CardioExchange Archive

For most cardiology fellowships, the bulk of the clinical training is in the first two years. The third year is rather variable, with some fellows taking the time to get to level two certification in several of the subspecialties. Fellows going into interventional fellowships typically spend time in the catheterization lab to increase their skills. We ask John Ryan, co-moderator of the Fellowship Training discussions on CardioExchange, about his third year.

How is the third year structured in your fellowship? 

During third year, we have a couple of weeks of clinical responsibilities, such as perform cardiology consults, act as senior imaging fellow, and work in the CCU. However, the third year of our program is designed to give us the opportunity to do research, be it clinical or basic science. The expectation is to produce some published manuscripts; also we present at cardiology Grand Rounds at some point during the year. We also need to apply for subspecialty fellowships such as heart failure or interventional – these applications can take up a lot of time as well. It seems to be a busy year, but it’s a lot more autonomous than the preceding years of our training.

How did you decide what to do for your third year? 

The reason I came to the U.S. originally was to get trained in basic science. However, between doing Chief residency and fellowship, it has taken a while to start doing legitimate research. So for my third year, I wanted to go into the research lab. University of Chicago has a large pulmonary hypertension program; so it made sense to take advantage of the mentorship and bench research that are available here. Right now, I am working on models of Group 2 pulmonary hypertension (PH secondary to heart failure)

How is your research going? 

So far it is okay. The hardest thing is that by the end of second clinical year, I could do almost everything that was asked of me, whereas now I am essentially getting retrained. With no formal training in basic science or statistics, I am starting from scratch. I face a few other struggles as well, one in particular being that data do not lie. Sometimes when taking care of patients, doctors can discover no exact right answer. However, experiments are different. They are either done right or done wrong. If you get an unexpected answer, provided you did the experiment the right way, you have to find a way to explain it.

 How is the third year structured in your fellowship? How would you change it?

 How do you decide what you are going to do for your third year? Would you combine it with a fourth year — for example, two years of EP?

 What type of research opportunities are available in your third year?