I have toyed with the idea of going back to fellowship from PP. CT was always fun in residency, but it has been a long time since I've done cardiac. I feel like I'd be really behind. Would they want to see someone like that get testamur status or something as a reassurance?
I probably wont ever pursue this avenue, but anyone with insight just humor me.
No, you do not need to get testamur to be a serious applicant.
@pgg went back for CT after being out for awhile so he can tell you what he did regarding letters of rec and such
I went back for CT fellowship 7 years after finishing residency. I did exactly no hearts in those 7 years, and had barely touched a TEE probe. I did feel behind when I started, compared to my fellowship classmates who were straight out of residency, who had all done a bunch of hearts in the previous year. I definitely was not as smooth with TEE, getting people off bypass, etc. But it worked out fine.
The program assumed we all were completely ignorant about TEE and started with the basics. Our PD explicitly told me that since the program takes people from lots of residency programs, with extremely variable TEE curricula, that they don't assume any baseline level of competence. Honestly, there's such a huge gulf between a graduating resident who's "good" with TEE and the level of skill expected of an ACTA grad, that small gaps between the new fellows' TEE knowledge are just noise.
There are some advantages to going back to fellowship late. Experience and comfort practicing independently is worth something. You're already board certified, so while your co-fellows have to devote time and energy to oral board study and practice, you don't.
I can see the pay cut being a big dissuading issue for people. I went to fellowship funded by my employer (the USN) so I took no pay cut, and kept accruing benefits like vacation time and pension credit. Win all around.
LORs were easy enough - my old PD wrote one for me. I was the assistant PD / ed coordinator for a residency program at the time, and the PD was a cardiac guy who wrote one for me too. We'd spent ~7 months together deployed to a trauma center in Afghanistan a few years before I applied.
When interviewing, every program asked me how I'd handle going back to being in a subordinate role with an attending telling me what to do. I thought it was an easy question. I think anyone who's ever practiced independently and been bottom-line responsible for taking care of sick and complex patients, who isn't a narcissistic fool, ought to be glad to have a smart, qualified, experienced person around to offer guidance and backup. But I guess they get some fools who walk in thinking they're too good to be taught anything, else they wouldn't ask.
And of course, there's the (unspoken) obvious mundane truth that they had something I wanted: a new skill set from their cardiac case load and teaching, and a certificate that was going to open lots of doors and make me eligible for echo board certification. I would have put up with a lot more than the occasional attending ego or power game to get those things. Every one of us has eaten crap and tolerated abuse and delayed gratification to get into training, and through it. How would I handle being a trainee again? Like an adult, how else?
I did have a handful of altercations with surgeons, however, that in retrospect I should have avoided as a trainee.
It's hard to listen to bull**** though and just smile and nod, after years of not feeling obligated to indulge such bull****. A couple of similar encounters with OR staff that again, I should have just let go. Oh well. In retrospect, even those are basically happy memories.
I'm glad I went back and did it. I'm now a few years out of fellowship, still love doing hearts. Love the cases, the sick patients, the small teams ... even the cardiac surgeons. Well, almost all of them. And I wouldn't be doing hearts at all, if I hadn't spent that year as a fellow.
