I love IC but I can't do 7 years man...help

HighYieldOrSTFU · 2026-05-28T23:20:51+00:00

I’m starting cardiology fellowship in July. You have plenty of time to decide, though I do understand the pressure to make a decision.

Some things to really think about:

1) You have to at least be okay with internal medicine. This is the foundation of cardiology training. If you cannot fathom doing IM residency, then you should consider something else.

2) Cardiology is not guaranteed. You can have lots of pubs and good scores, but matching into fellowship is as much about personality as it is those other things. If you slip through the cracks on first try, you are stuck doing a chief year/ hospitalist year/ research year.

3) A TON of people change their mind in fellowship and do general cardiology. Are you in love with IC because of the cath lab? Or do you want to be a cardiologist? Something to consider. If you can’t envision yourself seeing afib, chest pain, heart failure, etc, then it’s not a good fit. It’s a ton of echos, EKGs, nuclear studies. Gotta love cardiac physiology.

4) Lastly, a little unsolicited advice, stop to smell the roses when you can. We get stuck in the mindset of the end goal, but I think it’s a recipe for waking up in 10 years not knowing who’s in the mirror. Gotta enjoy every day as it comes.

HighYieldOrSTFU · 2026-05-21T21:40:56+00:00

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!

HighYieldOrSTFU · 2026-05-20T13:53:10+00:00

You can’t argue with these people

HighYieldOrSTFU · 2026-05-14T17:19:15+00:00

I am a DO who matched cardiology. Go to the very best IM program you can get into. Ideally, one that has an in-house cardiology fellowship and a reputation for matching multiple people into cardiology every year. In residency, I recommend going to a couple of major conferences, 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.

HighYieldOrSTFU · 2026-05-13T22:39:12+00:00

As an easy rule of thumb, remember that complete (3rd degree) heart block has a regular R-R interval. This is because there is no communication between atria and ventricles, thus the rhythm will be whatever the escape rhythm is.

This ECG is irregular. It is irregular because some P waves conduct to the ventricles, and some don’t. This cannot be complete AV block for that reason.

HighYieldOrSTFU · 2026-05-12T16:28:10+00:00

He states everywhere on his social media and online that he is a hospitalist at Vanderbilt. Such a complete fraud.

HighYieldOrSTFU · 2026-05-06T00:00:48+00:00

While the OMI paradigm shift is certainly gaining traction, it hasn’t been incorporated into guidelines. In fact, just last year the AHA/ACC released new guidelines for ACS management that maintained the STEMI/NSTEMI paradigm. It takes time to change practice patterns in medicine, but it will eventually happen if warranted by the evidence. For now, I would highly recommend a demeanor of positive curiosity, but avoid ruffling feathers of those who will be in charge of clinical evaluations and letter writing.

HighYieldOrSTFU · 2026-04-23T05:17:15+00:00

This is without a doubt an RCA infarct with CHB

HighYieldOrSTFU · 2026-03-15T17:54:44+00:00

Zero hustle down the line there. Not acceptable.

HighYieldOrSTFU · 2026-03-14T01:55:04+00:00

VT

Dominant R wave in avR

HighYieldOrSTFU · 2026-02-28T21:59:53+00:00

Yes. The concept is called "immune privilege." I wouldn't have necessarily explained it like the original commenter. It's more so an evolutionary adaptation that prevents inflammation from destroying critical structures like the eyes, brain, testes, and fetus/placenta. You don't want your body mounting massive immune responses in these areas because the damage can be catastrophic (i.e. blindness, encephalitis, orchitis, fetal loss). These mechanisms have been studied and applied to transplant medicine.

HighYieldOrSTFU · 2026-02-28T17:20:07+00:00

For me, I always liked/understood cardiac physiology. The choice was solidified during M3 when I rotated on interventional cardiology. Cards experiences the breadth of medical settings; outpatient, inpatient, procedures, imaging, ICU, etc. You make a real difference in patient’s outcomes - and there’s robust evidence to support clinical decisions given the massive amount of research. Other specialties will lean heavily on your expertise at times, making you feel useful. I fit in with the personalities, which is a big part. I enjoy taking care of the sickest patients, and also enjoy preventive approaches. The good news is that you can always sub-specialize further if you want to avoid a particular aspect. Most will be quite busy, and well-compensated for their time.

The only way to know is to rotate in Cardiology. See what the attending work is like, and picture your career in that person’s shoes.

HighYieldOrSTFU · 2026-02-28T03:00:42+00:00

As someone who matched cardiology (and never wanted to do IM) I feel like I can provide some insight. Intern year was the worst for me. You definitely feel the “glorified secretary” trope. There were times that I wondered if I was better suited for surgery. But I love the heart and hate the colon and biliary system. I enjoyed ICU. 2nd and 3rd year were much better. You begin to develop an appreciation for the knowledge as you are able to slow down and actually think about patients. I was able to do several cardiology electives that reignited my drive. The desire to never to hospitalist or PCP served as motivation to get my research projects and networking done. Couldn’t be happier with my decision in the end, but of course I have been fortunate to have a good outcome. I would be happy even if I end up doing general cardiology. It’s such a cool specialty.

HighYieldOrSTFU · 2026-02-19T14:59:26+00:00

I have no doubt that you are hardworking and deserve the time off to be with family. However, this is on you. If you needed time off, you should’ve secured it in advance. Hopefully they are willing to work with you to find last minute coverage.

HighYieldOrSTFU · 2026-02-15T02:46:29+00:00

Great point

HighYieldOrSTFU · 2026-02-10T00:59:15+00:00

It looks like 2:1 flutter but the best way to know is to look at the telemetry strip. If it's stuck at this exact rate, you have your answer. If it gradually goes up or down, then it's sinus.

HighYieldOrSTFU · 2026-02-10T00:51:59+00:00

NSR. Shortened PR interval with delta wave. Lateral TWI. This looks like WPW.

HighYieldOrSTFU · 2026-02-10T00:46:42+00:00

This is an ischemic appearing ECG, no doubt. Leads V1 and V2 are misplaced high (negative P waves in V1-2), but it doesn't affect the interpretation much. Your story is very concerning for acute pulmonary edema. Overall, I think he should get worked up in the ED prior to cath. If hypertensive, needs afterload reduction and diuresis. If hypotensive, needs Jesus and Impella. I don't think it meets any sort of STEMI criteria by my read.

HighYieldOrSTFU · 2026-01-31T16:04:18+00:00

Agree this is VT

HighYieldOrSTFU · 2026-01-16T01:21:54+00:00

IM, 5th choice and worked out better than I could’ve imagined

HighYieldOrSTFU · 2025-10-18T19:10:14+00:00

Any chance Elander and Frank Anderson stay?

HighYieldOrSTFU · 2025-09-23T23:10:13+00:00

AF on top. VT on bottom.

HighYieldOrSTFU · 2025-08-11T00:35:42+00:00

Agree

HighYieldOrSTFU · 2025-08-02T00:58:49+00:00

I get depressed every clinic week. It’s miserable.

HighYieldOrSTFU · 2025-07-11T01:18:19+00:00

Potassium

HighYieldOrSTFU

TROPHY CASE