 Let's answer some questions why your friends what's going on if you're new here? My name is Laksh. I'm a board certified internal medicine physician and currently a cardiology fellow and today you have caught me on a 28 hour shift where I am would be using some of that time that I have relaxed fingers crossed for a little bit longer Answer some of your questions about what it's like to be just a cardiologist now a few weeks ago I asked you guys on Instagram on YouTube through the emails to say let me know what questions you have about my life as a cardiology Fellow lives cardiologist. I'm gonna do my best to answer them So that's exactly what we're gonna do as I'm trying to enjoy some dinner These are some french fries some caffeine on a 28 hour shift here in the cardiology I see you which I'll get into in a second and to make this episode a little bit more interesting and a little bit more Just freeform I really enjoyed the video that I made for you guys about my updates for 2024 Where I felt like I could just answer questions off the cuff and talk a little bit of detail without really worrying about what the YouTube algorithm had in store whether the field is gonna do well or not So I feel like this where I come up with my best answers And so now I'm ready to get into answering some of your questions If you just want to go ahead and look down below the description and the bookmarks You'll be able to see all the questions that I answer during this episode So if you're interested in the ones particular one or a few of them feel free to jump around the video And if you do just make sure you hit that like and subscribe button if any of those answers are helpful to you So let's now talk about today's call day before we get into the questions Now as a cardiology fellow at least in my program you take call once a week That means that you are in charge at least here of the cardiology I see you want to make sure that it's always cardiologists covering the ICUs and for us the fellows cover six out of the seven days And when we cover that means we are responsible for those patients overnight Now when ICU is not something that you would want your cardiologist not to be close by in Ideally you would want them to be in-house and so we do what's called in-house call That means that once a week I am in the hospital both throughout the day for whatever rotation I'm on As well as during the night just managing those patients in the ICU and then I go home the next morning So currently my normal rotation during the day is actually being the ICU fellow During the month of December and January as a recording this video And today is Sunday which is my call day that means I came to work this morning at 7 o'clock I am going to stay until the rest of the night until the morning And the only difference is that no one really relieves me because I'm the ICU fellow So I'll see all the patients again tomorrow write all their notes Staff them with my attendee and make sure we have plans and then go home Ideally by 11 sometimes a little bit later but usually the rule is you try to stay for no more than 28 hours And ideally try to get some sleep this is the call room As you guys can see there's actually a bed behind me which hopefully I get to enjoy at some point tonight So currently it's 6 p.m. And by this time I have seen all the patients both myself my tending and third time just by myself I've done certain procedures on patients who are a little bit sicker and might need things like lines Now I already am aware of one patient who is coming from a different hospital and transferring to ours We're transfer hospital that means a lot of sick patients coming from other hospitals who may not have all the capabilities So we may have here will come and bring their sicker patients And so that person is somebody I'm expecting later tonight Right now things are okay fingers crossed So I'm gonna try to enjoy my dinner and we'll get into your questions So if you guys enjoy these styles of videos that are very laid back and hopefully come with a lot of nuggets Make sure you hit that like and subscribe to make sure that these kinds of videos come out to more people who may be interested in cardiology Medicine all the things that we talked about here at the MD journey So starting with our first question which is coming from Instagram asking will you have good lifestyle as a cardiologist now This is big spectrum my life as a hospice which I did for one year in case you're not familiar with my story I went into residency I knew where I wanted to match into fellowship And so I chose to become a hospice at that hospital where the fellowship was taking place Which happens to be where I'm doing my fellowship right now So worked out because my wife and I wanted to stay near with the rest of our parents and be close to family as we were Expecting her first little girl who is now about to be six months old long story short being a hospice comes with an amazing Lifestyle because you work seven days in a row you have an entire week off and you do that an entire year So you work 26 weeks out of the 52. It's a pretty good life as a cardiologist I likely will be busier and working more hours because there's no seven on seven off really as a cardiologist And there's not often just five days a week Sometimes you'll have to work weekends But a lot of it will depend on the type of cardiology I choose to to choose and do but also the group that I work for So just how I say call right now as a cardiology fellow I'm likely going to have to take some form of call as an attending independent provider because when you're working with a Group you want to make sure there's questions from any of their patients Somebody is there to be able to answer questions if you are working in a group