Fellows Corner

Thinking about an academic career? Listen to our audio interview with Dr C William Balke

Tue, 04 Nov 2008 09:25:00 -0500

What should be the primary concerns as you set out in your academic career? Should publishing take precedence over securing grants? Dr Larry Allen, recent ex-fellow and assistant professor (University of Colorado Health Sciences Center, Denver), interviews the national authority on funding opportunities and career development, Dr C William Balke (senior associate dean for clinical research, University of Kentucky, Lexington), on career hurdles and watershed events and why now is a stimulating time to be embarking on an academic career.

Sources of support:

National Institutes of Health (NIH)
National Heart, Lung and Blood Institute (NHLBI)
NIH Extramural Research Training Programs
NIH Loan Repayment Programs
NIH New Investigators Program
NIH Extramural Fellowship (F) Programs
NIH Extramural Career Development (K) Awards
Veterans Affairs Career Development Awards
American Heart Association
American College of Cardiology

CV Boards Crunch Time

Sat, 11 Oct 2008 14:19:00 -0400

The weather is beautiful outside today, and I'm indoors studying for the boards. Anyone have any good crunch time studying advice? I've been slogging through some question books. I liked the Braunwald question book (not just because Amy is a co-author -- I found out after I bought it :), and today I've been going through the new 2nd edition Cleveland Clinic question book. It's OK, but there are some major copy editing issues -- I'm on Chapter 3 now, and the questions don't match up with the answers.

I lined up like a lemming and have also been slogging through the Mayo "concise" textbook. Despite its heft, it's quick reading.

Anyone have the new version of O'Keefe? I've been studying my old version -- I doubt there have been any landmark breakthroughs in electrocardiograms between the editions.

Brian Choi, Asst Moderator

Planning to specialize in HF?

Mon, 29 Sep 2008 15:05:00 -0400

The American Board of Medical Specialties recently approved the American Board of Internal Medicine’s proposal to establish secondary subspecialty board certification in advanced heart failure and transplant cardiology. Cleveland Clinic cardiology fellow Dr Eiran Gorodeski interviews Dr Marvin Konstam on the implications of this move: what does it mean for fellows heading into HF and for physicians who already specialize in HF?

Boston Scientific Taxus Liberte study: statistical smoking gun or who cares?

Thu, 14 Aug 2008 07:39:00 -0400

I was surprised, both by content and by tone, of an article printed in today's Wall Street Journal:

http://online.wsj.com/article/SB121867148093738861.html

It questioned the statistical integrity of the study that was submitted to the FDA for approval of the Taxus Liberte (by the way, does anyone know where I can find the publication of this study?). In almost breathless tone, the article described how the Wall Street Journal conducted an independent analysis to determine that the Wald Interval is the inappropriate test for statistical significance in this kind of study and criticized that the study was not randomized (comparison was made to historical controls of patients that received Taxus Express) or non-blinded. But is there any real "gotcha" here?

First, is it really necessary to have a randomized trial to approve an incremental design change from Taxus Express to Taxus Liberte? Second, is it even possible to blind it? Third, who cares if it only meets statistical significance with the Wald only? It's commonly used and every other p value in the WSJ analysis had p=0.05.

It is interesting to note that no cardiologists (besides Baim of Boston Scientific) were interviewed for the story, and the expert criticism comes from statisticians, a mathematician and an internist.

I think that most interventionalists would still say, "Give me Liberte!"

The most fascinating aspect of this article, I think, is that it is another example of the new phenomenon of a post-publication "peer review" by the lay press.

Any thoughts? (BTW, I have no relevant disclosures, but if you really want to nitpick, I do have a Boston Scientific pen lying around my home somewhere).

Brian Choi, Asst Moderator

Flowing uphill? Residency workhours and fellowship experience

Wed, 30 Jul 2008 18:55:00 -0400

I'm curious as to what the experience has been, not in terms of the workhour restrictions to which we as cardiology trainees are subject, but rather, do you think that the workhour restrictions on residents has had an effect on what you are expected to do as fellows? Is work flowing uphill? Is it flowing over fellows' heads to attendings? Is it being shifted over the physician extenders? And perhaps most important, do you think that we're at steady state, or are shifts going to continue?

Interventional Cage Match?

Tue, 22 Jul 2008 20:50:00 -0400

With the release of the Xience stent in the past few days we've had a rush of device reps into the cath lab trying to outmaneuver one another to promote their products. We currently have open access to three drug eluting stents and the competition is cutthroat but very subdued.

SES have dropped off due to the release of the newer stents. ZES are less popular with the unconventional delivery system, but seem very deliverable in tight spots. EES are just out and everyone is hot to try them out, but have seen some PES-like sticky balloons.

Curious to know whether anybody else is havine a similar experience with stents or reps?

Stress MRI

Tue, 08 Jul 2008 11:10:00 -0400

Just curious - I train at a facility with "stress MRI" means dobutamine MRI, but last night was talking with a friend at another institution who said "dobutamine MRI - you can't do that, it's too hard to gate...stress MRI means adenosine MRI." A quick glance at the literature suggests that there's evidence for both approaches - I'm just curious what's used where, and why...does anyone know of places that routinely use both, or does the world divide into 2 clearly defined camps?

Which textbooks are most helpful to general fellows?

Wed, 18 Jun 2008 22:16:00 -0400

As we approach 1 July, senior medical residents are heading off to their new positions as cardiology fellows and wondering how to prepare for their new lives as experts in cardiovascular medicine. From those of us who have been doing it for a while - which books did you feel were most helpful in getting you through fellowship?

Consider it a given that the guidelines are a great place to start, but which textbooks are worth paying money out of your pocket to put in your library?

