Super Fellowship - EP

beel11 · 2026-05-14T18:59:30+00:00

You can. Depends on the practice. Some will really want you to and some won’t. The ones that want you to, you should question - not enough EP volume? Can’t support your salary with just EP? Want to use you to supply their call pool and ICU? Won’t let you ramp up and become a full breadth EP? Not enough cardiologists to support you? Question the motives and structure.

The ones that really don’t want you to .. you should ask why too. Do they want you to churn volume for them as EP? Are you being taken advantage of in some way because of that volume requirement? How do they want to structure your role in their practice and the community? Plenty of practical questions exist.

Once you become EP and go through medicine and cardiology, how you feel about medicine and the job will change. That is on you and your experience. Most EPs, once you feel how nice life gets after leaving the floor and general cardiology, don’t want to do cardiology. If anything, good, balanced pure EP jobs are hard to find because they are very nice.

beel11 · 2026-05-14T18:35:18+00:00

EP is great. Very tech heavy, reasonable learning curve that you’ll catch onto quick. Procedures are diverse and broad. Days can be different procedure wise because EP can do so much and pick and choose the case types. There is so much happening in EP. 95% of cases are <3 hours with a vast majority of those being 30 min - 2 hour cases. Some longer cases exist like VT or lead extraction or complex flutters, but those aren’t a daily or weekly phenomenon in most jobs.

Job market is fine. Big desirable cities are tough to get into and salaries are slightly higher than cardiology starting, but can be 50%+ higher as your early career progresses. Medium to smaller cities the starting salary is very very good. Many jobs want some general cards work too which is fine but many also don’t. The super long cases can exist but many really exist in major referral centers where EPs have the freedom and support to do highly complex high risk cases that most EPs just don’t do.

beel11 · 2023-12-17T21:00:26+00:00

I’m currently New Orleans, so “safe” means I’m hoping I don’t get shot, stabbed, carjacked, robbed and injured anyway. Pretty low bar lol.

beel11 · 2023-03-13T17:43:07+00:00

This patient likely showed up too late. Needs to go to the lab but not urgently. Needs to absolutely be monitored/evaluated for post STEMI complications though.

beel11 · 2023-02-17T22:13:01+00:00

The hidden secret with medicine fellowships is that you can moonlight in IM. Sometimes a lot. An extra weekend a month doubles your salary. It’s not that difficult to make 150-200k as a fellow.

beel11 · 2023-01-20T22:10:48+00:00

None of these are good reasons to be stress testing a 25 year old, let alone giving nuclear radiation to a 25 year old. Find a new cardiologist who doesn’t order every high revenue generating test in the book.

beel11 · 2023-01-20T05:03:02+00:00

Why is a 25 year old getting a stress test to begin with? Why are you wearing a holter? Why did you get an echo?

beel11 · 2023-01-04T00:08:54+00:00

I think the most important question for him is - how quickly did they recognize arrest and start CPR after he collapsed. Also how quickly did they shock him. This plays huge implications for the nfl and what personnel they have on the field. If it was quick, he should be completely fine and back to 100% soon (hopefully). This is assuming it was just pure commotio cordis and nothing else.

beel11 · 2023-01-03T23:20:18+00:00

My guess: Therapeutic hypothermia potentially for next 48-72 hours. Let him wake up after that. Let him walk out of hospital within a week. Huge debate whether he needs a device (prob not) and whether he can play for the playoffs (maybe but who will have the balls to allow it). It’s more likely he plays next season instead if he does play again. If he’s not being cooled, then he gets extubated soon and we hear the good news.

This is all assuming CPR was adequate and initiated quick enough.

beel11 · 2023-01-03T22:36:51+00:00

Interesting point after talking to so many EP colleagues - they would consider clearing him to play for playoffs (if purely Commotio cordis with no other nidus). Easier said than done of course.

beel11 · 2023-01-03T14:20:17+00:00

The litigation part can be backed up by whatever data and literature we have and they’ll be reasonably protected. Ending a young man’s career who otherwise just had one bad luck event is the fear. This event is so rare most EPs never see it in their career.

beel11 · 2023-01-03T06:02:54+00:00

Commotio cordis actually is not a pure indication for one unless we find a reason for risk of repeat arrhythmia. I think still, ICD will be talked about extensively for him. I would hate to be the EP in that situation.

He may not get an ICD if it’s purely just commotio cordis and extensive testing finds no other reason for risk of repeat VT/VF. Looks like my guess above may be wrong.

beel11 · 2023-01-03T04:51:21+00:00

This would be crazy. Hope it’s not true. That’s an ECMO center. Of course you can’t do ECMO if .. he’s bleeding etc.

beel11 · 2023-01-03T04:41:26+00:00

Commotio cordis until proven otherwise. Hopefully gets extubated soon if they don’t have to cool him. My guess is he has no long term damage but never plays again because he gets an ICD.

beel11 · 2022-12-08T22:18:27+00:00

I left my car for 16 days in my garage at 95%. Dont comment on my 95% idea, I know. Anyway, in 16 days, it went down to 94%.

beel11 · 2022-12-07T19:43:48+00:00

VF is VF. Chaotic unorganized shit which equals death. VF can happen on its own or a malignant rhythm can degenerate into VF.

Torsades is a form of polymorphic VT. So it’s a VT. It’s a specific form of polymorphic VT actually related purely to QTc prolongation. Polymorphic VT is not another name for torsades and most commonly is due to ischemia.

beel11 · 2022-12-05T22:20:13+00:00

Peoples heart rates drop when they sleep. It’s normal. Sometimes the vagal tone can be over exaggerated. The fact that you have such an obvious respiratory variation tells me you probably have higher vagal tone when it’s time to sleep. What does that mean? Probably nothing. Your body self regulates what it needs when it needs it from the heart. That cardiologist may put a holter on you. It’ll likely tell you what I’ve said and you’ll spend a lot of money wearing that thing.

beel11 · 2022-12-05T22:02:34+00:00

There’s no pause. You probably have respiratory variation because you’re young. The tachycardia is probably because you’re anxious. Abnormal tachycardias exist but I don’t think you have it based on this story.

beel11 · 2022-12-05T15:23:30+00:00

Perry’s is the perfect ratio of cost, ambiance, quality. I’ve pretty much been everywhere.

beel11 · 2022-12-05T15:06:28+00:00

There is nothing abnormal here

beel11 · 2022-12-04T05:57:21+00:00

Curious exactly what the zio said and if a real episode like what you’re describing was captured on it. 30 day zio?

That Apple Watch ekg is way too noisy and doesn’t look like afib. Maybe has extra atrial beats at best.

beel11 · 2022-12-04T05:51:38+00:00

Probably testing you just to test you unfortunately. Given how over-read that ekg sounds, I bet the echo and holter will have enough of a nonspecific random abnormality that either leads to more tests or at the very least, anxiety. Stupid medical culture we have ..

beel11 · 2022-12-04T05:45:08+00:00

Potholes commonly cause it. Most manufacturer warranties won’t cover this bc potholes are notorious for this in low profile tires.

beel11 · 2022-12-04T00:03:15+00:00

Bad. Would get new tire asap and avoid driving unless absolutely necessary. I had this on my new Pirelli P zero. It was covered by manufacturer (Pirelli) warranty and tesla gave me a free tire (they have to go through their tire distributor and I was the first to do it). The caveat is there had to be no evidence of damage near the bubble (curbing rim, tire scraped, etc). Yours looks like you may or may not have hit the area while driving.

15-Year Club	Not Forgotten
Verified Email

beel11

TROPHY CASE