that works in the hospital You want to make sure that there is somebody from that group assigned to cover those patients if need be It's gonna be very dependent on the group that I work with of what my call schedule will look like usually It's not in-house calls So I'm not gonna have to stay in the hospital like I am right now as a fellow But maybe I am going to be covering a lot of services or more than one hospital or doing call more frequently I don't know and so that's gonna determine a lot of what my lifestyle will look like and another aspect of this is that your lifestyle likely will become Easier or better as you go further into your training because maybe you commit to not doing as much call You may get paid less But you have made yourself an asset otherwise to the group that you're joining in and thus you get benefited from not having to do As much call again a lot of this will depend on the employer ultimately work for which right now I'm just a first-year fellow six months in and so I have a lot of time before I can get down there And so while that's a great question right now the answer is I just simply don't know just because I'm way too early into the Journey to know what kind of employer I'm to be working for and what their call schedule looks like I think my lifestyle is definitely gonna be busier than it was when I was a hospitalist But I think I'm gonna be or I know I know I'm gonna be happier as a full-time cardiologist than I am as a medicine doctor I'm gonna make a completely different video about that and I have actually about the pros and cons of being a hospitalist in case you guys are interested I'll link that down below so our next question is what is the difference between a structural cardiologist and an interventionist It's a great question and to be frankly honest for the longest time including when I was a residency didn't really know what that meant So an interventionist is kind of what it sounds like it as a doctor who does interventions and the easiest one in description They think about the doctors who play stents if you have a heart attack you come into hospital You have a blockage you need somebody to go in there and to open up your pipes open up your coronary arteries You put a stent in that's done by an interventionist a structural cardiologist is Typically the way that is described is an interventionist who can do everything we just talked about But they have decided to make their field of cardiology specialized in doing things like putting in a prosthetic valve So patients who have an aortic valve disease aortic valve is the last thing Essentially the last door between your left ventricle and the blood flow leaving to the rest of your body and a lot of patients Especially when you get older that valve gets really tight and it can cause a lot of symptoms And they can actually increase your chances of having very big complications like passing out chest pain and just increasing your chances of things Like death and so for those patients who have a really tight valve We actually recommend replacing them as you imagine as you get older You're not the best candidate for surgery so a structural interventionist can actually go and do something like you're growing and essentially take catheter and place them and replace your bad catheter by something called a tapper that is just one of the many Procedures that a structural cardiologist can do and so usually the description of structural cardiologists is given to somebody who is an interventionist There are people who are non-invasive structural cardiologists These are people who specialize and not necessarily doing the procedure But may have a lot of expertise and providing information like doing the trans esophageal echo and being able to get you information on how big Is the valve what does the rest of the anatomy of the body and the heart look like is the valve as bad as everyone thinks it is And so there could be a wide spectrum of what you can be called when you talk about being a structural cardiologist But usually when I think of it I think of as an interventionalist who typically will do procedures around things like valve repairs But a big takeaway is that a structural cardiologist is often interventionists not all interventionists do structural cardiology So our next question is what are the things that a cardiologist can do that an internal medicine doctor can't? This one's actually perfect up my alley because I worked as a year as an internal medicine hospitals as I talked about and there's a lot There's a lot of overlap for sure first we can talk about some of the similarities There are a lot of diseases that is if you're a good internal medicine doctor You will see in the field of cardiology that you should feel comfortable taking care of and I know that when I was in an Internal medicine hospitalist I would get excited of taking care of these patients and often would not call the cardiologist unless there was something that They were sick enough or I needed help or they needed follow-up that it made sense to just get the cardiologists to see them there So they could continue to follow the patient when they got discharged But to be a patient who come in with heart failure and they have fluid overload heart failure basically means you have a bad pump Your heart doesn't squeeze as well fluid doesn't move as well fluid being blood And so it starts to back up in places like your lungs your liver have lots of problems people can feel terrible Plus blood's going off going forward So people are just not getting blood flow to their brains and all the other organs that are important So you can think about all the complications that come from that It's really easy disease to manage when it's straightforward. You just take the fluid away