UAB cardiology Fellowship

[UAB_cardiology]

To all prospective applicants

Full Disclosure
I am an internal medicine resident who is now an attending physician in department of medicine. During my training, I gave serious thoughts to cardiology fellowship as a subspecialty. Due to family issues, wanted to stay locally. I was unsuccessful in the match at UAB.

Current Affairs
The rumor is the program is in shatters and they recently had the worst ACGME reviews for the fellowship and ACGME plans to put the program under probation.

All the renowned attendings have retired including Dr. Nanda, Dr. Kay and Dr. Iskandarian. Junior faculty from relatively small programs is rampant as the program has been completely unsuccesful to recruit competitive candidates. The fellows are fed up of the program director due to his inability to address ongoing problems and openly vent their frustration on residents and medicine attendings. It was only last week that one of the first year fellows yelled and shouted at my team for calling a consult over the weekend. The associate program director who is usually on consult service is verbally abusive to fellows,residents and medicine attendings.

Given the fellowship season wanted to update y'all reagrding choices you guys plan to make.

Dont hesitate to contact me for any further details

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[tivark]

i fully admire you for clearly disclosing your circumstances. however your disclosures clearly indicate you are highly conflicted. could it be bitterness of not matching? could it be trying to reduce the number of competitive applicants for next year so you can match there? could it be you are frustrated at being yelled at by a fellow/attending? perhaps neither of the 3, but the conflicts of interest are clear.

just to play devils advocate: is it officially on probation? 3 big names quitting doesnt necessarily say much about the program: big names go in and out of programs all the time.

 

[befuddled]

Having experienced UAB training in the last few years first hand, I would like to clarify some things stated above.

One, there is no new medicine attending who went unmatched for a cardiology fellowship with us in the last few years. Anybody who is so well regarded by the department of medicine as to be accepted as faculty would surely get a fellowship spot at their home program.

Two, yes there have been retirements or semi-retirements and I wont lie it is almost impossible to replace Dr(s) Nanda, kay and Iskandrian. However they are still actively engaged with fellows. Nanda and Iskandrian still read echos and nukes respectively and are devoting more time to their journals. They have more time to help fellows with scholarly activities and fellow publications have gone up in the recent years as well. Iskandrian also oversees the fellowship conferences and has made the experience much more structured.

UAB is still a great program if you want to hone your clinical skills - the pathology there is immense and the autonomy granted to fellows in the procedural labs made me very confident. The volumes of cath, TEE, and the opportunity to learn 3D echo is better than most institutions I have seen.

However let me make a disclaimer - UAB is not a program that will spoonfeed you and hold your hand - you are thrown in the mix heavily from the beginning and you have to learn to swim. If you sit back and expect people to find you and teach - its not going to happen. You have to be pro-active. Also a 3 year fellowship there is not conducive to a research career - you need to be on the 4 year track if you want to do any serious research.

Lastly, I would encourage everyone to visit the program if you are considering it for training and talk to the fellows. You will know for yourself what you are signing up for.

 

[GeneJock]

I have to agree with befuddled. There have been a number of less than favorable posts about the program in the last few years. Having completed training at UAB I can say with certainty that the training is OUTSTANDING! It prepares you to treat complex CV patients and if you participate in your training here there is nothing that will surprise you. You will get your "numbers" with no problem. Over 1000 cath, 300 TEE, etc as first operator. The faculty is no different than any other place. Some are turds, but most are dedicated practitioners to their patients and education of their fellows. The aforementioned names are still around and continue to mentor fellows. Dr. Kay's anatomy lecture is unbelievable and he still proctors the Friday morning EKG conferences. Dr. Nanda's reads at the Kirklin Clinic and always welcomes fellows to read with him. To read one nuclear session with Dr. Iskandrian is worth its weight in nuclear gold. There are other outstanding faculty who are there to teach as well (Drs. Talaj, Doppalapudi, Lessar, Bittner, Lloyd etc.) The conferences are attend by MACC, PI on the original TIMI study group and writers on multiple guideline committees. If you want to work hard and in exchange get outstanding clinical training then UAB provides an avenue for you to obtain these goals. But as the last post stated visit it an make your own assessment. PM me if you have any additional questions.

