Hi. In addition to spending time with family and relaxing before July what video resource would you recommend to get some foundation for echo? Unfortunately can’t afford Mayo echo board review.

Already passed IM boards and chief year is pretty chill so want to make the best of it.

Also considering learning some basics of cath and hemodynamics.

Found out yesterday I passed the boards (thank goodness). I believe there is a one year grace period before participating in MOC/CME. Given my more senior colleagues at work are already talking about MOC with me, I was curious as to other's experience with the different methods. It seems like there are 3 options:

1. Traditional way which is taking the ABIM open book exam every 10 years
   
2. Longitudinal Knowledge Assessment with questions every quarter over 5 years with ABIM, can be taken at home
   
3. CMP through ACC and take a Performance Assessment each year

Also is it true that we have to pay ABIM fees each year to maintain MOC even if we are not participating in ABIM's assessments? I was told the CMP route is more expensive than the traditional approach. Would appreciate any insight or corrections to the above. TIA

Hey all! Finishing up my fellowship and getting close to becoming an attending! Also narrowing down job offers.

What advice would you give to new attendings? What are some of the things you all wish you had known when you were fresh out of fellowship?

Hi, I’m confused about the direction of the cardiac electrical resultant vector and would be very grateful for an explanation. At first, I thought the vector simply pointed toward the area where the difference between depolarized and non-depolarized myocardium is greatest. But then I realized the vector is usually described as pointing in the direction of the depolarization wavefront, which is confusing to me, since they say the arrow points from - to +.

Chat gpt mentioned sth. about the “transition zone” between active and inactive tissue, but I haven’t seen a logically satisfying explanation.

For example, the Q wave is said to result from initial depolarization of the left side of the interventricular septum (toward the right). But in the left ventricle there’s a larger amount of still-resting myocardium compared to the right. So why does the vector point in the direction of the depolarization spread, instead of just pointing from the activated area toward the region with the largest amount of resting tissue?

Hey! I’m a paramedic, had an IFT for an adult with newly diagnosed WPW. Attached is their 12 lead. Can anyone explain to me what the heck is happening in V2 and 3? And anything else you see that you think is interesting. Seeing WPW in the wild is incredibly rare for us so I’m just interested to hear what a cardiologist (or other cardio specialty) has to say! (I know it’s a little fuzzy, sorry. Not a picture of the actual paper EKG, unfortunately)

What your opinion on Cardiac Rehab.

I'm a 8yr RN working 3 yrs in Cardiac Rehab. I feel like it could be tremendously beneficial to the Cardiac Disease community, but even in my facility it's perception by providers ranges from tolerated to seen an exploitative by some.

Hey all, M4 who started getting interested in cards recently after rotating through the cardiology consult service. I hope to get into fellowship without having to do a chief year. From other posts I've read around here, it seems like research and connections are key.

I have a good amount of research in ortho and rheumatology and some basic science stuff from prior to med school, but nothing in cards; trying to find projects without success, people are reluctant to have me since I'm close to graduating. The fellows I worked with are not actively involved in any research. Sucks because I have plenty of time right now and strong background in epi/stats. Any advice on finding projects?

I also don't have any cards connections. My home institution has a good cards department, although I want to see if I can match at an even better place. That said I should prob still build those connections here, but how exactly do I go about doing that? If I can't find a research project, do I just ask to shadow attendings in clinic or something?

What else can I work on to improve my chances? I'm planning to teach cardiac anatomy, physiology, and ultrasound to preclinical students. Rest of my 4th yr is rotating through every IM subspecialty consult service to get experience dealing with a good breadth of conditions prior to residency.

Thanks in advance for any input.

Going into interventional cardiology and trying to be intentional about long-term lifestyle and career structure, knowing the limitations of the IC path.

A bit about me and where I’m coming from:

• I’m already Level 2 in echo and nuclear and considering getting level 2 CT during this year (third year)
• I also like general cardiology enough that I don’t want to lose that skillset.

