What are my chances currently as the upcoming fellowship application season begins?

[Doctor_Strange]

Hey There,

Neurotic PGY-2 here. I am a USDO at a university IM program with an in-house cardiology fellowship (IC and EP too). I am planning on applying this year to cardiology and would appreciate any insight into my application as it stands. I have flirted with taking a year off to boost my app further while pursuing either a hospitalist, non-ACGME fellowship, or being a Chief Resident at another institution.

Anyways, as it stands this is what my app looks like:

Publications

Peer Reviewed Journal Articles/Abstracts

14 total (mixture of manuscripts, abstracts that were presented at conferences with a DOI, and case reports)

• Of the 14 about half are cardiology related and of the 14 I am the first or second author on almost all
• One in ACC and one in HRS

Poster Presentation

10 poster presentations (some include abstracts while others were not published and were stand-alone posters)

• Most are cardiology related

Oral Presentation

4 oral presentations

~

Outside of research, my CV is otherwise nothing to brag about -- I am on one residency committee. I expect my LORs to be average: my IM PD LOR will be generic only because I know my PD won't write a glowing LOR, but he won't say anything to hurt my chances (he cares about his residents matching well). Our CCU director will write me a LOR and she likes me a lot. Finally, the PD for our EP program has already volunteered to write me a LOR (I am publishing with him) and he is well-known in EP academia (this would probably be akin to a research LOR). My career goal is non-invasive general cardiology or maybe EP.

USMLEs 240s/230s

No other red flags.

I have about 5 remaining case reports that I am finalizing and hope to have published by mid-July. Most of them are cardiology related.

Anyways, I would be happy to match anywhere. My fiance lives in Ohio and I am comfortable leaving the South. The goal is to work PP with potential for medical student preceptorship.

Thanks for reading,
Doctor_Strange

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[MaxPlancker]

Craft a compelling PS that makes sense and speaks to who you are, cast a wide net, be normal in interviews, and you will likely match.

 

[peterparker12354]

Hey There,

Neurotic PGY-2 here. I am a USDO at a university IM program with an in-house cardiology fellowship (IC and EP too). I am planning on applying this year to cardiology and would appreciate any insight into my application as it stands. I have flirted with taking a year off to boost my app further while pursuing either a hospitalist, non-ACGME fellowship, or being a Chief Resident at another institution.

Anyways, as it stands this is what my app looks like:

Publications

Peer Reviewed Journal Articles/Abstracts

14 total (mixture of manuscripts, abstracts that were presented at conferences with a DOI, and case reports)

• Of the 14 about half are cardiology related and of the 14 I am the first or second author on almost all
• One in ACC and one in HRS

Poster Presentation

10 poster presentations (some include abstracts while others were not published and were stand-alone posters)

• Most are cardiology related

Oral Presentation

4 oral presentations

~

Outside of research, my CV is otherwise nothing to brag about -- I am on one residency committee. I expect my LORs to be average: my IM PD LOR will be generic only because I know my PD won't write a glowing LOR, but he won't say anything to hurt my chances (he cares about his residents matching well). Our CCU director will write me a LOR and she likes me a lot. Finally, the PD for our EP program has already volunteered to write me a LOR (I am publishing with him) and he is well-known in EP academia (this would probably be akin to a research LOR). My career goal is non-invasive general cardiology or maybe EP.

USMLEs 240s/230s

No other red flags.

I have about 5 remaining case reports that I am finalizing and hope to have published by mid-July. Most of them are cardiology related.

Anyways, I would be happy to match anywhere. My fiance lives in Ohio and I am comfortable leaving the South. The goal is to work PP with potential for medical student preceptorship.

Thanks for reading,
Doctor_Strange

Your application looks very solid to me and I don't think you'd need a year off. You have solid step scores, good research, and go to a university IM program so I wouldn't be too worried.

 

[Imtocardio]

I am starting my fellowship this July and have some experience. You have an excellent profile and you will do well. Don't get discouraged by applicants who have 50 papers. The goal of the selection process should be to look out for candidates who will be good clinically [in dealing with patients] along with a bent of mind to question evidence and stay current in the field [read this as demonstrating interest in research, which you have enough]. Unfortunately, with more candidates applying, 'research' became a big deal in the last few cycles. I saw candidates having 30-40 abstracts/pubs quite a bit [which was pretty unusual in other reasonably competitive specialties]. You can always overcome this by working hard, being a good IM resident, and having your IM attendings call the Cardio faculty [at least in your own program] to vouch for you. My IM PD called and spoke to the Cardio PD in favor of me, which was really valuable.
Apply broadly, stay positive, and give each interview your best shot and you will be good. You have already achieved a lot, you should definitely be proud of yourself.
And finally, DO NOT pay attention to the negative comments in SDN, the Cardio Interview spreadsheet for last year was one of the most toxic spreadsheets I had seen over the past few years [across various specialties] and really sucked the life out of me. Do NOT believe what people post there.

