Research Ideas – How to Start?

As research is a key component for your CV, you have to get an early start in residency. The sooner you know you want to do cardiology, the better. You have to start right away in your intern year with research so you can get some abstracts/posters done prior to completing your 1st year. As you know, your applications go out in the middle of your second year, so not that much time to polish your CV and get things done.

What type of research? A double-blinded, randomized anything will be very difficult to do for most people, some might get in on something at big research intuitions, but most will not and should not try to get something like this started.

What I suggest is chart review. This allows some great options to look for trends at your hospital for what you are looking to investigate. Chart review provides you with a fairly larger n (can go back as long as you like), it gives you all the data in hand and if you put together a team, lots of manpower to look at all the data. Just look for simple and clean ideas for your research, only concentrating on 1 variable, this will allow you to come up with many ideas.

Good Luck.

Cardiology Fellowship – How to Get In?

American Medical Graduates (AMG) – you have worked hard and you deserve an easier path to fellowship. You still have to be pretty good, not exceptional like FMGs, but good. Then all you have to do is wake up on a fine day, fall out of bed and more than likely you will be able to get a cardiology fellowship unless you are a complete fool and really get the program director upset with your interview. Other than a few rare circumstances you can pretty much get a fellowship if you chose to do so. But this is great for you, as you have worked hard over the years to secure admission into a great medical school and residency and you deserve the fruits of your labor.

Foreign Medical Graduates (FMG) – this is a whole different kettle of fish. Get ready to show yourself to be great. Average, even good will not do, you have to set yourself apart from all the others trying to get the very limited spots out there. So here are some thoughts – the Real Deal (no sugar coating).

1. Every Problem has a Solution. Stay true to those words, as there will be a few set backs before you get your spot. Be prepared for “what if.” If you do not get a spot in your first try, do not get caught off-guard and be prepared for the next step. Have something else lined up, applications ready for the extra year or research or another fellowship.
2. Extra Steps/Work Needed. As a FMG, you can get lucky and get a position without much research or an extra year. You will need to do research or Chief Resident year to make your application stand out from the rest.
3. Build Connections. The best chance you likely will have is at your own hospital, so make sure you stay involved with your cardiology department from the beginning of your residency.
4. Research. This is almost a must; it helps a great deal to be a first author on a published manuscript. You can get by with some abstracts or posters but you will need some papers published to make a real impression on you CV. AMGs do not need much research.
5. Make yourself “appear” special – even though most doctors are not (AMGs or FMGs). The easiest way to do this is through hard work, which could have a lot of different applications. Doctors are somewhat smart, but most work hard to get where they are. So, if you take the extra steps just by putting in the extra work (cardiology morning reports, going to cardiology conferences, looking at cases in the cath lab, etc), you can thus make yourself standout from the rest.

Last thing, if this is what you really want....Never, Ever, Ever, Ever Give Up! Will write more on the tpoic some other time.

Femoral Artery Access – Some Thoughts

One of my main goals in the first few months in the cath lab was to get access without any complications or help (although, one always could use the help). One of the tricks that I learned is where and how I felt the artery. Four fingers on the pulse, now here is what I think made it easier: After you feel the pulse move your fingers form lateral to medial direction and then back. This way you will get your fingers where the pulse is the strongest. My first few times, I would make the mistake of just feeling the pulse and going in with the needle, which at times would cause me to miss the artery as I was too medial or lateral. Now, I can get access most of the time (knock on wood) with my first attempt as I know where the pulse is the strongest.

Also, once you are advancing the needle, at times you can feel the needle pulsate in your fingers as you approach the artery. This was another little trick taught by one of my attendings, as you are advancing the needle slowly and if you are not sure where you might be, just stop for a second, hold the needle lightly and see if you can feel the pulsations of the artery in your fingers.

Good Luck. Would love to read more from others…

First Note

Hope all is well out there. This is the first post in this blog. I hope to write here often. Just want a forum to post my day-to-day activity as a cardiology fellow. I hope others can add there experiences and we all can learn a bit from each other. So lets see how things go...