Unmatched cardiology

[Throwaway121212]

Hi all,

As the title states, unmatched cards this year...

Im an amg at a mid tier im program. Passed all steps on first try with scores 240+. Research includes abstracts at acc, nla and TCT (first author on all of them) . One first author pub currently in process. No other red flags on my app and reportedly very strong lors. Applied to 40ish programs and got ten interviews so not sure exactly what went wrong.. maybe not enough research or applying too narrowly... Was told that I interview well fwiw.

Anyway, I was offered a chief resident position at my home institution as well as a one year non invasive (non acgme accredited) cardiology fellowship. Both of these options sound reasonable but was wondering if anyone has insight in to which would be the better/higher yield option for successfully matching in to cardiology this upcoming year (planning on applying very broadly) .

Thanks

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[deleted480308]

Is there cardiology at your home program or where the fellowship is?

 

[Throwaway121212]

Yes, there is cardiology at both places.

 

[deleted980918]

10/40 interviews is very unusual given your stat and even if you only had 10 interviews you should have matched. we have very similar stats and i applied to ~50 programs and got 30 interview invites. is your list too top heavy? anway, the chief position will give you far better chance than any of the non-acgme fellowships out there. i would also take another look at your application and lors to see if there is any potential red flags.

 

[Egghead34]

anway, the chief position will give you far better chance than any of the non-acgme fellowships out there.

Based off of what are you saying this? Seems unfounded, and if it is opinion should be labeled as such

 

[deleted980918]

*my opinion

 

[shouldigomd]

Wow tough luck that is unfortunate. You have options though so you will be fine.

I would talk to your home program cardiology PD and see which they would value more. I think it depends on your goals. If you want academia / research based career than you need to find out which would look best at big name programs ( I would guess chief resident as doing a non accredited 1 year is basically holding a flag saying you didn't match when you apply next cycle).

That being said if they can guarantee you a spot at your home institution or you just want solid training (don't care about big name) than I would think the cards 1 year to give you a running start for fellowship. You would learn a whole lot rather than be a secretary for a year.

 

[timpview]

Ugh. Tough one.
I agree that I would speak with PD at your home place to get some feedback.

In regards to your question I think you could go either way. Personally I would do the fellowship. It will get you working directly with cardiology folks, plus it would be nice to get some numbers (if imaging) or experience (if heart failure)

 

[TAVR4life]

Do chief year it will make your CV stronger, it’s considered a prestigious honor and some top programs use it as a filter. Don’t do non-accredited fellowship, it’s for weaker candidates it won’t help you.

 

[drk]

I disagree with the above. Lots of places don’t hold any value in the Chief year. Some of the top places may use that as a criteria to interview outside their own “ivy” league group but otherwise for your future and training it’s a waste of time.
The imaging fellowship, while non accredited, will let you be far ahead of your peers. I believe post gen cards fellowship you can apply your numbers. You will also be able to use them for CT boards and MRI boards. One of our current first year cardiology fellows did a non accredited imaging year and sat for his CT boards and passed. Pretty sweet.
If I were a PD I’d consider that more advantageous than a chief year.

My opinion and the opinion of my Gen Cards PD.

 

[shouldigomd]

I disagree with the above. Lots of places don’t hold any value in the Chief year. Some of the top places may use that as a criteria to interview outside their own “ivy” league group but otherwise for your future and training it’s a waste of time.
The imaging fellowship, while non accredited, will let you be far ahead of your peers. I believe post gen cards fellowship you can apply your numbers. You will also be able to use them for CT boards and MRI boards. One of our current first year cardiology fellows did a non accredited imaging year and sat for his CT boards and passed. Pretty sweet.
If I were a PD I’d consider that more advantageous than a chief year.

My opinion and the opinion of my Gen Cards PD.

But many top programs do. I am at a mid tier university program and the residents who stay for a chief year have a distinct advantage year after year.

 

[TAVR4life]

I disagree with the above. Lots of places don’t hold any value in the Chief year. Some of the top places may use that as a criteria to interview outside their own “ivy” league group but otherwise for your future and training it’s a waste of time.
The imaging fellowship, while non accredited, will let you be far ahead of your peers. I believe post gen cards fellowship you can apply your numbers. You will also be able to use them for CT boards and MRI boards. One of our current first year cardiology fellows did a non accredited imaging year and sat for his CT boards and passed. Pretty sweet.
If I were a PD I’d consider that more advantageous than a chief year.

My opinion and the opinion of my Gen Cards PD.