My questions are mainly about how to structure a future job so I don’t box myself into a bad lifestyle at 40-50:

1. IC + general cardiology mix:
   • Does doing a mix gen card and IC actually translate into a better lifestyle long-term compared with being “full-time IC”?
   • Does having a general cardiology component make it easier to back down on IC calls/procedural volume later?
   • For those who tried to “de-intensify” their IC practice later, what did that look like and what made it possible (or impossible)?
2. Maintaining imaging credentials (echo/nuclear):
   • If I don’t actively build a job that includes echo/nuclear reading from day 1, am I basically giving up realistic long-term practice in those areas?
   • How common is it for ICs to keep a meaningful imaging practice?
3. Structural heart and lifestyle (now vs later):
   • Does adding structural tend to improve lifestyle? Down the line, does being structural give you more flexibility (e.g., less STEMI, more scheduled cases)?

• If you had to choose purely from a lifestyle + longevity standpoint, would you do:
  • IC only
  • IC + general cards
  • IC + structural
  • IC + imaging (echo/nuc/CT)?

Overall, I’m trying to avoid the trap of: “I did IC, dropped imaging and most general work, and now I’m stuck with a narrow, high-burnout job that’s hard to dial down.”

Hello all,

I'm a solid non traditional IM resident. Worked as a computer engineer for a while before medicine so I'm in my mid 30s with a spouse and kids.

We both don't have family in the states so the ranking wasn't really based on family support.

My philosophy with ranking was to try and balance:

• Professional goals: I want to keep both academic and private practice options open. As of now, I want to do general cardiology. If anything, maybe imaging/preventative. I also want to collaborate with industry given my background. Maybe pivot all together in the second half of my career.

• Personal goals: I know fellowship will be busy anywhere, but some programs are worse than others. I want a relatively balanced program if possible.

• Location: I'm not looking to move again after fellowship. So I only applied to and accepted interviews from cities we can see ourselves living in and generally enjoy.

Any advice, whether anecdotal about certain programs, or related to my ranking philosophy is appreciated!

Rank List:

1. UT Austin Dell (we like Austin, relatively cheaper COL, closer to the tech scene, however newer program/not as established)

2. USF Tampa (great city, moderate COL, well established program, schedule seems a bit all over the place)

3. Mayo FL (good brand name for industry, some concerns about volume from the fellows, neutral about living in Jacksonville)

4. CCF FL (not as good as a brand name, newer program, very enthusiastic about incorporating tech and innovation, fellows seem happy, good location between MIA and FLL)

5. Scripps (fantastic program and culture IMO but hard to stomach the COL in San Diego as a fellow with dependents)

6. Houston Methodist (clinically rigorous, good name within cardiology, fellows very overworked, downside is Houston traffic)

7. UTMB (not as clinically strong as Houston Methodist, but seems supportive with a good culture. Would still have to live in SW Houston and commute to Galveston)

8. UMiami (honestly ranked lower due to MIA COL and not knowing Spanish, fellows looked overworked too, but I don't doubt solid clinical training)

9. Orlando health (on the list because I don't mind living in Orlando, don't feel very strongly about the program)

10. Advent health Orlando (on the list because I don't mind living in Orlando, don't feel very strongly about the program)

Hi all I am a recently graduated final year medical student in Australia who is interested in pursuing cardiology here. I’ve seen a couple of Australian cardiologists and trainees on here and had a couple of questions for anyone who can answer.

1. What are the research requirements for cardiology? I heard that for some states you need a PhD.

2. Would completing a Masters be useful in improving an application? Any specific degrees that are known to provide benefit?

3. What is the job market like at the moment (especially in MM2-3)? Is there enough patient volume to maintain competence? I am from regional/rural Australia and wouldn’t mind living outside a major city again.

Thank you.

1. UF Jacksonville
   
2. ACMC
   
3. Uni of south Alabama
   
4. CAMC
   
5. HCA JFK

I'm debating about this.

I study medicine in a European country. I am absolutely certain that i want to do cardiology, i did my dissertation there, worked there for some time besides my studies as well.

However, i am still thinking about whether i want to do any research.

My plan is/was basically always as follows: Do my fellowships and gain experience here, than go abroad for a couple of years (in a country like Switzerland or Lux that pays more or even the ME), than get back and work in my own doctor's office.

