Advice needed from those in practice (EP or interventional)

[Southernfire88]

Hi All.

Recently started in an advanced fellowship which is by far not as advertised during the interview season.

There is no good teaching, volume is low and overall the program is much weaker than anticipated for a procedural specialty.

I have thoughts on quitting and reapplying. I am a competitive applicant, had multiple offers from strong institutions but choose this one as my husband is also doing an advanced fellowship in the area and we did not want to be apart. This is likely to put me behind a year or two depending on whats out there. Really stuck and unsure how to proceed. Any thoughts are appreciated.

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[TAVR4life]

Answer depends on a variety of factors:

1) is it IC or EP?
2) is this a brand name institution?
3) is the volume low because of COVID?

If it’s IC I would say continue forward for the one year commitment you’ll learn enough to be a competent IC plus on the job training. This is assuming they have enough volume to meet COCAT numbers.

If it’s EP and it’s a 2 year commitment and you wanted to learn more advanced procedures then might want to cut ties now if you don’t see it improving although make sure it isn’t a match violation.

Either way it’s still early only a few weeks into the fellowship try to make the most of it as remember there is always on the job training and learning after you finish subspecialty training—an option that academics don’t highlight.

Also keep in mind, COVID has cut volumes at a lot of the institutions.

 

[NYknicks44]

I think it depends on if you are doing IC or EP.

If you are doing IC for on year, then I would suggest continuing in your program. It is very competitive and might be hard to get a spot if you leave a program.

If you are doing EP, leaving is a more reasonable as there are open spots available and you will be able to get them immediately.

Just keep in mind, volume fluctuates through out the year. Summer months are slow as a lot of people are on vacation. And covid has dropped volume all across the US, so other places probably have the same issues as the current place

 

[nlax30]

Completely agree with what has been mentioned above. If IC then I’d lean toward staying put and just gunning for althe cases you can get. If looking at doing a structural year then certainly go somewhere else for that.

If EP and if it’s truly a function of the program being weak and not able to sustain itself then you may want to look elsewhere. Especially with the current breadth of procedures that EPS are involved in it can be hard to get broad exposure to everything during fellowship. You certainly want to come out able to do AF ablations, and implant CRTs. Things like extractions may be not all that important depending on where you’re going to end up.

That said the past few months have been really hard on proceduralists and you may not have really even exposed to the behind the scenes aspect of how much volume has been affected at your previous facility during general fellowship.

 

[timpview]

Broken record but 100% agree with others.

IC - suck it up and get through the year. You learn most those first 4-5 years out of fellowship anyways

EP - get out. It’s just like being in a different specialty altogether and if you don’t really get it/like it, then can be miserable. Just do gen