I am a first year fellow at a community cardiology program with interest in applying for EP fellowship. Would like to know the competitiveness and how much research is involved in securing a spot. I also intend to apply broadly. Thank you

Hi there.

I have read that amiodarone should be avoided in pre-excited atrial fibrillation due to a potential AV nodal blocking effect which may excacerbate the problems causing even faster ventricular rate and possibly degeneration to VF, the same argument for not using other AV nodal blocking agents such as beta blockers. However, I have asked some of my older colleagues some of which are quite competent in arrhythmias and they do not show this concern and say amiodarone is OK. Do any of you have any thoughts / experience / input towards this? I know flecainide can be used, and often these patients are younger without concerns of structural heart disease but flecainide is more finicky than amiodarone. Of course, there is still DC cardio version but if we want to use drugs. I have never had such a patient in real life.

Hypothetical question: Is a research year at an academic institution the best move that would significantly help a community IM resident grad match cardiology? Or is taking a hospitalist job at an academic hospital and networking with their cardiology department a better move?

Hey cardiology friends,

Anesthesiologist here. Have had a situation arise a few times over the past year and was hoping to get some expert input:

Elderly patient (~70y/o) shows up with little/no prior medical care, found to have a large (7cm or more) AAA which requires relatively urgent repair (~25% or higher chance of rupture in 6 months, so not looking to delay surgery by much if at all). Either low functional capacity, or unable to assess due to mobility. EKG with some chronic looking changes, maybe LBBB, but nothing acute. Echo largely unremarkable. Maybe some DOE but otherwise no acute symptoms. Can be either open AAA or endovascular repair.

My questions would be:

1. Would this patient benefit from cardiac consult prior to their surgery? If so, what would that look like? According to these guidelines from Society for Vascular Surgery, this patient would qualify for cardiac risk stratification: "In patients with significant clinical risk factors, such as coronary artery disease, congestive heart failure, cerebrovascular disease, diabetes mellitus, chronic renal insufficiency, and unknown or poor functional capacity (metabolic equivalent [MET] < 4), who are to undergo OSR or EVAR, we suggest noninvasive stress testing."

2. What sort of workup/eval would you do? What questions would be important from a risk stratification standpoint?

3. Can you actually stress test patients with large AAAs? Literature shows 6-7cm seems to be safe, but not much data on anything above 7cm. Or would you go straight to angio if concerned?

4. Other thoughts/things to know?

Thanks ya'll!

Hi, I'm a first year med student, wanting to learn more about cardiology. I've loved everything about cards, the ability to have meaningful procedures and medicine, the mix of complex and more straightforward patients, and the impactful patient interactions you can have. The only thing I really wonder about is the problem solving in cardiology.

I've really liked the kinds of things where you are given a bunch of info about a patient and its up to you to figure out what is going on and how to treat them. Is there much of that in cardiology? From my extremely limited exposure to the field I haven't seen too much of that aspect which is why I ask. Additionally, what types of problems are cardiologists generally solving? Are they complex and requiring some real thought or are many of them just routine? Thanks so much!

Does anyone have a log-in that they would be willing to share with me? Trying to do some last-minute board prep but the price for the subscription is crazy. Would be willing to pay you some amount to get access to it. Thanks!

TL;DR: How much dexterity is necessary to be successful in interventional fields?

I'm nearing the end of my studies and am increasingly focused on choosing my medical specialty.

Cardiology has brought me a lot of joy during my studies, so it's likely my first choice. In particular, I was fascinated by the catheter lab, where I spent a week during an internship. I got to see everything from heart valves to stents.

I feel the same fascination for interventional radiology, although I generally prefer cardiology outside of interventions. But that's not the main focus here.

I’m aware that interventions in both fields are popular bottlenecks, and it may take a long time before you can actively work in them. This makes me worried about working toward something that I might not be good at or may not be able to properly learn.

I would describe myself as only averagely dexterous or skillful, and I’m concerned that I won’t be able to get the hang of it, or that I’m not suitable for the training. Also I'll be 31 when I start residency, I'm a little bit afraid that that age will be a factor also.

Perhaps some of you can share your experiences – I’d greatly appreciate your responses.

Hello, I am a perfusionist and trying to better understand the IABP wave form. I understand the basics but I just want to have a better grip on the cause and effect. Here is one example waveform and if someone could help me understand what would be the difference between lack of trigger and no augmentation that would be great. I assume early inflation and late inflation are incorrect assumptions based of the position of dicrotic notch? The Arterial wave seems to been unaltered so i would assume there is simply no augmentation occurring? if there is, i'm not sure what would cause this appearance besides lack of trigger possibly from failed to open balloon.

Any explanations are welcomed and appreciated thank you!

I am NOT looking for abcd answers, I have a key. Just want to understand because there's no explanations.