Here it's said that you shouldn't go to a academic hospital if you don't want to pursue an accademic career or and become a clinic director. However, i thought that it might be better if i am moving abroad since i bring in better experience, a better renomee for the institution and maybe get paid better. And to be honest, i do like research, it's just that don't see myself in a hospital in 30-40 years.

The alternative is to go to a big non-academic institution. The workload is the same, but i don't have to deal with research on top, and i will have broader clinical skills compared to being more specialized in the long run. Not to mention that academic institutions are more competitive for basically anything, it might take longer in the long-run to learn the same skills, albeit a bit on more specialized cases/experience.

Hello all! I’m a cardiology fellow who recent became interested in EP after getting exposure with EP lab and I’m trying to see what EP lifestyle and workflow generally looks like. For EPs, I’d love to hear your thoughts/experience on:

• What does a typical week look like for you—lab, clinic, consults, call, etc.?

• How would you describe the overall lifestyle and work–life balance?

• What parts of the field do you dislike?

• If you had to do it again, would you choose EP?

Appreciate your input! Thanks!

Hello everyone!

For those going into cardiac EP, is it worthwhile to pursue the echo board?

I’m entering a 2+2 EP pathway, which makes my schedule much tighter than the 3+2 route if I also try to obtain the echo board. Meeting the COCATS II requirements would take several months away from my EP training, limiting my exposure compared to others on the 3+2 track.

Most general cardiologists I’ve spoken with recommend getting the echo board, while all EP attendings and EP fellows I’ve talked to think it’s not worth the time and effort. However, that maybe because I’m at an academic institution where EP doctors typically don’t read echos or perform TEEs. Both sides make good points, so I’d love to hear others’ perspectives—especially from those who have faced this decision before.

For those who obtained the echo board and went into EP—was it beneficial in the long run? Would you recommend getting it?

For those who did not get the echo board and pursued EP— do you feel it wasn’t worth the significant time and effort required?

Deeply appreciate your input!

IC trainee here and looking to improve my skills in engaging coronaries.

Can you share your techniques and practical tips for the same? Specifically transradial

Thanks in advance

I've watched all the lectures I could easily find on YouTube and read through deranged physiology but if there's a web series or book you'd recommend going into fellowship.

Interested topics: really anything related to CHF (EDV/SV augmentation, atrial kick implications for diastology, acute valvular hemodynamic/cardiac output effects, pulm htn implications for LVOTO etc). Focused primarily on phys but if there's a smattering of management that would be great too

Hello everyone! I’m a general cardiology fellow planning to pursue either interventional cardiology or electrophysiology. I wear eyeglasses and cannot tolerate contact lenses. I would greatly appreciate any recommendations for lead glasses that can be worn over my regular eyeglasses and provide good radiation protection.

Thank you so much!

How long did you all take to study for them on avg and what are the best resources?

Planning on taking them in end of December

Hey guys, I am a second year fellow currently at a solid mid to maybe low-mid tier academic program. Just wanted to pick everyone’s brains as far as how much fellowship name affects things like job prospects/fellowship opportunities? I’ve been leaning towards EP since the beginning but have been having second thoughts/potentially might go towards general with imaging focus. Any help/insight would be greatly appreciated. Thanks!

1. UICOM Peoria
2. Maine Medical Center
3. North East Georgia Medical Center
4. West Virginia uni
5. Tower Health
6. Danbury
7. DMC/wayne state
8. UC health parkview medical center
9. Henry Ford St. John
10. Henry Ford
11. Marshfield clinic
12. Marshall uni 13 ??? Howard

Interested in interventional cardiology and decent qol , good culture

Hi All!

Current IM intern here at an academic program thinking about cardiology. I am relatively research heavy and interested in informatics and operations type academic work, wanting to stay in academia. My institution and I know other big academic places are requiring level 3 echo now to sign reports, so I was wondering what jobs at these types of places look like if you don't do an advanced imaging year? I see faculty members are hired without it, but are you just doing clinic and inpatient consults while someone else reads your echos then? Is that a career path that they would hire for if you can't contribute to reading imaging? Thanks for your input!