You make them peak those a medicine doctor you can do that the cardiologists can do that medicine doctor could do that another example You can have patients come in with weird rhythms For example typically our heart will beat from the top of the heart to the bottom or our atrium Which is the top chamber of the heart will send an electrical signal down to the heart Eventually the ventricle which is the bottom part of the pump will eventually squeeze So essentially like two drummers that are playing to a very natural beat giving you a stable heart rate Now as you can imagine if any of those two drummers and since the signal is coming from the top one of the atrium If he starts to play off beat or play too fast for any reason then it can really throw off the bottom one So you can understand that the two drummers are not in sync mainly because the atrium Which is the first drummer the first beat doesn't work consistently or is working too fast Or just not working appropriately it can cause the second part the ventricle to not be able to squeeze Consistently or at a regular interval that's something that we call a fib is very common in cardiology It's very common in sick patients is very common in older patients and as an internal medicine doctor You should be experienced to say that's a fib so recognizing it seeing it on EKG And then kind of knowing what your algorithm is going to be of the first few medications You'll try if the patient stable if they're not stable and you're taught this throughout med school You're taught this throughout residency So a medicine doctor can often take care of a fib and there's tons of diseases where there's a lot of bread and butter Cardiology that a medicine doctor can do a cardiologist can do and often when I'm on consults or consultant services where I'm called by a Surgeon or an in-medicine doctor saying this patient has one of those bread and butter problems often If it's a good doctor It's because they've tried those first few things in the algorithm and it's not working and so they need my help But sometimes you do have medicine doctors that are busy or surgeons who are just not familiar with algorithm anymore because it's Been forever where it may be the first step no one's taken it and they need your help to initiate it So there's that overlap aspect now the parts to that medicine doctor can't do that a cardiologist can is especially when the heart gets Really sick some of the things we talked about is that if you have a blockage a medicine doctor cannot go in there and open that Stent that requires an interventionist so not even me at the stage although I am in the cath lab helping with those kinds of things But there's somebody who's specifically trained to do things like open steps put balloons in identify which arteries causing the most amount of Blockages thus causing the discomfort or the chest pain there are things that we can do when the heart gets really sick and can't pump it Somebody has really bad heart failure and we can't just simply take fluid off for a variety of reasons We can put extra devices within the area of the heart to essentially offload how it works For example imagine essentially having a mini vacuum near your heart to that if you have a bad pump You can essentially just suction out blood for the heart and essentially do some of the work for it helps it on load That's a device that we call an impella or a balloon pump those are devices that we often put new patients Groins and they Have all the way up near or through the heart and then we use those to essentially do some of the workload for the heart temporarily while whatever insult that the heart is having over can you know improve or Revaluate those patients for things like transplants You can imagine what those patients gets really sick to that level that cannot be done by an intro medicine doctor And there's definitely a big spectrum of where somebody draws a line that it's just a cardiologist I can do that versus a medicine doctor But usually when people get really sick they will call me anybody that is in RICs right now Usually will need me versus just a medicine doctor to do the variety of things that we are to make them more stable So next question is something that I get a lot in the comments Which is I want to ask you about work life balance and compensation of a cardiologist I'm gonna start the second one first because I get a lot of these questions and they're to be honest guys Sometimes they're like forceful as in all that the question is really trying to get to is just like how much money You're gonna make and this is me being very honest that answer is very easy to Google or search and the YouTube comments probably not the best place to get it because I don't make this channel to talk about How much I'm going to make as a cardiologist or how much money I make now as a fellow I know that those are topics that are very attractive because you shouldn't care about money in medicine I mean it is an important part of which career path you may pick if you have two career paths that you like equally You should pick the one that pays more means appease your lifestyle for you and your family, etc So I understand money being important But often I feel like sometimes the questions come across as I'm only going to pick the fields that pay Well because that's ultimately what you want And this is way too long of a feel to go in and just for the money or continue to pursue it for the highest salaries There are cardiologists that make a ton of money, but they work a lot of hours And I don't want to be one of those because I want to spend time with my daughter She's six months when I spent time with my wife when I spent time with my dog and the rest of my family So if I have to make on the lower end of what