Hey everyone,

I’m a PGY1 at a mid tier academic IM program. I have no research on my resume. Was wondering how much cardiology research someone at a mid tier program needs to have a high chance at matching, assuming everything else on my resume is average?

Hi, I’m a PGY 2 IM resident interested in cardiology. I was wondering if anyone knew good/free resources to learn cardiac imaging modalities including echo, ct , mri and nuclear tests

Hello,

Cardiology fellow here. I've wanted to do IC since end of medical school. However, after a couple of years of rotations with wearing lead, I've developed some back pain. Usually 2 or 3 out of 10, but 5 or 6 when it flares after a long case. My MRI showed osteophytic complexes and multilevel facet arthrosis. Didn't know what to make of it. I'm in my 30s. My PM&R doc said I have signs of arthritis and that it could get better with strengthening exercises.

So I find myself at a crossroads. On one hand, I don't want to make a rash decision and not do IC when this could get better with improved conditioning and better posture. On the other hand, part of the lack of conditioning is the time demands of the training. And if I'm already showing signs of arthritis at this age, is it worth it?

Hi I would appreciate help with the following:

1.Letter of Intent: I’m conflicted between sending it to a very competitive top choice versus a less competitive but more reasonable second-choice program. How much does a letter of intent actually matter, and can it really impact how a program ranks you? Would love to hear thoughts on this from anyone who’s been in a similar situation.

2.Program Name vs. Training Fit: I am wondering how much the program’s name or prestige should influence my decision. While reputation seems important, I’m primarily focused on clinical training, mentorship, and work-life balance. Is the program’s name a major factor in the long run, particularly for non-invasive cardiology, or should I focus more on other aspects like case volume, culture, and fit?

Cardiology applicant here. I’ve been told to go to programs with good cath volumes since I am interested in interventional and have also heard the Boston programs have low Cath volumes. On one of the websites they said they do over 4000 cases a year which is similar to numbers quoted by programs that are said to be high volume. I’m a little confused on how to rank programs based on this conflicting information. Should we be trusting these numbers? Also what is good cath volume?

Currently terrible at both, and haven’t found any great resources yet. Would really appreciate any recommendations

Looking to get a consensus here on when to remove these. Got into a little debate with a coworker. Lets say you place one for 3rd degree block in the setting of sepsis or some other reversible cause.

Do you pull after 24 hours with no pacing? Do you pull sooner? Do you leave it in and just upgrade to a permanent pacer?

Hi all,

I’m trying to configure my third-year rotations and could use some advice. I’m interested in general cardiology and will probably sign with a large non-profit institution (aka prividemic place). I am level 2 in Nuclear and taking the boards this year. Per my discussion with our imaging leadership below are my options:

• Level 3 Echo:
  • I’m somewhat academically oriented and would love to be an expert in something.
  • Most jobs will likely give me echo/TEE time.
  • Future leadership positions in echo could be possible with this path
  • I’m already Level 2 and echo-boarded at this point.
• Level 2 CT/MR:
  • Being a multimodality imager is a big plus.
  • However, I feel like Level 2 MR isn’t as respected as it used to be, and I’m wondering if I’d need an advanced imaging fellowship to really get the most out of this path.

What are your thoughts, Reddit community? Which path would set me up better long-term?

Hi,

I'm currently studying for the AdvPTEeXAM(TEE), mainly using PTEMasters and Sidebotham's text. I'm also wanting to sit the ASCeXAM (TTE). My question goes out to those who have completed both, and the crossover in study and feasibility of sitting both in the same year.

Was it a lot of extra work to study or was TEE stuff just as relevant for TTE?

Any extra texts you would add for ASCExam study? Is one exam 'harder' than the other?

Cheers.

Just wondering since there will be weekends where my partner might be gone/working and if I wanted to work more do I just take extra call from other partners or do y'all ever reach out to other hospital systems since their call rates are higher? I'm working likely in academics but if I pick up call at a community hospital, I imagine I could 1.5x my rate. Is that correct? What numbers could I be looking at as I sacrifice my weekend/sleep?

I am a fellow, looking to review a few topics. I obviously cannot afford these, would be helpful if anyone might be able to share, thank you.

Hi all. I am wanting to go into cardiology fellowship. I am a current hospitalist and trying to figure out which cardiology conference I should go to this year. I went to and presented at the HFSA conference last year and had a good experience. I am hoping to at least attend a cardiology focused conference this year. I was considering the ACC conference, but it feels like that is the "big" conference everyone attends to try to advance their career, and I don't know how much I'd "stand out" in the largest crowd especially if I didn't present there.

Are there any cardiology centered conferences that you think would be useful to start to develop connections that might also be useful for my current job as a hospitalist? Thank you in advance!