 

[HemeOncHopeful19]

I am starting my fellowship this July and have some experience. You have an excellent profile and you will do well. Don't get discouraged by applicants who have 50 papers. The goal of the selection process should be to look out for candidates who will be good clinically [in dealing with patients] along with a bent of mind to question evidence and stay current in the field [read this as demonstrating interest in research, which you have enough]. Unfortunately, with more candidates applying, 'research' became a big deal in the last few cycles. I saw candidates having 30-40 abstracts/pubs quite a bit [which was pretty unusual in other reasonably competitive specialties]. You can always overcome this by working hard, being a good IM resident, and having your IM attendings call the Cardio faculty [at least in your own program] to vouch for you. My IM PD called and spoke to the Cardio PD in favor of me, which was really valuable.
Apply broadly, stay positive, and give each interview your best shot and you will be good. You have already achieved a lot, you should definitely be proud of yourself.
And finally, DO NOT pay attention to the negative comments in SDN, the Cardio Interview spreadsheet for last year was one of the most toxic spreadsheets I had seen over the past few years [across various specialties] and really sucked the life out of me. Do NOT believe what people post there.

Just for others reading, if you have 30-50+ publications and aren’t an MD/PHD then everyone knows you didn’t actually do most of the work for them.

OP you will be fine unless you do something like apply only to programs in Ohio or are a weirdo IMO which if you’ve convinced a woman to marry you then probably you can at least be normal for 5 hours at an interview

 

[ROBINHO]

Only red flag is saying that your LORs will be average.
Cardiology is very competitive and a lukewarm letter of recommendation will hurt you. Program directors LORs almost always follow a standard format and I dont find the to necessarily be glowing. But you have control of who writes you letters so you want to enquire if they are writing you a very strong letter

 

[Doctor_Strange]

Only red flag is saying that your LORs will be average.
Cardiology is very competitive and a lukewarm letter of recommendation will hurt you. Program directors LORs almost always follow a standard format and I dont find the to necessarily be glowing. But you have control of who writes you letters so you want to enquire if they are writing you a very strong letter

I guess what I meant was I am an average resident, and therefore I expect my LORs to not be overly effusive like "he saw subtle de Winter's and saved the patient's life" level of glowing praise. FWIW, I had two of my LOR writers offer to write me a LOR without me prompting which I would think is a good sign.

 

[Doctor_Strange]

Also, I met with one of the APDs yesterday for my Cardiology program. Again, while I did not tell him this, privately I do not want to stay in-house. Anyways, he is really big on ITE scores and when I told him I was lower than 50th percentile for both of my scores, he said subtly that it was a red flag. He did add that if I apply broadly, "You will match somewhere." Outside of this conversation, I have to admit it is silly that he is weighing my ITEs so much when the data out there is weak in correlation with other high-stakes exams. Not to mention, I got divorced a few days before I took my ITE, but again not making excuses -- I do need to study more earnestly for my ABIM next year.

 

[ROBINHO]

Maybe he has internal data about graduates from your program with a certain range of ITE scores. I agree that scores doesnt define people however ABIM monitors board pass rate etc and that may be a big deal in some programs and not others. FOr instance a fellowship which has 6 fellows a year can afford it if one fellow doesnt pass. A fellowship with 2 fellows is impacted if one fellow doesnt appear

Having said that programs dont have access to your ITE scores

 

[dozitgetchahi]

Also, I met with one of the APDs yesterday for my Cardiology program. Again, while I did not tell him this, privately I do not want to stay in-house. Anyways, he is really big on ITE scores and when I told him I was lower than 50th percentile for both of my scores, he said subtly that it was a red flag. He did add that if I apply broadly, "You will match somewhere." Outside of this conversation, I have to admit it is silly that he is weighing my ITEs so much when the data out there is weak in correlation with other high-stakes exams. Not to mention, I got divorced a few days before I took my ITE, but again not making excuses -- I do need to study more earnestly for my ABIM next year.

He doesn’t have access to your ITE scores. They are explicitly not allowed to be used for advancement or for fellowship matching. Don’t reveal the results of them to people like this, if asked (there’s no such thing as someone like this being “big on ITE scores”, because they’re never supposed to have any access to them in the first place…)

Also, you got divorced before one of the ITEs but you’re already engaged to be married to someone else who apparently lives several states away, from the sound of it? As someone who went through a divorce while going through residency, all I can say is…pump the brakes, dude.