 

[LTGADTGA]

I graduated from UAB, and I did my subsequent training at another prominent institution. Can say for sure that I don't regret my clinical training at UAB a bit. The volume and acuity at UAB are amazing (too high and complex respectively). Just because of its location in the southeast, it will always be a major player, in spite of 'big' people retiring. When I was there it was the major EP program (for complex ablations) in 6-state area (Louisiana, Mississippi, Georgia, Tennessee, Florida panhandle and Alabama). We would periodically get referrals from Emory and Vandy, but would only refer to other higher-tier centers. Similarly for heart transplantation/MCS it's quite prominent (and towers over Vandy and Emory) and INTERMACS is housed there. PAH experience is unparalleled. The heart failure group (Tallaj/Pamboukian) is clinically very strong, but very busy. And unlike many centers each HF specialist does VAD, transplant and PAH. They work very well with the surgeons. The cath lab had taken quite a hit after Dr Misra's unexpected demise, but is on its way back. UAB would need at least 5 years to replace him especially as he was getting referrals from a four state area. One of the national leaders in prevention- Vera Bittner is housed there, and she is an excellent mentor if you are interested in prevention. CV Epi through SOPH is very strong as well (REGARDS,CARDIA). The primary contacts for these studies are not housed in cardiology though. As a clinical fellow, you will be quite busy to interact w/ them. But there are additional opportunities for postdoctoral research (4 or 5 year fellowship).


UAB is a busy place, can appear very chaotic and intimidating (to non-southerners) and the clinical fellowship may not be able to foster everyone's research careers. And each place has its unique issues. UAB does as well. Another big ding against UAB is its location. Birmingham is not NY, Boston, DC, or SF, but it's not Cleveland, Detroit or St. Louis either. The ethnic/social disparities still prevalent in the deep south may actually add to the learning experience.

If you'd like to be clinically strong, it's an excellent program. Didactics in the general fellowship were also better than the 'prominent' subspecialty program I went to. However, the main emphasis on learning is by exposure to high volume and acuity.

Feel free to pm me if you need more information.

 

[EPADHA]

It has been interesting to note that comments about UAB's cardiology fellowship come up at the same time every year
Among cardiology programs they seem to be more controversial than others. I wonder why that is. Is it because 'fellows' are not suppressed as they are other big places?

 

[UABCards]

I am one of the 3rd year Cardiology fellows at UAB and would like to reply to the original post which tries very hard to destroy the reputation of the program built over years of hard work by some of the best known names in Cardiology across the country. I would like to counter each argument posted originally:

"Rumor that the program is in shatters and had the worst ACGME reviews"
- UAB Cardiology provides very well rounded training in all the sub-specialties with strong focus on teaching and clinical training. Fellows interested in research are provided enough elective time (7-8 months) to start and be involved in research endeavors. Due to all this, the fellow satisfaction is high. Program attracts very strong applicants (same was true this year). I am not sure where this idea of low fellow satisfaction came from...we were able to retain 2 chief fellows last year.

"ACGME plans to put the program under probation"
- I know for a fact that nobody has heard anything like this whatsoever so this is all fabrication.

"All the renowned attendings have retired"
- Some of the teachers/ mentors including Drs Nanda, Kay, Iskandrian are all still very involved in teaching fellows holding regular teaching sessions/ conferences, they continue to be our mentors guiding us through various research projects.

"Junior faculty from relatively small programs is rampant"
- We are in process of getting Dr. Chandra from Mayo as Echo chief. In EP, Drs. Lewis from Duke and Awad from UPenn, two of the best EP programs, have joined UAB faculty. UAB has right balance of junior and senior faculty members making the overall environment fun to work in for the fellows.

