December 3rd, 2010
When the Hunter Becomes the Hunted
Andrew M. Kates, MD
One of the joys of running a fellowship program is watching Fellows mature and complete their training. The end of this process, of course, is the beginning of one’s professional career.
For many of you Fellows, as you finish your training, you will be recruited as never before. For the first time in your career, people will be actively seeking you out rather than vice versa. The hunter becomes the hunted. This is quite a change from your position in previous stages of your education — be it applying to medical school, residency, or fellowship. Now, your university may want you to stay as junior faculty, or practice groups want you, the well-trained Fellow, to join them.
I would like to open up the conversation at CardioExchange for you to share your thoughts on the job search process: What interesting encounters have you had? For those who are post-fellowship, do you have words of advice for those who are at these new frontiers? It’s a brave new world out there.…
4 Responses to “When the Hunter Becomes the Hunted”
NEJM Journal Watch — Recent Cardiology Articles- Persistent Symptoms After Valve Replacement for Severe Aortic Stenosis
- Is Diltiazem Safe in Patients with AF Taking Apixaban or Rivaroxaban?
- Does Lowering High Childhood Lipid Levels Prevent Adverse Cardiovascular Events in Adulthood?
- Self-Expanding Supraannular Valve vs. Balloon-Expandable Valve in TAVR for Small Aortic Annulus
- A New TAVR Prosthesis for Aortic Regurgitation Shows Promise
What is clear is that your world will be different. The available jobs will probably tend away from private practice, and toward large “integrated” practices with many specialties and facilities under one roof to increase efficiency. Small fee-for-service practices will have increasing difficulty competing with declining reimbursements and the movement away from fee-for-service.
On a brighter note, this scenario will test your clinical skills and judicious use of diagnostic studies, as opposed to the previous “shotgun” approach used by many which has led to the current crisis of expenditure for health services. Your ability to go back to the “basics” of good history-taking, physical examination and thinking about the patient will hopefully be better-rewarded in the coming years.
Best of luck!
Competing interests pertaining specifically to this post, comment, or both:
None. 25 years of private practice experience, without industry or other connections.
Why did I choose cardiology??
The heart, as an organ, captured my attention right from the time I could read-for there was no escaping the plethora of popular literature that linked the heart to human feelings,emotions and sentiments. As I started my biology lessons in high school, the heart and the circulatory system in general unfolded in all its wondrousness before me.From the anatomy to the physiology, from the automaticity to the regularity the cardiovascular system captured my imagination.As I gained a chance to study medicine, I fell in love with Cardiology; from clinically deciphering the whooshing murmurs of patients with valvular heart disease, to the adrenaline-pumping atmosphere of a cardiac catheterization lab, to the art of maintaining fluid balance in a patient with heart failure, to cardioverting a life threatening arrhythmia.In addition to the clinical aspects-the exciting new advances in Cardiology as well as the opportunities it offered in research fascinated me.Having spent a few years doing some clinical research and being part of the Cochrane Review Group in peripheral vascular diseases, the option that research in Cardiovascular Diseases offers in extending the boundaries of our understanding of pathophysiology, in contributing to the relief of human suffering and in prolonging a life free of morbidity,never ceases to amaze me.Variety is a spice of life-and for me the options that Cardiology, even now offers a trainee/recent graduate-becoming a clinical Cardiologist, Interventionalist, Electrophysiologist, Imaging Professional, Full time researcher,Teacher-Mentor or having a career in Epidemiology and Preventive Cardiology holds an immense attraction for me.
All of which now brings us to future directions-and with decoding of the human genome and phenomenal advances in proteonomics-the horizons of Cardiology are set to expand as never before.It is an unbelievably exciting time to be in Cardiology with the immense and rapid strides it is taking in understanding and then in alleviation of disease pathology in ways quite unimaginable even recently.
Yes- with the down trending of the economy there has been lot of reduction in fundings for research and in salaries for Cardiovascular professionals. And purely from a financial perspective-it is possible that Cardiology has lost a bit of its appeal.However for me,choosing Cardiology is a way of life and a career choice far beyond just an option for making a living.It is a commitment for life to something I truly love.I have traveled nearly half the globe in search of excellence in training-and I eagerly await to take my next step in my chosen path.And whenever someone attempts to detract me from Cardiology-I always remember a few words I read about one of the leading Interventionist-Educators of this generation who pointed out that ‘no matter how crowded a field becomes, there is always room at the top'(as apparently conveyed to him by his mentor).
Competing interests pertaining specifically to this post, comment, or both:
PS-Some of the portions of this writing is present in my personal statement of application for my Cardiology fellowship-a small disclosure just in case a program director takes notice………………
I’m hungry like the wolf!
It really is surprising how many fellowship programs donot allow candidates on an H1 visa to convert to J1 citing’uncertainty’ of the process, while in reality its quite a simple and in-expensive process-and the very fact that a candidate had been able to garner an H1 in the frst place should actually place him on a higher probability for getting the J1 subsequently…….