 Every year hundreds of doctors apply for future training into the field of cardiology and many unfortunately are rejected and turned away. For example in 2023 out of nearly 1,700 applicants more than 500 were turned away and didn't match into a fellowship program. But fortunately I was one of the lucky few to find that I did match into my number one program into cardiology on my first try. Here's a clip of me crying about it as soon as I found out. So today I'm going to break down everything that I did to get into a competitive fellowship like cardiology on my first try into my number one program but also doing it while applying to significantly less programs than most people do. And number four by the way is the most important to make sure you stay tuned. And number one is research. Now with any type of fellowship or additional training like cardiology research is usually required mainly because it's an easy way to show that you're interested and have invested in the field during early parts of training in medical school and residency. And so while research is important particularly within the field of cardiology that doesn't mean you have to have dozens and dozens of publications. I frankly didn't and there's tons of applicants who get in every single year that may just have a few projects that never actually went to the finish line of being published. But ultimately what matters and I'll share with you guys my research stats in a second is just contributing to a project with some meaningful contribution. So whether you're doing data collection actually working with the subjects of its actual clinical trial getting information in the backgrounds writing the manuscripts whatever you may be doing and then taking that as far as that project will go with the assistance of your mentors and researchers whether that means through a full-on publication or something like an abstract or a poster presentation or just presenting that to your fellow residents or medical students all that counts as a former research that you've done that then can go into your application. So personally by the time that I was submitting my application for cardiology fellowship I had about three to five publications from medical school alone. In addition there were projects I never actually made it to publication but maybe I did an abstract on them or I did a poster presentation or I did a presentation in front of the residency program. All those went into my CV and so that gave me a nice healthy list. Now with all that being said in full disclaimer I by no means think that I'm a researcher in the field of cardiology. I don't think it's going to be necessarily involved into my future but it's something that you should try out because again it shows people that you're at least interested and invested in the field and at least you gave it a shot because some people do find out that they're pleasantly surprised. I actually like this. So if you're interested in the field of cardiology and you don't have some research experience try to find a few mentors that possibly you could be doing research with send them all kind of a template email of like who you are what you'd like to do and ask them if they have any projects that they can help kind of finish or start and then maybe you'll have a few meetings with them and then you choose based off your interest and which sounds like the easiest thing for you to contribute with your busy schedule that you'd like to do. As a pro tip I'd recommend taking out about one to two projects at a time because usually some projects will be delayed or maybe you'll be waiting on something to be done for one project and then you can go ahead and work on another that just gives you a little bit diversity when it's time to submit your application. Maybe one of them turns into a publication another one just an abstract but you get the benefit of both work. And number two is your clinical performance or your rotation performance. Now this goes for all rotations just like when you're in medical school applying a residency if you're going to be a surgeon you still want to do well on your internal medicine rotation just to show that you're a good clinician and that you're willing to work hard even if it's a field that you're not initially interested in. So you want to make sure that you do well on all of your residency rotations and internal medicine but also when it's time to get into that cardiology ICU or a cardiology consult service whatever you may have at your institution you want to absolutely crush it. And so some pro tips that you can do before your rotation is just to learn some of the basics and that way you can come in with a nice foundation. So make sure you understand some of the guideline director therapies for things like heart failure how to do basic things like reading EKG just having a flow and a structure maybe managing somebody with a heart attack or chest pain managing somebody with brand new arrhythmias and some of the complex things you may see in ICU just create a list of topics and go down through them one by one. And as you're going through your rotation you find new topics so you're not quite familiar with go ahead and add them to your list and then add them to your evening and morning reading before you go into work. Now having a solid foundation is literally the base of what you should be doing. A lot of what your clinical rotation performances and what people will write about you that end up on your dean's letter when you're applying to fellowship really just comes out to the character of the person that you are. Now you want to be a good clinician but there's tons of smart people who don't get into cardiology fellowship and that's because they're usually missing a little bit of an extra oomph. An easy way to do this is make sure that you are just a strong leader of your team. Usually by the time that you're being