"Fellows fed up of the program director" "Associate program director is verbally abusive"
- Again, I am not sure where this notion came from....we have a great program leadership, always available & supportive of us, always implementing positive changes to improve our training experience.

In nutshell, I have had very positive experience and have thoroughly enjoyed my training since the first day I joined the program.

 

[uabcvmed]

UABCards- Please don't sugar-coat the program so much. I agree with LTGADTGA that each place has its problems. I think the teaching has gone down in the fellowship in the last couple of years, and the atmosphere is not as collegial. UAB's fellowship is good, and used to be great (top 5-10 or so).. but is no where close to what it used to be or what it can be. We both know of multiple departures (young and old) in the last couple of years and why they left. Few of them were actually quite good educators. We both know of issues with division leadership.And our associate PD is not a nice person.. we all know that!

Many places are going along similar paths..I encourage all the applicants to try and get the dirty laundry out for each place they interview at and plan to rank. I know fellows at Vandy and UCLA who're not happy w/ their training. UAB training has mostly been excellent.

Good luck to everyone in the match.

 

[ashrafeldabh]

I am one of the 3rd year Cardiology fellows at UAB and would like to reply to the original post which tries very hard to destroy the reputation of the program built over years of hard work by some of the best known names in Cardiology across the country. I would like to counter each argument posted originally:

"Rumor that the program is in shatters and had the worst ACGME reviews"
- UAB Cardiology provides very well rounded training in all the sub-specialties with strong focus on teaching and clinical training. Fellows interested in research are provided enough elective time (7-8 months) to start and be involved in research endeavors. Due to all this, the fellow satisfaction is high. Program attracts very strong applicants (same was true this year). I am not sure where this idea of low fellow satisfaction came from...we were able to retain 2 chief fellows last year.

"ACGME plans to put the program under probation"
- I know for a fact that nobody has heard anything like this whatsoever so this is all fabrication.

"All the renowned attendings have retired"
- Some of the teachers/ mentors including Drs Nanda, Kay, Iskandrian are all still very involved in teaching fellows holding regular teaching sessions/ conferences, they continue to be our mentors guiding us through various research projects.

"Junior faculty from relatively small programs is rampant"
- We are in process of getting Dr. Chandra from Mayo as Echo chief. In EP, Drs. Lewis from Duke and Awad from UPenn, two of the best EP programs, have joined UAB faculty. UAB has right balance of junior and senior faculty members making the overall environment fun to work in for the fellows.

"Fellows fed up of the program director" "Associate program director is verbally abusive"
- Again, I am not sure where this notion came from....we have a great program leadership, always available & supportive of us, always implementing positive changes to improve our training experience.

In nutshell, I have had very positive experience and have thoroughly enjoyed my training since the first day I joined the program.

I'm one of the new Heart Failure fellows at UAB and I agree w UABCards, the program is pretty nice. I like it so far and it has a lot of clinical exposure.

 

[shomolangma]

Hello, I think all the above comments are very reasonable. I witnessed the program myself 2 years ago and have been dreaming to come and get training from here. Now, I am applying for EP program and UAB is clearly my top choice. Any "unbiased comment" on EP program? I believe Dr.Kay's legacy is still there and faculty is still very productive in research. It sounds to be very very notorious about the politics inside. Will it affect the fellow who is getting training?? Politics is everywhere and we clearly cannot avoid it. Dr.A just left the EP program, but it seems like both him and EP staffs are both not happy of each other. Anybody knows the insight story? Anybody is coming from outside as a new faculty member?? I can see all stable faculty was mainly trained from UAB and it may be difficult for an outsider to stay if he/she practice things differently. Thank you.

My point is that no place is perfect. The more we clarify, the more we can feedback to them and improve the program. It will clearly be great for both applicants and institutes. PM me if you don't feel comfortable putting full story here.

 

[LTGADTGA]

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