 

[aspiringcardiologa]

OP - If you apply broadly (+50 programs nationwide), you have good chances of matching. I see that you have a lot of research under your belt, but to stand out from the many other competitive applicants you do need to have excellent LORs because that speaks to your work ethic, personality and passion. I wonder why you do not want to stay in-house? Obviously the best chances are to match in-house unless the fellowship program is highly competitive that they can get applicants from other top programs.

Moreover, your ITE scores are only seen by your IM PD and no one else has access to them. However, the fact that your scores have consistently around or less than 30th percentile SHOULD make you worried about your passing the actual IM boards in August and the General Cardiology boards later down the road. It makes the program look bad if you don't pass, and you can only take the IM boards once a year so that would be another issue looming over your head while you go through the first year of fellowship which is a HUGE learning curve.

I saw from your previous posts that you've had some troubles during residency. The glaring thing is that you didn't like IM in the first place so I don't know why you would consider doing a chief year or hospitalist year prior to applying to fellowship. It's true that you don't need to practice general medicine as a cardiologist, but having a strong foundation in IM will make you a better cardiologist and you do encounter a lot of IM issues when managing clinic and hospitalized patients. Sounds like you need to get those other issues cleared up ASAP otherwise your performance in residency/fellowship/real world job will be negatively affected.

 

[Doctor_Strange]

OP - If you apply broadly (+50 programs nationwide), you have good chances of matching. I see that you have a lot of research under your belt, but to stand out from the many other competitive applicants you do need to have excellent LORs because that speaks to your work ethic, personality and passion. I wonder why you do not want to stay in-house? Obviously the best chances are to match in-house unless the fellowship program is highly competitive that they can get applicants from other top programs.

Moreover, your ITE scores are only seen by your IM PD and no one else has access to them. However, the fact that your scores have consistently around or less than 30th percentile SHOULD make you worried about your passing the actual IM boards in August and the General Cardiology boards later down the road. It makes the program look bad if you don't pass, and you can only take the IM boards once a year so that would be another issue looming over your head while you go through the first year of fellowship which is a HUGE learning curve.

I saw from your previous posts that you've had some troubles during residency. The glaring thing is that you didn't like IM in the first place so I don't know why you would consider doing a chief year or hospitalist year prior to applying to fellowship. It's true that you don't need to practice general medicine as a cardiologist, but having a strong foundation in IM will make you a better cardiologist and you do encounter a lot of IM issues when managing clinic and hospitalized patients. Sounds like you need to get those other issues cleared up ASAP otherwise your performance in residency/fellowship/real world job will be negatively affected.

Appreciate the advice and insight! I was going through intern blues last year, to be honest, not to mention going through a very traumatic divorce. Things are much better now for me both personally and professionally!

My in-house Cards program is just a bit odd that's all. They seemingly value IMGs over US graduates. Not to mention they were on probation a few years back. And finally, at the recommendation of one of the current Cards fellows, he told me to experience another work culture. And, I guess, I want a fresh start since my institution has some structural and cultural issues I find just a little corrosive.

Re: ITEs, I never studied for them. I am slightly worried, but I know I can pass them I need to devote studying to it. At this juncture, research > internal ITE score as far as the success of my application.

 

[Doctor_Strange]

Just an update...I guess the competitiveness continues to drastically increase because I have not obtained a single external interview invitation. I feel pretty blindsided as I thought my application would at least grant me an interview at community programs.

If any has any advice or guidance on what to do if I do not match, I am all ears. I think I need more original research other than case reports. I don't know. I am at a loss really on what to do. 🙁

 

[Doctor_Strange]

Wanted to give a brief update: sadly I did not match, but secured a PGY-4 Chief Resident spot at a community program w/ in-house fellowships. I came to learn one of my LORs was not good because it had the wrong name written on it (which is all the more disappointing and surprising since the individual offered to write me a LOR).

I think that 1/3 of applicants not matching shows how competitive cardiology has become. My program does not do much research, I had to find case reports and a few manuscripts to collaborate on entirely on my own. Still, I thought I had a good application. I am hoping the Chief Year helps get more eyes on my application. Since not matching, I have had about 6 abstracts accepted and a few awards at regional conferences. I will be going to ACC next weekend as well. However, when I see people's CV online w/ >35 or >40 abstracts with original research it is demoralizing. I think I will dual apply to PCCM as well next year since I have some overlapping research and I have enjoyed working in the MICU a lot.

 

[DrElectricity]

You'll do great. Clearly that LoR was the reason. Make sure you trust your letter writers this year!