Top Academic Programs and Level 2 Training

[HarryGary]

A lot of top academic programs don't offer level 2 training in all fields. Either they don't have the clinical volume or their focus on research makes it hard for fellows to obtain the clinical exposure.

I'm hoping student doc can help pool people's knowledge of programs so we can sort out which programs get people certified in level 2 training for all branches of cardiology, and which one's don't.

I'll start with posting what I think I know. I hope people can correct me if they have better insight. I also hope people can add what they know about other programs.

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[HarryGary]

Hopkins: ? level 2 training opportunities

Duke: Huge clinical volume. PD stated they wanted everyone well-trained clinically to help shape their research.

UWashington: Unclear if they meet level 2 in cath.

Penn: supposedly everyone meets level 2 training in all fields.

Columbia: Heard that they try and prevent people from obtaining broad level 2 training

Brigham and MGH: actively discourage broad level 2 training.

Cornell: If you sub-specialize in cath or EP, will miss out on level 2 for some fields..

Tufts: Level 2 in all fields

Yale: Level 2 in all fields

Mt Sinai: ?

NYU: Level 2 in all fields

Northwestern: ?

U Chicago: ?

Wash U: ?

Cleveland Clinic: ?

UCSF: low cath volume

Stanford: ?

other programs...

 

[nstemi]

texas heart: level 2+ in whatever you want

 

[Instatewaiter]

Cleveland seemed like they have the volume to easily get you level 2 across the board.

At hopkins you will probably get level 2 in echo if you push for it. You can get level 2 in nucs if you give up some research time. It seemed very difficult to get level 2 across the board.

 

[BGriffin]

In general, the more academic the program, the less likely you'll be able to get level 2 in "everything". If that is what you are aiming for, you really should be looking at clinically oriented programs and not institutions where research is emphasized, as in major academic institutions, your goal is to focus on one area and become an expert while publishing in that area.

 

[HarryGary]

In general, the more academic the program, the less likely you'll be able to get level 2 in "everything". If that is what you are aiming for, you really should be looking at clinically oriented programs and not institutions where research is emphasized, as in major academic institutions, your goal is to focus on one area and become an expert while publishing in that area.

I guess Duke, a place with arguably the strongest research in the country, isn't a very academic program then. All of us are not matching "in general", we are matching to one specific institution.

The point of this forum is to figure out which top academic programs allow you to be well-trained clinically. Level 2 training is an imperfect but decent proxy for that.

 

[EPADHA]

Most 'top' academic programs will not give you level 2 training across all specialities. This is engineered in some cases (with one year of research and 2 years of clinical training you really can get level 2 training in only one or two modality) and 'forced' in others as programs want to churn out clinician-investigators- prime example being Mayo Clinic. In many cases, esepcially 'top' programs may not provide EP device training to fellows so that they can keep their referral base. When the market is tight people dont want to train their own competition. Makes sense?

On my interview trail in 2009 programs that I came across which gave strong clinical training across all specialties were busy and included Indiana (very busy), UAB (very rigorous and well respected though), Texas Heart (no residents, designed like private practice), I thought Emory was quite good as well for level 2s in everything.

Another way programs are able to give away level 2s in everything is if you have less fellows=more numbers per fellow, and the program does not care.

Also programs that give you a lot of numbers will be busy. So get ready..

ACC mandates 24 months of core training (includes 7 months of imaging, 4 months cath, 2 months vascular, 2 months EP and 9 clinical months), That just leaves 12 more months in a three year program, and if one does not do research, one may be able to get away with level 2s in echo, nuclear, CT/MRI, cath and EP (level 2 meaning competence in implantation of pacemakers and ICDs). This may become important in light of changing economy and demand for well-rounded general cardiologists going up. Dont know for sure though...


I hope this is helpful.

 

[BGriffin]

I guess Duke, a place with arguably the strongest research in the country, isn't a very academic program then. All of us are not matching "in general", we are matching to one specific institution.

The point of this forum is to figure out which top academic programs allow you to be well-trained clinically. Level 2 training is an imperfect but decent proxy for that.

Hey I'm not trying to offend or anything, just telling you the way things are. As EPADHA outlined above, it is just not possible to hit all the numbers required to get level 2 in all possible techniques in cardiology and do meaningful research in a 3 year fellowship.

 

[CanIMakeIt]

WashU has 6 month research requirement in 3rd year, so you can design your own patway for the remaining 6. You can get level 2 in most areas except EP and probably nuclear - but if you try hard enough, you can still get nucs. Volumes are high so you can get numbers easily.

 

[Trifling Jester]

AFAIK there is no stipulation that the individual months have to be dedicated to that area only. For example, you can have one month which counts for echo and nuc and cath etc., as long as your PD signs off on it. Most programs that I am familiar with (I'm not anywhere near the ivory tower institutions) will give you level two in everything you want without a big hassle.

 

[EPADHA]

AFAIK there is no stipulation that the individual months have to be dedicated to that area only. For example, you can have one month which counts for echo and nuc and cath etc., as long as your PD signs off on it. Most programs that I am familiar with (I'm not anywhere near the ivory tower institutions) will give you level two in everything you want without a big hassle.

Programs may be doing it.. but it is not allowed.. The ACC COCATS document very explicitly states that you can not get double credit for a month. In my program this is not allowed. This may be a common occurence in smaller programs.

 

[CanIMakeIt]

Programs may be doing it.. but it is not allowed.. The ACC COCATS document very explicitly states that you can not get double credit for a month. In my program this is not allowed. This may be a common occurence in smaller programs.

This is correct. You can not take credit for more than 1 thing at a time during a month. COCATS requirements clearly states the time spent in months and the number of procedures/interpretations done. So at a given time you can be full-time on one service only.

 

[Trifling Jester]

Programs may be doing it.. but it is not allowed.. The ACC COCATS document very explicitly states that you can not get double credit for a month. In my program this is not allowed. This may be a common occurence in smaller programs.

Guess I'll be happy in my ignorance then