evaluated for somebody like fellowship you're usually a second and third year resident meaning you're considered an upper level you're usually supervising some of the interns maybe even some of the second years. You may have some medical students on your service and you're expected in addition to a fellow that you may have on your service to lead the team and your attending is supposed to help guide you guys. So the more that you can do to make your team look good the better the reflection will be on you. For example when I was on my cardiology I see rotation it was time to just go ahead and work my butt off. The first thing I wanted to do is to make sure that I knew everything about every single patient both on my side as well as my buddy team. Often there'd be two upper level residents at a time so if my fellow upper level was off on that day I wanted to make sure that I knew about their patients that could help their fellow intern. Now in addition to knowing just the basics of what's going on with every patient I also wanted to make sure that all the team members that were taking care of these various patients felt comfortable with the plan so that meant I want to make sure the interns knew what they were doing or wanted to do and then giving them suggestions based on my experience of like maybe we should try this for x, y, and z reason. Over time after the span of three to four weeks you could see how they can start thinking like you based off the experiences that you've shared with them. In a similar fashion with the medical students that were on that rotation doing their sub-i as a fourth year medical student it's the same thing. I would ask them basically which patients they would be taking care of what their thought process was helping guide and shift that based off of guidelines and my own experience and also what I knew the attending would want and then ideally when we go into rounds and the attending would show up for the first time the fellow is expected to hear kind of broken presentations and if you worked your butt off everyone is on the same page offering good recommendations they may still need some shifting based off what the fellow and attending want but you have a team that just feels like they're cohesive and that starts with you as the upper level resident. So it's not only about being smart within the field of cardiology there's so much more that I had left to learn that I was taught on those rotations but simply having a team that felt cohesive and in control where you feel like you're the leader and everyone can look at you for support really does create a strong culture and that definitely gets reflected on both your recommendation letters if you do ask for them as well as your valuations that end up on your dean's letter. And as a final protest from my personal experience the last time that it did my cardiology ICU rotation I had one of my attendings basically tell me that for the first week she thought that I was one of the fellow. There was a new attending she didn't really know who the fellows were and she thought that I was the fellow on the service and that just speaks not necessarily to my level of knowledge but the ability to just create a team where everyone's calm on the same page that's what your attending wants. And as a pro tip if you really want to get that extra oomph on your rotations and have it show up on your evaluation make sure as an upper level resident that you're focused on teaching. So sometimes that means learning the basics of cardiology of things that you don't feel comfortable with yet practicing in that home teaching them on a whiteboard and then coming into your rotation and setting time to teach your medical students in your interns you'll find that not only will your med students and your interns learn but your learning will also be more cohesive and often your faculty and your fellow start to notice upper level resident is teaching this is awesome I love this team this team is cohesive this is what they want and again it all reflects upon you without you ever having to kiss up or do anything extra. You're just working your butt off your interest in cardiology this is how you do it. Now number three is working on your outside cardiology learning. Now depending on your institution it's going to be very dependent on how much cardiology exposure you get. There are going to be some residency programs that when you're an intern at a resident you're going to have amazing cardiology exposure just because of where you are. On the flip side there's going to be some that's going to have a very general bread and butter where you'll see your heart failure your arrhythmias some heart attacks and that's about it you don't see albads or heart transplants or some crazy other diseases that you may transfer to other hospitals it's just going to depend on where you're doing a residency and to make sure that you're not missing out you want to have some extra time set whether it's during your drives in to work or back to work or during your workouts where you're listening or just constantly learning about new things. Some easy and effective resources that were super helpful during my three years of residency as well as my gap here right now as a hospitalist include listening to podcasts such as the Cardio Nerds podcast or this week in cardiology which is a medscape podcast is just both very quick to the point and teaches you something that you probably didn't know about the field of cards particularly as a resident or a med student and even now as somebody who's about to be a cardiology fellow but also websites like the Jack website which I'll put down below or Wave Maven if you're somebody who's struggling learning at EKGs is something that I use intensively through my three years of residency to really just get more comfortable of looking at EKG and like what the is that and over time you're like I