Is doing an Electrophysiology Fellowship worth it ?

[Vtach00]

I am in a huge dilemma: have an offer for an EP fellowship from a top ranked place but am having second thoughts. Looking at the current job market (academic and/or private) I am wondering if doing one year of ACGME accredited EP fellowship post-cardiology worth it?
Especially since I am hoping to find a job on the west coast after..

I should add that I am equally attracted to Interventional and can get an interventional spot at my home program if I hustle.

Can anyone comment on the job prospects, lifestyle and salaries that would help me decide... thanks

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[bronx43]

I am in a huge dilemma: have an offer for an EP fellowship from a top ranked place but am having second thoughts. Looking at the current job market (academic and/or private) I am wondering if doing one year of ACGME accredited EP fellowship post-cardiology worth it?
Especially since I am hoping to find a job on the west coast after..

I should add that I am equally attracted to Interventional and can get an interventional spot at my home program if I hustle.

Can anyone comment on the job prospects, lifestyle and salaries that would help me decide... thanks

This is just anecdotal, but I hear that the EP fellows at my institution are having trouble finding good gigs. The senior EP guys are still making bank, but it's apparently impossible to squeeze into the market. I'm interested in this topic as well, if someone with more insider info can offer insight.

 

[intcards]

I am in a huge dilemma: have an offer for an EP fellowship from a top ranked place but am having second thoughts. Looking at the current job market (academic and/or private) I am wondering if doing one year of ACGME accredited EP fellowship post-cardiology worth it?
Especially since I am hoping to find a job on the west coast after..

I should add that I am equally attracted to Interventional and can get an interventional spot at my home program if I hustle.

Can anyone comment on the job prospects, lifestyle and salaries that would help me decide... thanks

If you want to 100% EP, the job market is tough because you are limiting yourself to large practices with at least 10ish cardiologists or large hospitals. If you are willing to do a fair amount of general/noninvasive cardiology, it will be easier...still sorta tough, but easier. Lifestyle and longterm earning potential can vary widely depending on you practice structure. Obviously, the lifestyle for those who are 100% EP will be best since your call will be limited to EP call, which is generally fairly benign.

 

[josephf1]

yes the market is very tight 2/2 oversaturation in desirable markets.
your main issue is going to be taht to be competitive enough for the really good jobs your gonna need to do the full 2 year ep fellowship to bring all the available skills to the negotiating table. if not theyll pick the 2 year trained guy over you. Now you have the realy dilema should you do 2 more years of training with poor job prospects and declining $$$.
I guess thats more for you to decide.

 

[Vtach00]

Thank you all. I really appreciate the insightful comments.
Would really love if other people who have gone through this thought process weigh in too. Thanks..

 

[josephf1]

people i know from my program either had to do a mix of gen cards + ep (dont neglect nuchs and echo) or had to move to BF to get a descent job.

 

[AlmostAnMD]

But if you go EP, don't you worry about lifelong exposure to radiation from the C-arm? Same with any procedural specialty, I guess, but that would worry me. I mean I'm sure the lead does a good job of protecting you, but that's still a lot of gamma radiation over 30-40 years.

 

[sacrament]

But if you go EP, don't you worry about lifelong exposure to radiation from the C-arm? Same with any procedural specialty, I guess, but that would worry me. I mean I'm sure the lead does a good job of protecting you, but that's still a lot of gamma radiation over 30-40 years.

An interventional cardiologist can expect about a 3-4% increase in lifetime risk of cancer (above the baseline of ~20%). So it's small but real.

 

[doctorTT]

That sounds reasonable, where did you get that statistic from? Do you have the citation?

 

[bronx43]

An interventional cardiologist can expect about a 3-4% increase in lifetime risk of cancer (above the baseline of ~20%). So it's small but real.

Haven't the radiation protective measures also improved in the past few decades? That is one potential problem I see with any kind of longitudinal or even cross sectional study about cancer and interventional proceduralists.

