraining to be a CCU director cause nobody in a MICU would hire a cards/crit guy?

Also, if anybody knows someone who has done this and has advice with regards to hours worked / salary to expect, I would appreciate the help.

Thanks

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[CCM-MD]

Hey all, I'm a PGY-1 at a decent MD-IM residency that historically has great placement of its grads into cards fellowships.

That said, I love cardiology, but I also really really enjoy the MICU. I also like spending time in the CICU, and my CICU director mentioned that Cards/crit is an emerging field, but he's also a little biased (he's gen cards trained purely) and doesn't have CCM boarding.

Would it be possible to get a job with a gen-cards practice and simultaneously get a job with a CCM group such that I could alternate my time with the gen cards group and pickup shifts occasionally at the MICU? Or the SICU?

Or would I simply be overtraining to be a CCU director cause nobody in a MICU would hire a cards/crit guy?

Also, if anybody knows someone who has done this and has advice with regards to hours worked / salary to expect, I would appreciate the help.

Thanks

You wouldn’t have problems getting hired to do CCM. Would be hard to find a way to do both. I know 2 people who are boarded in both cardiology & CCM. One is close to retirement and only does eICU shifts - does not do any cardiology. Another one works in the Long Island area and does only CCM at a community hospital.

Financially speaking you would be better off doing a year of interventional than a year of CCM. According to the most recent compensation surveys - interventional cards will get you 500k-600k; general cards 400k-450k; and CCM 400k. Typically you will probably be working more “hours” as a cardiologist than as an intensivist and will be on call more. Lots of different set ups for cardiology but usually will involve Monday to Friday work with weekday and weekend call. How much call you do and how much the call sucks varies. CCM is usually 14-15 days of work a month either week on week off or scattered shifts. May have to work some night shifts depending on where you go.

When I was finishing residency I also struggled between choosing Cardiology or CCM. I considered doing both also. My advice is: doing both would be a good option if you wanted to end up in an academic institution - cards/crit would be a nice niche. Outside of academics I think doing both is a waste - it will be hard to practice both and 4 years is a long training time - you will probably end up practicing one or the other. Another thing to consider is there are more CCM job opportunities in cities than cardiology currently but who knows what it will be like when you finish. Choose your field based on what you like more.

 

[tartesos]

You wouldn’t have problems getting hired to do CCM. Would be hard to find a way to do both. I know 2 people who are boarded in both cardiology & CCM. One is close to retirement and only does eICU shifts - does not do any cardiology. Another one works in the Long Island area and does only CCM at a community hospital.

Financially speaking you would be better off doing a year of interventional than a year of CCM. According to the most recent compensation surveys - interventional cards will get you 500k-600k; general cards 400k-450k; and CCM 400k. Typically you will probably be working more “hours” as a cardiologist than as an intensivist and will be on call more. Lots of different set ups for cardiology but usually will involve Monday to Friday work with weekday and weekend call. How much call you do and how much the call sucks varies. CCM is usually 14-15 days of work a month either week on week off or scattered shifts. May have to work some night shifts depending on where you go.

When I was finishing residency I also struggled between choosing Cardiology or CCM. I considered doing both also. My advice is: doing both would be a good option if you wanted to end up in an academic institution - cards/crit would be a nice niche. Outside of academics I think doing both is a waste - it will be hard to practice both and 4 years is a long training time - you will probably end up practicing one or the other. Another thing to consider is there are more CCM job opportunities in cities than cardiology currently but who knows what it will be like when you finish. Choose your field based on what you like more.

That's sound advise. There are a lot of private practice groups that would suck your genitalia to hire you with those creds, but you might as well do ccm alone or cards alone time and money wise.

 

[SpartanStrong]

You wouldn’t have problems getting hired to do CCM. Would be hard to find a way to do both. I know 2 people who are boarded in both cardiology & CCM. One is close to retirement and only does eICU shifts - does not do any cardiology. Another one works in the Long Island area and does only CCM at a community hospital.

Financially speaking you would be better off doing a year of interventional than a year of CCM. According to the most recent compensation surveys - interventional cards will get you 500k-600k; general cards 400k-450k; and CCM 400k. Typically you will probably be working more “hours” as a cardiologist than as an intensivist and will be on call more. Lots of different set ups for cardiology but usually will involve Monday to Friday work with weekday and weekend call. How much call you do and how much the call sucks varies. CCM is usually 14-15 days of work a month either week on week off or scattered shifts. May have to work some night shifts depending on where you go.

When I was finishing residency I also struggled between choosing Cardiology or CCM. I considered doing both also. My advice is: doing both would be a good option if you wanted to end up in an academic institution - cards/crit would be a nice niche. Outside of academics I think doing both is a waste - it will be hard to practice both and 4 years is a long training time - you will probably end up practicing one or the other. Another thing to consider is there are more CCM job opportunities in cities than cardiology currently but who knows what it will be like when you finish. Choose your field based on what you like more.

Did you end up going for pure CCM or did you do pulm/ccm?

The issue is, I'm trying to do what I like more. Ever since my first MICU rotation as an M4, I knew I liked it in the ICU. But even as an intern, I feel the burnout come along, so I know I need a day job. Pulm/CCM has been a proven thing with regards to the clinic/MICU model works. I'm wondering if it's financially feasible compensation-wise to get a similar thing but with Cards/CCM, such that I either work part time in 2 groups (cards and CC) or get some kind of thing going with a multi-specialty group.

However, I'm also aware that this may all be a pipe dream and I would be wasting earning potential by doing cards/crit cause people end up practicing only one or the other, like the 2 folks you mentioned.

 

[Redpancreas]

EDIT: Didn't grasp your question and the context initially. I think your question is essentially whether it's feasible to do Cards (3) + CCM (1 if integrated) so you can work two practices (gen CCM and gen Cards). I think he already answered your question by saying if $$$ is your thing, why not just do IV Cards in that year. If niche is your thing, you can find one in academia, but I don't think a Cards/CCM'er so there is no real added value for your dual qualification vs. Cardiologist to monitor the CICU since there are already intensivists there? (could be wrong)...awaiting expert opinions, this interests me as well! So then if that's true, you'd basically be working as a half time Cardiologist (225K) and a half time intensivist (150K) so you would earn 375K for 7 years of training when EM on the other hand makes 350K with 4 years less in training and less work time.

 

[CCM-MD]

Did you end up going for pure CCM or did you do pulm/ccm?

The issue is, I'm trying to do what I like more. Ever since my first MICU rotation as an M4, I knew I liked it in the ICU. But even as an intern, I feel the burnout come along, so I know I need a day job. Pulm/CCM has been a proven thing with regards to the clinic/MICU model works. I'm wondering if it's financially feasible compensation-wise to get a similar thing but with Cards/CCM, such that I either work part time in 2 groups (cards and CC) or get some kind of thing going with a multi-specialty group.

However, I'm also aware that this may all be a pipe dream and I would be wasting earning potential by doing cards/crit cause people end up practicing only one or the other, like the 2 folks you mentioned.

I practice CCM only. I don’t think it is a financially smart decision to do both and it will be logistically hard to find a place that lets you do both as the trend is towards hospital employed/hospital based intensivist groups. Part time cardiologist part time intensivist is going to be hard to do - best to pick 1. Check out some of the anesthesiology/CCM and EM/CCM discussions on this board - you will see that it’s very hard to do both. Not that many EM/CCM but they usually practice one or the other and anesthesiology/CCM typically stick to anesthesiology but that may change with the CRNA encroachment.

Rest - as I mentioned above.

 

[gutonc]

Duplicate thread in Cards. Closing.