Ucla liver transplant fellowship

[Dr.anesthesia]

Anyone know anything about this program?

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[Ignatius J]

Anyone know anything about this program?

I know nothing but can 100% guarantee that they will get cheap labor out of the deal. Understand liver transplants are big cases, but there is nothing proprietary about the cases that require additional training. It's almost like we want graduating residents to be scared of their own shadows these days.

 

[btbam]

Put in big lines, give products, correct big swings in electrolytes and blood gases. That requires a fellowship?

 

[GA8314]

I know nothing but can 100% guarantee that they will get cheap labor out of the deal. Understand liver transplants are big cases, but there is nothing proprietary about the cases that require additional training. It's almost like we want graduating residents to be scared of their own shadows these days.

I agree. It's getting ridiculous.

That being said, I do think that if you didn't get great liver transplant exposure as a resident, then IF you want to go somewhere with a large liver program, THEN this type of fellowship will help you w/r/t that.

Otherwise, yes, see the bold from Ignatius...

 

[deleted171991]

Anyone know anything about this program?

Are you interested in this kind of stuff? Go do a critical care fellowship. You'll learn more.

Not interested in critical care? You don't belong in the liver transplant room.

Just my 2 cents.

 

[Dr.anesthesia]

UCLAs program "seems" to offer TEE certification with this fellowship and that's the draw over CC fellowship. I am considering that too. I agree a fellowship is not necessary to do these cases BUT if you want to teach these cases or be academic staff a fellowship would be useful imho.

 

[bigdan]

OP -

If you (somehow) knew you wanted to be a "Director of Liver Transplant Anesthesiology" somewhere - or if you are being groomed to become the Director - I think there was a recent guideline or consensus statement that says you must complete a liver transplant fellowship.

In regards to TEE certification, you can get your approved numbers for the advanced exam through a critical care training program (Duke and Michigan provide the time opportunities for this, and other places likely will as well).

 

[periopdoc]

UCLAs program "seems" to offer TEE certification with this fellowship and that's the draw over CC fellowship.

Just want to point out that the only "TEE certification" they are offering with this fellowship is the Basic Perioperative TEE certification, for which no fellowship is currently required.

In order to obtain Advanced PTE certification, one must complete a

minimum of 12 months of clinical fellowship training dedicated to the perioperative care of surgical patients with cardiovascular disease.

If the twelve months of fellowship that you want to apply towards certification is from a cardiac anesthesia fellowship, then that fellowship must be accredited.

There are a few CC fellowships, notably Duke, that offer the opportunity for Advanced PTE certification in addition to CC certification. In order to do this, they must be claiming that 12 months of the fellowship is "dedicated to the perioperative care of the surgical patient with cardiovascular disease."

Duke is a facility that is somewhat unique in their ability to offer a full 12 months of ICU time that includes some degree of focus on surgical patients with cardiovascular disease. The "dedicated" part is debatable, but as long as Solomon Aronson is part of the faculty, there should be no problems.

If you are considering the CC pathway, you should pay close attention to the way that Duke structured their CC fellowship to ensure that all 12 months have some component of that "perioperative care of the surgical patient with cardiovascular disease." You want to be sure that any program you are considering has a similar structure so that you aren't denied by the NBE when you apply for certification.

- pod

 

[IlDestriero]

That's completely crazy.
We do liver transplants. If I wanted to be on the team, all I would have to do is ask. We have the new members take shadow call for a couple transplants, and than do a couple themselves with one of the current team helping them as back up.
That's it. And of course reading up on our transplant guidelines, etc.
That's at a major academic center. No additional fellowship required.
If you want to do livers, great, but if the chief suggests you need to complete a fellowship first, tell him he should probably take a break from the pipe.

 

[sleepallday]

I agree with what most are saying here, that a fellowship is not required. But I can say that about any of the subspecialties. And imo, liver transplants can be the most challenging of cases out there. If you haven't had much exposure to livers as a resident and you would like to make it a career path, the fellowship might be beneficial. Also, UCLA is a busy transplant center. I would just first look closely into how the fellows are utilized at the program.

 

[Ezekiel2517]

I have a friend who is director of liver transplant at her institution who never did a liver transplant during residency/fellowship. She did a cardiac fellowship.

 

[kazuma]

I agree with the above and saw and examined the patient myself with the resident.

UCLA does have a very busy liver program though, so I guess if someone feels like they need that sort of thing then that would be a great place to train. I also agree with POD's TEE assessment. Any resident could optain the basic tee training they are offering. As he mentioned, becoming boarded is a different anmimal and its extremely difficult to do at most CCM fellowships, Duke and I believe Michigan are exceptions.

Every person I talked to at 6 programs either told me it was extremely difficult or flat out discouraged going for advanced certification.

 

[Dr.anesthesia]

Yes basic tee cert. I think the cardiac guys think the other is their turf. How about this? Cleveland clinic for liver or ucla? Or ?

 

[bigdan]

I have a friend who is director of liver transplant at her institution who never did a liver transplant during residency/fellowship. She did a cardiac fellowship.

You're right. I was wrong. The OPTN Bylaws for Directors of Liver Transplant Anesthesia say Liver, Cardiac or ICU fellowship training.

 

[DrBeaker]

Basic TEE cert during a liver fellowship. I don't see the point. As far as the advanced goes, you can take the exam and will be a testamur if you pass. Doing a fellowship where you care for people with CV disease will then get you certified.

 

[lazypanda]

that liver fellowship at ucla would probably be beneficial if you wanted to work at UCLA and didn't train there. A paid year long interview .

 

[deleted171991]

that liver fellowship at ucla would probably be beneficial if you wanted to work at UCLA and didn't train there. A paid year long interview .

A very well paid one. By the fellow, at the tune of about $200K/year in lost wages.

 

[lazypanda]

A very well paid one. By the fellow, at the tune of about $200K/year in lost wages.

You are absolutely correct.