a cardiologist makes average And I think I've talked about this in prior videos is about four hundred four hundred fifty thousand dollars If you're interventionists, which we talked about before you're gonna make more because you do procedures Usually the compensation that comes with those because you require more training is a little bit more You may be making five hundred five fifty again That spectrum may be much higher maybe much lower depending on what part of the country you work with and what exactly you do So that's the compensation answer But the big take that I want to give for the comments is try not to ask with the pressure of just feeling like that Answer is going to make the decision of what you pursue. I love cardiology I really enjoy what I learned despite having long days I'm eating my first or second meal of the day But that's because I've been busy about taking care of patients and really just honestly just forgot to eat That should be a good example of stat you found right field not because oh, I'm glad It's gonna make me X amount of hundreds of k's or whatever it is second question We kind of already talked about which is a work-life balance I think as I get older in the field of cardiology, I'll have more control of saying, you know what? My daughter is 10 11 13 years old and maybe we have more kids Then they'll be X amount of years and I want to spend more time with them when they are at that Teenage fun age to truly have your role as a parent and have you know more Experiences with them more journeys with them and maybe I don't want to work as much But when my daughter is one or my daughter is seven months Maybe she doesn't really know or remember all these little things when I'm more at work versus with her So it makes more sense for me to get in more hours early right now and some fellowship My schedule is already fixed but that will change I will likely want to have less time at work and more time my family And I think as I'm further and further into my journey I'll be able to say I have clearly had the expertise of being a great cardiologist But this is the work hours that I am willing to work that work-life balance My hopefully is going to increase as I work further and further into this field Next question is very similar which says do cardiology attendings have the busiest schedule Especially interventional cardiology EP and heart failure So a few terms to clear up for any of you guys that don't know what those are Attending basically means an independent practicing provider When I was a hospice I was at attending because I was practicing myself I could have had other people underneath me but I was kind of like where the buck stops Right now as I'm a fellow I'm in training and so I have an attending Even when I'm in the ICU who's overseeing my decisions Where I talk about things especially that I have questions In fellowship there's a lot less hand-holding But they are there and available to make decisions with you to help bounce ideas off of it But an easy way to think about them is supervisors Your attending is the head hot show So when somebody says attending they are attending up the service They are the head boss supervisor of the service IC or interventional cardiologists we've talked about that EP is electrophysiology these are doctors that are specialists And an arrhythmia of the heart So if somebody comes in with something like AFib like we've talked about They would take care of those but there's tons of other things Somebody having heart block where the signal is not getting translated The top to the bottom of the heart would be something That an EP or electrophysiology doctor would take care of These are your doctors that place things like pacemakers Defibrillators and other cool devices Pretty cool interesting field And it's definitely very heavy on the physics based And science based compared to maybe some of the other things that we do in cardiology Very cool I probably won't want to pursue it Definitely an interesting field And the last one heart failure we talked about There are specific doctors who are specialists in heart failure Especially when you're pumped your heart gets really weak Where you are probably a candidate for something like This person eligible to get a new heart Or if they do get a new heart who's going to take care of it Those are some of the things that come in the realm of a heart failure cardiologist Those are all the terms Now let's talk about who has a busy schedule They're all busy So your lifestyle as an interventionist can be very busy Simply because when you're on call It's not like you can take the call over the phone and say Do X, Y, and Z for the patient You are the person that comes in and places that stent to open up the heart So that's really busy Electrophysiology less so Although it can be busy because there's less emergencies Where you have to come in the middle of the night and just do them yourself There are a few situations here and there But I find that my electrophysiology colleagues and attendings are busy They work a lot They answer a lot of very unique questions But often it's kind of Monday to Friday With some call here and there on the weekends But they're still very busy And then heart failure can be very busy A lot of the heart failure attendings that I worked with when I was a resident And now when I'm a fellow Do a lot of kind of critical care cardiology as well Because the patients who are sick Being evaluated for things like transplants Are often the patients who are in the ICUs And so there's a lot of overlap Oh, these doctors taking care of them And so they probably have some of the busiest schedules Or the most dedication and focus to their patients Because an interventionist as you can imagine fixes the stent It is