I am currently interviewing for cardiology fellowship and deciding on my rank list. There has been alot of talk about going to a place with good volume. How important is this really for general cardiology training. I can see how this will matter for things like interventional or EP or imaging. But for general cardiology how big is having volume. Also how is this volume measured? Specifically people have talked down the Havard programs because of what they call "low volume". Is anyone familiar with this topic and can talk more about it?

Thank you mods for allowing me to make this post.

I know someone recently posted about being worried about not matching, but I would appreciate another perspective.

This is my third year applying for the match. My first year I applied to 90+ programs and had 4 interviews. I applied to 12 non-accredited 1 year fellowships that year and interviewed at 4 programs but ended up not being accepted into any of those either. My second year I applied to 120ish programs and had 1 interview. This year I've applied to 135+ programs and am sitting at 0 interviews. I'm currently in my second year as a hospitalist at a large academic center, but the cardiology program here seems to prefer outsiders (aka not hospitalists at the program).

I am wondering if my application is weeded out early and if there is anything I can do to fix it. I am a USDO who graduated residency from an academic/university affiliated program. I know more research would help my application, but I don't think reviewers are even getting to that part of my application. Do you think I am weeded out because of my board scores?

Level 1 - 561 (that was my only year taking Step 1 as well and that score was 235)

Level 2 - 536

Level 3 - My first attempt during intern year I failed. I really struggled that year mentally with adjusting but worked on my mentality and in six months, my Level 3 score went from the 200s (not passing) to 659. I address this issue in my personal statement, but I feel like that one exam "fail" immediately removes me from a lot of programs. I wish people would look at the actual scores and think something like "wow, she experienced this failure and seemed to have learned from it and improved exponentially." I would hope that overcoming this failure would show resilience, but my guess is that it's what is hurting me the most regardless of my second score.

Is there anything I can or should do to help programs reconsider reviewing my application? Am I probably correct that this one failure is what has been holding me back?

Any and all help is much appreciated!

Hello everyone!

I am a medical student about to start my interventional cardiology rotation and super excited! I was wondering if there were any resources y'all would recommend that you found helpful when learning your craft.

I have purchased Dale Dubin's book but it won't be here for a week or two and was curious what of the resources out there were the best. So far the only thing I'd been recommended was "the only EKG book you'll ever need" but don't have much outside of random online articles and the like.

Would love some insight if possible!

Does getting Diplomate status really matter for a cardiology career? I see many practicing cardiologists have the Testamur from the physician verification website, but not many have the Diplomate status.

Slightly unrelated question: who should consider getting the title of fellow of the American Society of Echocardiography (FASE)?

Hi.

I'm a 6th year medical student (IMG), this is my last year and I'm expected to graduate by July 2025.

I do have big interest in Cardiology as a future career especially Cardiac electrophysiology subspecialty.

Do you suggest me any good books to read / websites / etc that would grow my ambition more?

What skills to focus on in my last year before graduation in your opinion?
Throw any opinion you have even if it was a simple advice.

Thanks.

The r/cardiology subreddit sometimes feels like a blend of "Cardiology 101" questions and overhyped case presentations that are trying way too hard to flex obscure ECG patterns or some absurdly rare diagnosis. It's as if everyone just discovered Takotsubo Cardiomyopathy last week and now can't stop referencing it like it's the holy grail of heart conditions.

There’s always that one person who posts a blurry ECG asking for help with a complex arrhythmia, and instead of actual helpful advice, the replies are a mixture of "Google it" or some self-appointed expert turning it into an impromptu lecture on the minutiae of electrophysiology. And let's not forget the endless "Is this STEMI or not?" debates, where someone pulls up a case straight out of a textbook, but the only difference is their enthusiasm to tell you that their attending agreed with their diagnosis... eventually.

Also, for a subreddit that's supposed to be about cardiology, the random "what's your favorite statin?" or "rate my favorite cardiologist meme" posts somehow get the most upvotes. Maybe it's a sign that half the users are tired of reviewing guidelines and just need to vent about the hours they've lost to M&Ms or consults that end up being nothing more than reflux.

But hey, at least you’ll occasionally stumble on an actually educational thread, buried somewhere between someone's brag about their successful cath and another's rant about how they haven't seen daylight in months.

First year gen fellow with a little time on their hands

I am currently working as a hospitalist. It's nice seeing that paycheck and one week on and one week off schedule.
Applied for cardiology fellowship this year, God speed. I have few Questions for my attending Gen Cardiologists. I know it's very location/practice specific.

1. What does your work week look like? In terms of hours and calls?
2. How many weeks of vacation do you get? Are you happy with it?
3. Do you feel overworked or burned out? I know that's a common complaints of Hospitalists physicians.

Thanks so much.