How to prepare for the cardiology boards

Fri, 13 Jun 2008 13:47:00 -0400

At the ACC meeting earlier this year, Dr Abhinav Goyal (cardiology staff, Emory) presented a talk at the Fellows In Training meeting called "How To Prepare For The Cardiology Boards". Dr Goyal was kind enough to share his slides with us. I think the advice is practical and helpful. If you have any questions feel free to post them below, I'm sure he'll be willing to post a reply.

Eiran Gorodeski (co moderator)

Choosing a Fellowship - do you need to worry about the next step?

Fri, 30 May 2008 16:34:00 -0400

I'm curious to hear what people think about a question being raised by some of the residents applying to cardiology fellowships...say you know you want to do something procedural (i.e., cath or EP), and you think you'll most likely choose cath...but you're still a resident, you haven't actually *done* either to know which you like better. If you think that there's a chance that you will like / want to pursue EP, how important is it that your general cardiology fellowship is at a place with a strong EP program? Put another way, how much does general cardiology fellowship define or restrict options for subsequent training, particularly for "hot" areas like EP, in which it seems an increasiny number of programs are essentially closing their EP fellowships to fellows outside of their own program? And, given the rapid flow of electrophysiologists from program to program currently, can one accurately predict today what program you would/would not want to be part of ~4 years later?

Fellow Education Courses

Tue, 20 May 2008 19:56:00 -0400

As a rising interventional fellow, I'm wondering which of the available education courses directed toward fellows are worth attending.

Looking to get comments from others who have attended the Stone course in San Jose or gone to the C3 conference in New Orleans, etc.

What about the EP workshops put on by the device companies - anybody have anything good to say about these other than a nice hotel room and a free meal?

Imaging & Heart Failure fellows also welcome to add their comments.

Just got my ABIM CV exam registration receipt -- don't forget to schedule your exam early!

Wed, 14 May 2008 11:46:00 -0400

Hi everyone,

I just got my ABIM CV exam registration receipt that lets you schedule your exam at a Pearson VUE center. Assignments are first-come first-served, and I was surprised that the test site that I wanted to schedule my exam was already filled for the Nov 5th date. I can't imagine that exam spots are filled because of cardiology fellows signing up for exams so early (the deadline for registration was 5/1 after all), but these test centers also administer tons of other exams, too (e.g., real estate broker exam, GMAT, etc), so I am guessing that local test center availability may vary.

The bottom line...don't forget to sign up early :)

Brian Choi, MD

Moderator

AHA abstract deadline: June 6th

Tue, 13 May 2008 10:31:00 -0400

Brief reminder: the American Heart Association 2008 Scientific Sessions will be held in New Orleans in November 8-12, 2008. The abstract submission deadline is this upcoming June 6, 2008. Key things to remember is that you have to be an AHA member before you can submit, and once you sign up it takes a few days to get your membership number before you can submit the abstract... so plan ahead.

Good luck!

Eiran Gorodeski / Fellows Corner moderator

Dr Steve Nissen: Is fellows' training too long?

Wed, 23 Apr 2008 15:49:00 -0400

Drs John Galla and Casey Becker put "the chairman in the hot seat" as they interview Dr Steve Nissen on the future of training for fellows. Do you agree that training is too long? Should cardiology be a freestanding specialty? How to complete training before becoming a grandparent? Is "resistance futile"? View this lively discussion and then share your thoughts with us!

Cardiology Board Exam Registration Deadline - 1 May

Wed, 23 Apr 2008 12:01:00 -0400

Just a quick reminder to all fellows planning on taking the certification exam in cardiology this fall, the deadline to register at the ABIM website without having to pay a penalty is 1 May.

The ABIM website is www.abim.org - you'll need your NPI number and $1655.

Dr Valentin Fuster: From fellow to the real world

Wed, 23 Apr 2008 10:48:00 -0400

Dr Eiran Gorodeski poses the questions we all want to ask regarding the transition from fellow to "the real world". Starting with the basics, Dr Fuster stresses the importance of choosing the best personal fit rather than chasing the current "hot" specialty, seeking advice from a trusted mentor, and learning to be a good judge of one's self. A fascinating interview direct from ACC 2008. Watch this clip and let us know if you agree. What are your thoughts on "breaking out" into the real world?

Private practice or academic? Dr Jan Weber direct from ACC

Wed, 23 Apr 2008 10:46:00 -0400

Dr Eiran Gorodeski asks about the differences between private practice and working in an academic setting. How do skill sets differ? What to think about when making your own decision? Dr Weber shares his experience on topics such as the role of self-motivation and access to continuing education, as well as what he looks for when hiring a new member for his team. What direction are you taking: private practice or academic? Why?

Direct from ACC: From Ireland to the USA and back

Wed, 23 Apr 2008 10:44:00 -0400

Straight from the convention floor in Chicago, fellows' corner moderator, Dr John Galla, sits down with Dr Robert Kelly from Dublin, Ireland to discuss news from the ACC and differing perspectives in care based on country of practice. From radiation dosage with cardiac CT, the role of GPs in prevention of CV disease, national smoking bans, and prevalence of obesity through to media spin of trial results – watch this clip and share your thoughts with us! How are things different where you live?

Dr Steve Nissen straight from ESC 2007

Thu, 22 Nov 2007 15:27:00 -0500

Fellow Dr John Galla puts Dr Steve Nissen in the hot seat during an interview at the ESC in Vienna.

Pursuing a career in academic medicine?

Thu, 15 Nov 2007 14:55:00 -0500

Drs Galla and Cuffe address the thorny issues surrounding contract negotiations, job definition, and advancement. Find out why Dr Cuffe had to apologize to division directors all over the US for divulging many negotiating secrets of "the other side."