okay for them to be like Well, let me go help all the other people with heart blockages I'm going to have a cardiologist now take care of their vessels that are open Our heart failure doctor really takes a lot of ownership Of the patients that they take care of If they're in the ICU and the clinics are taking care of them And so that one is probably the one I feel like is the most involved Where it's you can't just give all your feet Into how involved you are with your patients You are all in and they're all great docs And they're all in with their patients Probably something again I couldn't do Because it requires a lot of your attention Towards your medicine to your patients And maybe some focus away from your family But I think it also depends on where you work And the style of your practice Take a quick break to get a fry French fries with honey mustard Super good That brings up one random question I can think of for you guys Which is do I get free food in the hospital? Answers yes There's a cafeteria where I have a badge I can scan And then I have like X amount of money Which I never reached the threshold And also doctors lounge with tons of resnacks And drinks and ice cream Which sometimes I dibble in at 2 a.m. If I'm awake So I'm never hungry in the hospital Okay, so now that we are down with someone's fries I'm gonna nibble on these chocolates And give ITLs questions Next we have How do you take care of your mental well-being As you juggle fellowship Being a father and a husband Heather kind of alluded to at the start of the video Hawaii and I just had our beautiful Now about to be six month old daughter And we've definitely had an amazing experience with her But my daughter is as old as my fellowship experience I had her my second year My sixth excuse me My second week of fellowship And so it came with a lot of challenges Of learning how to be a new cardiologist New cardiology fellow And a new dad And then being a husband to a new mom There's lots of the new roles that we had We just bought a house two months before that So being figured out at home So a lot to juggle Running this YouTube channel All these roles that I've chosen to take on The question is How do you take care of your mental well-being It's actually not as hard as the juggling sounds Because all those things that I talked about Identify those as being important to me Thus me having those in my life make me happy None of those roles are something that I'm taking on Because I have to I'm not taking on being a fellow Because I need to do this for anyone else I'm doing this for me It's gonna provide benefit to my family Later on through financial instability And I'm gonna have a job that I enjoy going to My patients ideally will benefit from a doctor Who's happy from what they like to do But me choosing to be a father A husband Homeowner Every other role I talked about keeps me happy And so because I'm very specific With the roles that I take on in my life And I don't say yes to things If I don't feel like they're gonna provide value to me And I think my threshold for value is pretty low I feel like I can give value from a lot of things Using that insight I feel like I'm happy I may be busy I may be not always getting as much sleep as I want My mental well-being comes with the package That I am enjoying what I do When I go home Tomorrow at 12 and I'm tired Not knowing how much sleep I'm gonna get tonight When I see my daughter Being a dad is going to make me want to be okay With those lack of sleep so I can spend time with her And that's how I've managed I think of my entire medical journey Where somebody would ask me how's it going And my answers usually can't complain And I think it's because I have elected to go through every path That I have been on thus far And I think that's one of the biggest takeaways that I've had Which is that this journey has been of my own volition And in a good way But even some of the bad moves that I've made Because I thought it would make me happy Maybe it didn't So all the roles that I've taken on and juggling Make me happy My wife makes me happy My daughter makes me happy My dog makes me happy Being a fellow and the colleagues that I work with Make me happy And so it's not that hard to balance my mental well-being Yeah, I think that's a good way to summarize that So that was pretty deep Let's come back to a more superficial question Which is what are the most common cardiology illnesses That you come across as a cardiologist? It's actually a great question Some of them we alluded to Bread and butter cardiology Is basically what you're used to seeing very often So you send it in buckets You deal with things like corneal artery disease Which basically is a fancy word for plockage And the heart vessels That supply the heart You have a bucket for things like the strength of the heart failure Which we talked about already We have a bucket for arrhythmia Which are things like aphid You have a bucket for things like babbler disease Which is the muscle is fine The heart is beating fine But the actual doors are too leaky Or too tight As we talked about aortic stenosis And I'm probably forgetting a few of the common buckets That we deal with But I feel like those four or five Usually can summarize the majority of the patients That I work with And a lot of times patients will have a multitude of those On average how many hours of work do you complete per week? As a cardiology fellow I'd probably say I'd work about 60 hours a week I'm on the ICU's Definitely pushing that 70 plus And then when I'm doing like an imaging rotation Where I can usually come in a little bit later While the imagines are being obtained So I'm doing like stress tests And people are obtaining nuclear scans And usually come in at eight And then leave about