think I've seen this pattern before so if you guys want to practice your EKGs it's a free website i'll link that down below now beyond the obvious of just improving your cardiology foundation the reason that this is important is that it helps in your future conversations usually on your fellowship interviews they want to know about you they want to know about why you want to go into cardiology and so the more reasons you can have of saying oh that was so cool so if you're listening to someone on a podcast like that's freaking awesome or this history of cardiology is freaking cool or that case was super interesting or this research article I read was super fascinating if you can have more of those experiences within your tool belt to share on interviews and in your applications you just look like you're more interested more invested that's ultimately what they want when it's time to pick a fellow and finally number four and probably the most impactful for me is to think about your future goals and niche within the field of cardiology now keep in mind that when you're applying to a fellowship program they may have like three spots for example the program that I got into has three fellows as of next year I'm one of them the program where I did my internal medicine residency is much bigger and they have seven to eight so even that is a small size so you have hundreds of people competing for these two to eight spots thus making it very competitive and so you want to make sure that when you show up for your interviews not only do you have the greats not only do you have experience not only do you have people who vouch for you because likely if you made it to the interview process everyone who's sitting in that chair has the same but you want to be able to present a clear picture of what your contribution and direction within the field of cardiology will be and by no means does it have to be crystal clear but right now based off your experience they're going to ask you are you going to be somebody who's going to be a great research and cardiologist a great clinician within the field of cardiology somebody who's going to be focusing on cardiology education women's health you know advocacy or public health within the field of cardiology to ask yourself based off your experiences and your attractions to the field of cardiology which of those are going to be the places that you likely will pigeonhole yourself maybe 10 years from now things will change but that's going to be the direction that you want to sell yourself to these fellowship programs and also evaluate will this program allow me to have this life if that's something that I continue to want to pursue if you want to be for example an electrophysiologist who wants to focus on education and the program you're applying to doesn't offer an electrophysiology fellowship in addition to where you're about to do or really lack of training in education may not be the best fit so having a niche based off your experiences not only helps the program understand this person is serious I can clearly see that they've thought about this answer but this person can also fit nicely into the program we absolutely want them so the personal example as you guys know I've been creating content on empty journey since like 2016 my second year of medical school and on youtube since like 2018 by 100 accident I found that I absolutely love content creation to be able to help with online education in the setting of the empty journey I'm teaching you guys about my experiences so you can have the successes and avoid the failures that I've had but ideally I can also translate that into patient care in the field of cardiology I'm really excited to be able to do that I talked about that every single interview that I went to so then by time I walked away everyone remembered that's the guy who's working as a hospice who also has a youtube channel it was easy to be memorable I knew the niche that I carved out for myself but also as I walked away from each program that I interviewed at I knew probably not a good fit or this would be amazing if I got here now if you enjoyed this breakdown and overview of how I got into cardiology fellowship and you guys want more to help you succeed on your medical journey then click down below to get access to the absolutely free med school success handbook this is 60 plus I think it's like 17 thousand word document that I'm still updating on a weekly basis with tips that I wish somebody gave me on my first day of medical school residency and so on so if you guys want access to that absolutely free just link down below and if you're somebody who is about to start residency as a part of your medical journey and you're interested in just crushing it as a brand new intern particularly in the field of internal medicine definitely check out our intern survival guide highly reviewed and step-by-step process how to be more efficient and basically just look like a superstar from the get-go and as I'm making of this episode myself and the rest of them the attorney team is definitely interested in doing some workshops to help you succeed on your medical journey but particularly within the clinical year so whether it's on your rotations and residency to ideally get into those competitive residencies as well as competitive fellowships so if you're interested in some of these workshops just let me know in the comments section down below what you'd like to see and the more interest I see down below the quicker that we'll get to working on these workshops but as always my friends hopefully this helped you guys on your journey thank you so much for being a part of mine and if you enjoyed this one check out this episode right here all the reasons why I picked the field of cardiology as well as this right here on my full day as of right now a full time possible enjoy these I'll see you guys in the next one peace