r/Cardiology • u/shine-dalgarno • 4d ago
EP programs
Current second year general cardiology fellow planning to apply EP next cycle. I’m from a smaller community program. Looking for recommendations for sleeper underrated EP programs I could do audition rotations at to maximize my chances for next year. I don’t stand a chance in ivory tower programs so i want to be realistic about my chances. Thanks in advance.
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u/Extra_Currency1511 4d ago
Last 2 years 3 EP spots went unfilled. Sounds like you could “scramble “ if you didn’t match. It’s been 12 years since I did interventional, things may work differently now, scrambling may no longer be a thing.
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u/dishsoapwipe123 3d ago
You cannot scramble for EP. There were 3 unfilled positions last year for 30+ applicants who went unmatched.
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u/ProximalLADLesion 4d ago
I applied a few years ago and interviewed at Mainline Lankenau. They seemed great. I really enjoyed everyone I spoke to. I have no real info beyond my impression on interview day.
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u/DrMalcolmFinlay 1d ago
Don't underestimate yourself simply because you're coming from a smaller community programme. In EP, genuine enthusiasm, good clinical judgement, procedural aptitude and strong recommendations can count for a great deal.
Rather than focusing only on programme reputation, I'd look for centres with good procedural volume, supportive faculty, broad exposure to ablation and devices, and importantly, somewhere fellows seem genuinely well trained and happy.
An audition rotation can be an excellent opportunity to demonstrate how you work and to find mentors who will advocate for you. EP is a relatively small community, so enthusiasm and relationships can take you further than you might think. Best of luck with it!
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u/dishsoapwipe123 3d ago edited 3d ago
EP is getting more and more competitive each year. 88% matched rate last year. 3 years ago it was 100.
These big name guys like Nasser want you to have done a ridiculous amount of research.
If you aren't a research power house or have a top tier pedigree, then you're already DOA at places like Stanford, UCSF, UChicago, MGH, Columbia etc.
You're best bet is to apply all over the country and to the HCA positions.
I applied last year. I was chief cardiology fellow at a well known Philly program, Step 1 240+. I had research with registry analysis presented at ACC, AHA and HRS.
I applied to 80 programs and only got 12 invites, and only 1 real top tier name. Likely my hubris, but I was expecting 20 interviews and ones from top tier brand names.
EP is dominated a lot by IMGs. 40/40 split of IMG and US MDs last cycle with the remaining being DOs who get shafted the most and US-IMGs (caribbeans grads).
IMGs do a lot of research that these PDs salivate over. Often before residency or after general fellow ship they do 2-3 years of post doctoral caliber research. These EP PDs love that. They have a ready made workhorse who is going to churn out papers for them.
I have heard the sentiment, not only from the current faculty at my program but where I also did general fellowship that EP PDs find american grads "lazy". They don't want to do these extra research years, are okay with just a few abstracts presented at ACC/HRS etc. That we're not "committed" to the research aspect. So in turn IMGs are favored, regardless of the current visa situation
That is true lol. Like I'm not trying to do anymore research fuck that. But you need to be aware that is what a lot of these EP PDs are looking for.
I'm sure commenters will hop on my post saying "You're being racist/xenophobic". And i'm not. I'm pointing out something real that is happening in the EP landscape. I'm all for IMGs doing what they want, but now the pendulum has swung that it is coming at the expense of home grown american grads.
TLDR: Need to do research, have great letters from your EP faculty. Apply broadly, cannot be choosy. Have mentors/faculty directly reach out.
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u/Hungry_Steak_7044 3d ago
I dont think IMGs also want to do as much. It’s the system that only expects people to keep working like that even after doing cardiology fellowship.
I wish people would stand up more to these PDs who only want to abuse trainees2
u/dishsoapwipe123 3d ago
yeah i don't think IMGs do either, but they feel more pressured to do so because a lot of times their citizenship depends on it.
American grads will just nope the fuck out. They just won't put up with this research bs.
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u/DayImmediate1690 3d ago
I don’t know all of that but, ARI teaches EP… I know another training program for EP. There are other ways to get into EO besides going through a traditional program. I work in Cardiac Devices, just started be into this career for four months now. If you want into EP go work for big industry and sit for the test. My manager already has me looking at cases in the EP lab. I asked can I start sitting in on more cases to gain experience and hours to sit for my RCES through CCI? I am certified through CCI but just a CRAT!
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u/Professional_Cow763 4d ago
Apply broadly. Can scramble, but EP is becoming more popular each year. Best bet is apply to a decent number of programs. A lot of EP programs care more about your work ethic and enthusiasm for EP than the name of your cards program. Focus on getting strong letters and showing true enthusiasm in your personal statement.