four Those are a little bit nicer And there's no weekends Do you see yourself pursuing an additional specialty Within the field of cardiology and the future? Great question Essentially what do I want to do in my life? The answer is probably not You can have a great career with a lot of variability After just doing three years of cardiology fellowship It does require you to be proactive And finding parts within cardiology That you are going to make your niche And I have a few ideas of places And the fields and buckets that we talked about That I want to become more of an expert Over the next year By the time I'm applying for a job in the next two years I can say these are the areas that I feel very comfortable with Taking care of patients If none of those providers in my group Really feel adept in taking care of those Those patients would come to me And essentially you would create a practice Taking care of those niches of patients And so I don't think I actually I know I probably will not 98% 99% 97% 97.5% sure And I will not pick another sub-specialty I think I am done with the training aspect Although I enjoy fellowship I think another two and a half years Which is what I have left Is going to be more than enough Next question as a generalist Do you know of cardiologists Are able to dedicate days of the week To being in the cath lab Or is it only for interventionists Like are you able to schedule Where you have clinic rounds In the hospital Interventional procedures All on different days Great question You can be a general cardiologist And do procedures You can do things like write hard cats Some general cardiologists Do things like pacemaker placement Some people will do things like left heart cat That is basically looking at the major arteries That heart and looking for blockages They don't put stents in But you can do those procedures You can do other procedures Like doing a transesophageal echo Most ultrasounds of the heart Are done from the chest But if you want more information For whatever reason A transesophageal gives you A lot extra additional information It is a procedure That a lot of general cardiologists Will essentially have Half days of the week Where they may be doing procedures In the morning It's like an afternoon Or a full day of clinic Or a full day of procedures Or some mixture Where they may be doing consults In the hospital And during different parts of the day They may be going to the procedure room To do the patient's procedures And then going back and saying more consults And so, yes, as a generalist You could do some of the procedures That an interventionist can But not all of them Essentially, the best way to think about it Is that if there's intervention That needs to be made That's usually where the buck stops So you can't put a stent in You can't open up a valve For most of the time It's a very diagnostic-based procedures Which honestly are kind of like Where I like to draw the line anyways So I enjoyed the flexibility that offers Next question How do you like your cardiology training? What are some difficulties And accomplishments while in training? I don't know if I have Very many accomplishments Of only six months in I feel like I'm much more comfortable Than I expected to be at this phase Especially being in the ICU As a brand new first year I feel like the comfort level Is probably higher than I'm expecting So that's good But how about I did that Absolutely loved it For a few reasons And I talked about this in my Four-month recap cardiology video So I'll link that down below If you guys are interested The people I work with are amazing This field is very interesting I enjoy coming to work There's so much to learn And then when you feel like You've learned something And you can apply it to help Another patient feels so good Which in cardiology happens Over and over again With more repetitions You're able to use Little clues here and there More imaging modalities Just put a better puzzle together And say I've seen this before I can use this to help this patient And then with more patient experience You can say I've seen this before Again, I can help this next patient Even better That part's rough But the training I've gotten here It's been amazing Lots of hands on The 10ings Usually I've found that 99% of the time Think of you as a colleague That they were trying to train To be the best cardiologist Versus like a trainee And I've enjoyed not feeling Like the person who just meant There to be to write the notes Next question is How much are you expected to know At a fellow at different stages Are you expected to be independent Doing echoes before entering fellowship And the other skills The answer is absolutely not At least where I train You're expected to know nothing And that you're taught things Over time through repetition I think the biggest difference For residency is that In both of them They're expecting you to know nothing On day one But in fellowship You learn a lot of it Just by doing and having reps So no one was expecting me To know how to read an echo Or an ultrasound of the heart Often the way it would go Is I would be in a month Of my ultrasound rotation And then somebody would say What is that? And if I got the answer wrong They would say nope Actually this is what it is And then I would run for the next time And then that perseverates down A thousand different questions About everything cardiology related And that is how you learn cardiology As a fellow Trial and error As a resident There's a lot of Let me teach you about this first And then I'll ask you questions There's just way too much to learn Very little time You just learn better by hands on And a lot of the way That our program works here It's hands on learning Use your attendings If you are stuck And you learn