I typically give the advice to go straight from residency to fellowship, wouldn’t sugggest a Chief year unless you’re gunning for top programs. But if you didn’t match and already have a year to wait then it’s a good option to immediately strengthen your CV, while giving you enough free time to do research, get to know your home cardiology fellowship program, and/or moonlight. Just look at Hopkins cardiology many of the fellows are from top to mid tier programs who did a Chief year.

Non accredited Imaging fellowships pre-cardiology fellowship are really variable in quality and most of those programs are either research based or they use that fellow as cheap labor to scut them out to get consents and help run the nuclear or echo lab—things that don’t require much cardiology knowledge. At my program we have a couple spots for pre-fellowship spots and two of the candidates did not match their first couple of attempts despite doing this imaging fellowship after residency.

If was truly an advanced imaging fellowship which I doubt (I.e. they let you do and read images and include them for your COCATS) then yes that would be good option.

Talk to your home cardiology PD.

 

[Throwaway121212]

Thanks for all the replies..

Home cards pd says to take chief with the non accredited fellowship being lower tier.

I guess my only question would be that I applied to the majority of programs this year in my geographic area (Midwest) and the non accredited fellowship is on the east coast. Do you guys have any idea whether the same programs (or even programs I applied to but didn't interview me) would interview again? Also would going to the east coast for the fellowship open up doors/ interviews on the east coast (versus staying local for the chief year) ?

 

[TAVR4life]

Thanks for all the replies..

Home cards pd says to take chief with the non accredited fellowship being lower tier.

I guess my only question would be that I applied to the majority of programs this year in my geographic area (Midwest) and the non accredited fellowship is on the east coast. Do you guys have any idea whether the same programs (or even programs I applied to but didn't interview me) would interview again? Also would going to the east coast for the fellowship open up doors/ interviews on the east coast (versus staying local for the chief year) ?

Do chief year and aim for a spot at your home program but apply more broadly. There will be programs who you re-interview you again.

PDs aren’t impressed by non accredited fellowships post residency because they know it’s for candidates who didn’t match.

 

[deleted980918]

If OP wants to apply for the upcoming cycle, he/she will be in the first month of non-acgme fellowship when applications are due in July. It's unlikely that any meaningful research or connections will be made in that time frame. But if he/she choose the chief resident route, first it will give you a definitive advanctage in the home program (assume you want to stay). second, it's another check box on the application and many programs (not all) do filter the chief residents in a seprate pool. and lastly, like some mentioned above, doing a non-acgme fellowship is essentially the same as putting a " I didn't match last year" sticker on your application. Its probablly true that a year of imaging give you a running start at gen card fellowship but u have to get into gen card first.

Again, this is just my personal opinion.

 

[timpview]

I personally would apply mostly to different programs and when asked why you didn’t match last year I would state I made a mistake and only applied to 5 programs because one had basically told me I was in.

 

[DoctorStrange2]

Just another guy in your shoes at this time! What did you end up doing? Chief or non-acgme? And how was your experience?

 

[Throwaway121212]

Just another guy in your shoes at this time! What did you end up doing? Chief or non-acgme? And how was your experience?

Hi, very sorry you didn't match this year.

I ended up doing chief and matched at a large university program (not my home institution) last year. I think the chief year gave me a lot of time to continue research and also probably helped with getting numerous interviews at places I likely had no business being invited to.
All in all, while I realized how much I hated being involved w hospital administration/politics as a chief, I would say that it probably helped me more than if I were to have taken the non accredited position.

Again, I know the demoralization of not matching, but keep your chin up and work on strengthening your application this coming year. Feel free to DM me if you have any other questions.

 

[thecalccobra]

Chief at own institution >> other institution. Research year can be great depending on mentor and how productive you are. HF fellowships are a toss up. You’re working 12 hour days/ 6 days a week, no time for research and pay is < PGY-1 at a lot of places. Working as a hospitalist at a small place with an in house fellowship isn’t a bad idea but definitely risky as you’re putting all eggs in one basket. Preventive cardiology fellowships (Brown and NYU) are worth it IMO and will give you a great chance at matching. There is no good one answer unfortunately and anything involves some risk and no real guarantee of matching.

 

[NotAProgDirector]

Whichever you choose, you need to get as much done in the last 6 months of your PGY-3 as possible to improve your application. As mentioned above, when you apply next year (assuming you don't plan on a gap year), you'll just be starting. You'll have nothing from it to add to your application. Improving your application now is critically important.

 

[Ivabradine]

I 100% believe a Chief year is better. Like others have said, a non-accredited fellowship tells everyone you didn’t match in the past. Also, let’s say it doesn’t work out again next year (hopefully it will), it won’t be of any value really, whereas being Chief goes with you everywhere and will always look great on your CV.

