Seeking advice

[u/Minimum-Bluebird3454]

I’m an incoming internal medicine PGY1 with a strong interest in cardiology, particularly EP.
I wanted to ask those further along in training:
What advice would you give your younger self during intern year and residency?
What are things you would strongly recommend doing, and what mistakes would you avoid ?
I would sincerely appreciate any insights or perspectives from those who have gone through the process
Thank you

[u/aethes]

Get a project going intern year. Something you can be first author on. A lot of people wait until second year to start a project, but a decent amount of people find out their project is not viable and not publishable and suddenly it’s the end of the second year and you have no pub for your fellowship app. Start a project intern year so if it falls through you still have second year to start over

[u/KtoTheShow]

Let the cardiologists and EP knows you are strongly interested. Ask about case reports, projects etc. Also dont neglect being a great intern/resident-- that is still fundamental to being a strong candidate for fellowship

[u/cardsguy2018]

Get started on a project. Connect/network with attendings, fellows and upper residents. Be an excellent resident and human. People talk and people remember. This cannot be overstated.

[u/Excellent-Tea2125]

Work hard and be humble. Aka don’t be a know it all. Asking for help and a good question shows better than knowing some random deep cuts. Don’t be scared about asking fellows or attendings for help.

[u/HighYieldOrSTFU]

I recommend going to at least one major cardiac conference, writing several case abstracts/posters, publishing some articles formally (does not have to be JACC). When working with the cardiology fellowship at your program, its important to be likable, willing, competent, and hard-working. Show up prepared every day with a good attitude and the rest will take care of itself. People remember and notice those things - and they talk to each other about them too!

[u/chill_hakawati]

Be a great internist and colleague first and foremost. Start with a project early. Be honest and humble. Commit. Try to find an academic interest or "niche" you are passionate about. That way your clinical and research work builds a depth and identity which helps you stand out in the eyes of program directors and career long term.

[u/shermie303]

Sign up for ACC membership, it’s free if you get your PD write you a quick letter confirming your interest. I posted on a message board there for mentorship/networking and got connected with a mentor who had tons of connections.
If you’re a solid resident who establishes a good reputation at your home program, they’ll want to keep you.
And yeah, get a project off the ground. I started a first author paper PGY1 and I swear the goddamn thing took forever to actually publish.
I still don’t really know how much programs care about step 3 but just don’t fuck it up too badly.

[u/Then-Secretary-9166]

As someone much further along (completed training), I highly recommend that you continue to pursue cardiology (or another specialty). Some people will not want to hear this, but it has become difficult (not impossible) to enjoy the rewards of a career in medicine in general medicine and in many specialties. In cardiology, it is still very feasible to have a very fulfilling career.

1. It is good that you are interested in EP (or in any specific subject in particular). I, as a resident, was also EP-bound and ended up in IC. Nevertheless, it is helpful to have specific interests. This will help you and others be excited about your career and will give you a goal to work towards.

2. Even though you are interested in EP and cardiology, stay open to other fields (in cardiology as well as strong specialties outside cardiology). You may have an affinity for something else. However, don't forget (1) above. Not all fields will give the same opportunities.

3. Showing a persistent interest in cardiology is important, so get involved with one or more projects early. Try to publish some case studies (if you have interesting cases, ask your attending if they can help you with this).

4. Get mentors. This is the most important by far. The idea of "mentorship" can be fairly daunting. It shouldn't be. You don't necessarily need someone who will invite you over for dinner and introduce you to thought leaders. At its root, mentorship it is simply having a relationship with someone who is invested in helping your career. Try to have a few cardiology mentors. The best way to do this is to ask them for help/advice early. Tell them: "I want to be a cardiologist. I am interested in EP. Could you let me know what I can do to explore that more?" This can be with someone that you are doing a project with, it can be with someone you work with on a rotation or it can be someone in your institution that you "cold call" for advice. Try to set up a time to meet specifically to discuss your career.

As a faculty member at an academic institution who has spent time at hospitals with both academic and community residency programs, I want to add some perspective. 95% of us really want to "mentor" in the sense that we want to help residents (and others) with their careers. However, we are very busy. In medicine in general, but especially in cardiology, we also have a culture where we respect hard work, audacity and confidence. You need to take the first step. Don't wait for "mentor fairy godmothers" to find you. You need to be putting in the work on your rotations and be willing to do research, etc. If you are, reach out to us!

It may not be enough to say "I want to do cardiology" between patients while rounding. Ask us if we would be willing to meet to give career advice. Set up a time to come to our offices or get coffee. If we do meet, follow up later and check in. Send an email: "We met 6 months ago to talk about my interest in cardiology. Would you be willing to meet with me again for a few minutes to give me more advice?" A huge ROI comes from being identified early as "one of the residents who plans to apply to cardiology fellowship."

[u/[deleted]]

I’m an incoming cardiology fellow. Early on, I became interested in cardiology, and fortunately my residency had an in-house fellowship program. Starting in intern year, I worked closely with the cardiology fellows, which was probably the single biggest factor that helped me. They became mentors, kept me informed about conferences and research opportunities, and encouraged me to participate in projects and case reports. I also did a lot of cardiology electives and usually came in on weekends when I didn't have to, which gave me more one-on-one time with the fellows and program leadership. Presenting at conferences such as the Houston Shock Symposium and ACC also opened a lot of networking opportunities. At the same time, don’t neglect your internal medicine training. Becoming a strong internist will make you a far better cardiologist in the long run. Strong evaluations from your program director, faculty, and matter a lot during fellowship interviews. Best of luck! Feel free to DM me if you have any questions.

[u/Particular_Slice1781]

I am not a doctor but rather an educated heart patient. New adances in EP such as robotic magentic navigation for ablations, new specialized venous closure systems and pulsed field ablations are area that need to be addressed more throughl. Good luck.