through experience But you're not expected to know anything When I started my first day As an ICU fellow On the ICU I wasn't really expected to know very much Because we do one night a week In the ICU You've learned that experience throughout time That comes with reps Next question is a little bit similar Says can you briefly compare Your fellowship experience To your residency experience We talked about the teaching And aspect of it I feel like as a fellow The biggest difference is that I see the finish line Much differently than I see on residency In residency it was about Getting into fellowship Or finding my first job But you don't think about Five, ten year plan You're just trying to think about Getting through training Getting through your call days Getting through your ICU rotations And often you would be doing rotations That you would be enjoying As a fellow there's less of that Everything is cardiology So although I may not enjoy Every aspect of cardiology I enjoy the field I enjoy the patients I work with And so it's easy to come to work Because I'm talking and learning about cardiology Each and every step of the way That part's nice And because I know the future I can design a practice Where I take care of those more enjoyable niches More often than the less enjoyable niches For example, I am not an interventionalist Don't hate me if you are interested In interventionalists Or you are an interventionalist If you're watching it to this point in this episode But I don't really care to do left-harcads Or play stets Not that there shouldn't be somebody who does I may not enjoy my cath lab experience As much as I enjoy Mac or ICU experience But I enjoy them a lot more Than being on a GI rotation Don't hate me if you are a GI doctor But I just don't enjoy talking about the liver Or poop or diarrhea Or abdominal pain It's not my forte For the resident You would have to be experienced In that field for me as an internal medicine So that's the biggest difference Is that every rotation feels like something That I will likely be doing in the future Aside from interventional or electrophysiology And then last few questions Have I planned out my medical school loan Three payment plan? Yep, basically the plan is Set aside some money between now and then My loans are technically zero dollars Because my income is not as high as it should be Given that I have a wife and kid That are dependent on income So to be fully frank My loan monthly payment is zero dollars Although my loan is about $180,000 And so the plan is to create a buffer Over this next year My first year of fellowship My second year of salary Would go up a little bit higher And using that buffer to start paying off the loans And then I'll be doing a lot of moonlighting here in 2024 And so using some portion of that To be paying the loan Just to get in the habit of seeing that amount Go down using a little bit of an avalanche technique So that's my overall strategy But that guys, although while there are a few more questions This video is now going into about 30 plus minutes And I would like to enjoy the rest of these franchise Before nurses call me But I have only been interrupted during this video once And it's from my attending Just kind of saying what's the touch space Before I go to bed I mean them Trying to see if that new patient's here But I think that that has been a successful Q&A With the life as a cardiologist Hopefully gave you guys some insight Into what my life as a fellow looks like How I perceive this journey Hopefully it can be a positive experience for you guys Because I truly enjoyed these last six months I'm really excited for the next 2 and a half Because again, I talked about this in my four month video Is that I can really see how exciting it's going to be When a year from now Or a year and a half from now How much cardiology I'm going to know Where this is going to feel more and more second nature to me And that is pretty cool when you're, you know Thinking about a 20-30 plus year career So with all that being said Hopefully you guys enjoyed this video Let me know in the comments down below What other questions you have What other questions If you enjoy this style of video Or I'm very raw Very limited editing And just kind of talking to the camera Answering the things that you guys want to know Particularly about my life as a cardiologist Let me know Because if so, it's very easy And enjoyable for me to make these kinds of videos For you guys As a kind of a last aside If you somehow made it to the end of this video And you want to succeed on your medical journey You essentially would want all of the things That I wish I did As well as the things that I didn't do On a medical journey How I would have studied differently How I would have been more productive How I managed my time How I would have studied for boards My team and I here at the MD journey Have decided to put all the things That we've ever created in one place Called the med school blueprint And I'll link that down below If you guys want to see the reviews That people have gotten through that program You can see it down below And if you're interested Definitely consider signing up If you're not, no hard feelings And if you are somebody Who needs some one-on-one help I'll link that down below We do have a coaching program If you guys are interested But most importantly If you did enjoy this video Hit that like button Hit the subscribe button Hit that notification bell To be notified when new videos like this Go out live And as always, my friends Hopefully this was a little helpful To you on your medical journey And as always Thank you for joining me on mine I'm going to enjoy my Dr. Pepper I'm going to french fries And fingers crossed Pray for me that I get some sleep Please Peace