 

[atm123]

Hi everyone. I did not match into cardiology this year. I had only 2 interviews. Thinking about what to do after residency. Chief vs non accredited at this point. And what are the chances I’ll get more invites next year? Afraid my application was filtered out.

 

[ROBINHO]

Whichever you choose, you need to get as much done in the last 6 months of your PGY-3 as possible to improve your application. As mentioned above, when you apply next year (assuming you don't plan on a gap year), you'll just be starting. You'll have nothing from it to add to your application. Improving your application now is critically important.

I agree with you.

This kind of debates come up every year - chief resident versus subspecialty fellowship. There is no right or wrong answer. It comes down to why you think you didn't match. They come to fellowship with a nice skill set.

I am a cardiology PD and I love chief residents. I also equally love strong candidates who didn't match for whatever reason who do an imaging fellowship or HF fellowship to make themselves even stronger.

I agree that that to make your home program a safety net, the next 6 months you need to continue to work hard and increase your research productivity.

Specific to this OP I think chief residency will be better ( to finish up your projects and strengthen your contacts). If its a small community hospital then it wont help you.
One thing that I would consider a red flag is to have a candidate have multiple abstracts/ presentations as first author but only ONE was converted into a manuscript. I personally look out for task completion especially since it is easy for house staff to nowadays publish at CUREUS, Cardiology case reports etc
I will also suggest that you apply a little more broadly. Virtual interviews have changed the landscape. Top tier programs are attending more interviews because they dont have to fly. This basically means that some mid tier candidates may be missing out on some interviews

Good luck

 

[ROBINHO]

I disagree with the above. Lots of places don’t hold any value in the Chief year. Some of the top places may use that as a criteria to interview outside their own “ivy” league group but otherwise for your future and training it’s a waste of time.
The imaging fellowship, while non accredited, will let you be far ahead of your peers. I believe post gen cards fellowship you can apply your numbers. You will also be able to use them for CT boards and MRI boards. One of our current first year cardiology fellows did a non accredited imaging year and sat for his CT boards and passed. Pretty sweet.
If I were a PD I’d consider that more advantageous than a chief year.

My opinion and the opinion of my Gen Cards PD.

Hi everyone. I did not match into cardiology this year. I had only 2 interviews. Thinking about what to do after residency. Chief vs non accredited at this point. And what are the chances I’ll get more invites next year? Afraid my application was filtered out.

WHy did you think you had only 2 interviews?
You need to identify weakness in credentials and seek ways to improve. It is not just a matter of re-applying or doing a chief/ non accredited year

 

[atm123]

I had a lot of publications, 2 years of post doc research in cards before residency, was a third year chief, very strong LORs, 100% university program. Unfortunately in house PD is super selective. Only red flag I see is that my scores are below average (229, 222, 211). If this is the red flag which I think then no chance in whatever more I do to show my capability and passion to be a cardiologist will matter unfortunately?

 

[Prehealth1011]

I had a lot of publications, 2 years of post doc research in cards before residency, was a third year chief, very strong LORs, 100% university program. Unfortunately in house PD is super selective. Only red flag I see is that my scores are below average (229, 222, 211). If this is the red flag which I think then no chance in whatever more I do to show my capability and passion to be a cardiologist will matter unfortunately?

Do you need visa?

 

[ROBINHO]

I had a lot of publications, 2 years of post doc research in cards before residency, was a third year chief, very strong LORs, 100% university program. Unfortunately in house PD is super selective. Only red flag I see is that my scores are below average (229, 222, 211). If this is the red flag which I think then no chance in whatever more I do to show my capability and passion to be a cardiologist will matter unfortunately?

You have 6 months to convince in house PD to consider you. Probably best shot
What is the track record of in house chief residents. If it doesnt help in matching then you should consider non accredited fellowship
Good luck

 

[atm123]

thank you for your response. Just for my knowledge do PDs usually apply score filters to applications? I’m definitely trying to accomplish whatever more I can in the next 6 months, but will my application even make it to a PD’s desk is the question.

 

[ROBINHO]

thank you for your response. Just for my knowledge do PDs usually apply score filters to applications? I’m definitely trying to accomplish whatever more I can in the next 6 months, but will my application even make it to a PD’s desk is the question.

Yes there is the option to apply score filters. Every program is different.
I don’t necessarily believe that your scores are the problem. Even when PD screen a candidate for scores, PDs go back and review the candidates because nobody wants to miss exceptional cardiology candidates. Fellowship doesn’t have as many candidates as residency. So one can easily look at somebody’s full application before you screen them out.