 

[sacrament]

That sounds reasonable, where did you get that statistic from? Do you have the citation?

It's from my interventional cards board review book. They don't give a citation, but even just googling "lifetime increased risk of cancer for interventional cardiologist" brings up some articles.

 

[sacrament]

Haven't the radiation protective measures also improved in the past few decades? That is one potential problem I see with any kind of longitudinal or even cross sectional study about cancer and interventional proceduralists.

Yeah, I'm sure things have gotten better. The equipment is better, but also there are lots of little tweaks you can do that people are getting used to (like using fewer frames-per-second when possible), and if you use an assist device for contrast then it's easier to stand further from the patient when doing cine. There is also stuff like the RADPAD. On the other hand, some centers (like mine) are starting to get more serious about tackling complicated CTOs and complicated peripheral disease, which tend to be longer cases involving more radiation. But we've sort of gotten off the track of this thread.

To refocus, I will offer my own anecdote: the EP fellows at my institution have had a hell of a time finding jobs over the past few years. They have all managed to eventually do it before graduating, but usually the jobs have involved a good deal of general cardiology work, and certainly you can't be picky about location.

 

[Vtach00]

Thanks guys. While I really like the idea of going to a big name program, the lack of jobs after scares me.
Now its turning into s nightmare decision for me: declining a top ranked EP program and choosing a lesser known program for interventional because of better job opportunities after.
I am bummed.

 

[Vtach00]

bump

 

[atach]

can anybody give us some more specific information regarding getting a job out of ep fellowship? is it really that hard?

 

[guzmaa]

Depends on your program and the job market at the time of application.

One of my colleagues opted to stay in a lesser program down south since they offered to hire him as a faculty after his fellowship. He could take that deal since he also had offer from a private group in his hometown who are still ready to take him and work with him whatever the sub-specialization he opts for.

Situations like these are hard to find by, but overall I know one of my professors who wanted to relocate to a more urban place could not find ajob despite having stellar reputation and great skills, that scares me outright.

 

[wheewer]

I'm a medical student interested in EP. Given that I'd be an attending in 10 years, what do you think the field will look like then? Just looking at the job postings now is disappointing salary-wise, especially when considering the long road ahead. The numbers don't nearly reflect what current national averages claim.

I see national averages listed at 500 - 600 K but the job postings and salary lookup tools in the northeast often show mid 200's for EP and even cards in general. Can someone comment on whether this is true or if I'm just not seeing the reality of things through online research? Thanks.

 

[wheewer]

I've also been thinking about the divide between academic/hospital and private practice. For how superspecialized it is, can someone do EP in private practice? I understand that they typically alternate between EP lab and clinic as well as occasional OR. Could this be done in an office + outpatient surgical center? My guess is probably not because cardiac procedures are no joke and probably need the resources of a full hospital to be available at moment's notice. If it can be, what is the disparity in earnings? I'd really appreciate the insight. Thanks!

 

[ItsAboutThePatient]

"Thanks guys. While I really like the idea of going to a big name program, the lack of jobs after scares me.
Now its turning into s nightmare decision for me: declining a top ranked EP program and choosing a lesser known program for interventional because of better job opportunities after.
I am bummed."

Yo, butthead. If you want to do EP then grab your nuts and do it you coward. You'll find a job.

 

[tachycore]

"Thanks guys. While I really like the idea of going to a big name program, the lack of jobs after scares me.
Now its turning into s nightmare decision for me: declining a top ranked EP program and choosing a lesser known program for interventional because of better job opportunities after.
I am bummed."

Yo, butthead. If you want to do EP then grab your nuts and do it you coward. You'll find a job.

I do believe the OP has long ago made his decision. That post you quoted was from 2013.

Regardless, the one who resurrected this thread 2 days ago should have started his own.

 

[ItsAboutThePatient]

Good point... sorry I'm new to the forum