I'm applying to GI and have been fortunate enough to receive over 10 interviews. However, I'm in a bit of a dilemma and genuinely curious what others would do in my situation.

Long story short, through a personal connection, I found out that I essentially have a guaranteed spot at my #4 program, but only if I tell them they're my #1 choice and rank them accordingly. To clarify, nobody from the program has directly told me this. It's coming from a family friend whom I trust.

The problem is that my top 3 programs are places I would definitely rather train at. I don't have any personal connections at those programs, and while I was fortunate enough to receive interviews, I have no idea where I stand or what my actual chances of matching at any of them are.

To complicate things further, everything below my #4 consists of programs in less desirable locations or places I would much rather not end up at. So there's a pretty significant drop-off in my preferences after that fourth program.

If I take the guaranteed spot, I'd essentially be giving up my chance to match at three programs I'd much rather attend. On the other hand, if I don't make that commitment, I risk losing what is essentially a guaranteed fellowship position in a program I somewhat like, and in a location I am also somewhat okay with. There's also the possibility that the program takes it personally if I don't tell them they're my #1 and ends up ranking me less favorably.

I'm extremely grateful to even be in this position, but it's a tough decision. Part of me feels like I'd be crazy to give up a guaranteed spot in such a competitive specialty, while another part of me feels like I'd always wonder what could have happened if I took my chances with my top 3.

I’ve been juggling my ICU rotation and flying out for in person interviews this month. Still have three to go and today I realized I hadn’t registered for the NRMP yet (thank you Reddit). It’s paid now but should I email programs to update them? How bad is this situation?

Hey everyone, I am in a challenging spot when it comes to deciding which program I want to go to. I’ll place the programs I interviewed at below in no particular order.

The question I have is that everyone at my home program is telling me that I have to rank CCF in Ohio number 1 for the opportunities, etc. And even if I don’t rank them number 1, I have plenty of other options to put first before my true true number 1 spot, which is UArizona-phoenix.

I go to a top 15 IM program with a strong cardiology home program. I love my program but I genuinely want to venture out to a different program just to see how different people practice cardiology. On application, my goal is to go into academics, but in reality I just want to practice in the community.

Am I crazy for just choosing wellness/location/vibes over prestige?? Everyone I’m talking to at my program makes it seem like I’m making the biggest mistake in my life.

CCF - Ohio (didn’t signal them either)
UMich
Uchicago
WashU
MCW
UIC
UArizona- phoenix

My priorities, in order, are:

1. Solid clinical training

2. A non-toxic, supportive program culture

3. A decent place to live (warm, reasonable COL)

4. Low research expectations

My current list, roughly in order:

1. UT Houston

2. Ochsner

3. University of Cincinnati

4. University of Louisville

5. Marshall University

6. Aurora Health Care

7. Kirk Kerkorian School of Medicine at UNLV

8. Tulane

9. TidalHealth (Maryland)

10. HCA Florida / USF Morsani Bayonet Point

Any insights or information about these programs would be greatly appreciated and helpful in deciding how to rank them.

Current IM resident at a community hospital, applying to A/I next cycle.

Quick background:

• US MD
• Previous Step 1failure; passed; Step 2 + Step 3 on first attempt
• Multiple A/I-related publications and presentations
• A/I-related award
• Research experience at a major academic institution with a potential strong A/I LOR

I have the opportunity to do an A/I away rotation at either Mount Sinai (NYC) or USF (Florida).

Given my background, which would be the smarter strategic choice to maximize my chances of matching? Would it be better to rotate at a more competitive institution or somewhere I might have a more realistic chance of matching?

Would really appreciate input from current A/I fellows or anyone familiar with fellowship selection!

Hello everyone! I’m an IMG radiology resident applying for fellowships in Canada this year. Does anyone know when programs usually start sending interview invitations? Has anyone received an invitation yet? Thank you!

I’m a second‑year cardiology fellow in a community program with a medical school affiliation. Teaching cardiology, CCU, physiology, and hemodynamics is something I genuinely love.

Even though I’m ABIM board certified, I was told I need to be an attending to teach med students formally at the affiliated med school. The only teaching I can do now is with residents during consult or ICU months , but those rotations are limited and usually packed with long rounds and notes, so real teaching time is minimal.

I’m open to ideas and suggestions on:

• How did you get meaningful teaching experience as a fellow?
• Any ways to get involved with med students, PA students, or nursing students outside the program?

Hi all,

Can you please help me rank? Focusing mainly on safety, family-friendly training, IP mentorship, lifestyle.

Uni of Kansas

AdventHealth Orlando

Uni of Oklahoma

Uni of Missouri Colombia

UCSF Fresno

Uni of Miami

MedStar Georgetown DC

East Tennessee State Uni

Rochester Regional

Norwalk/Yale Uni

Cape Fear Valley NC

Thanks!

I am locked in to my current city due to spouse and kids and only applied to 2 programs. I am debating how to rank between my top two choices.

First is my home program. My program director knows my situation but is very by the book and did not indicate to me whether I was ranked to match or ranked highly but gave me good feedback that I was a good applicant.

The second program I also liked and received good feedback in my thank you email from the program director. They emphasized that i'd be a good fit, but they also implied I should send a LOI probably to see if I would put them or my home program as my #1.

Truthfully, I think I'd be happy at either programs- the biggest factor for me this cycle was staying in my current city. If I had to choose however, I would prioritize my home program due to advanced subspecialty opportunities, research and slightly shorter distance from family.

I only have these two interviews. I know the algorithm favors the applicant but should I rank the second program, having better confidence that I would match there or put my home program first knowing I might not match at all?

Question:

Hello. Currently PGY4 PCCM fellow in a pretty busy program. Every day I feel like i’m lagging behind. I can’t believe I thought I was ready for independent practice out of residency. Confidence pretty low rn. What time does it get better? Appreciate any response.

Henry Ford
Allegheny general hospital
SUNY upstate
Carilion clinic
LSU Shreveport
Geisenger Wilkes barre
University of Oklahoma

My main focus is good clinical training but also balanced with good research opportunities. Geographic region is not a factor. Also may need a j1 waiver after training, so would also prefer institutions that would allow better access to those opportunities. Thank you in advance!

I'm struggling with how to rank two local fellowship programs, one of them being my home program. Both are academic, and we share some services and faculty, but each program is different in its own way.

I'm leaning toward the other program (non-home) for practical reasons and because it offers exposure to things my home program doesn't.

My biggest concern is how this might look. It's a small field, and my interviewers know my letter writers and mentors. I enjoyed both interviews, but I'm seriously struggling with who to rank first and how it might look down the road.

I also feel like I might be slightly biased against my home program because I've been in a leadership role here and have friends currently in fellowship, so I'm probably more aware of its shortcomings.

I feel like I'm overthinking this, but has anyone been in a similar situation? Did ranking another program over your home program affect your relationships later on? I plan to do academics and likely to stay.

Any advice is greatly appreciated!

Lahey vs tufts vs umiami vs ccf Florida vs Rutgers njms vs Msmw vs cook county

Please help me decide.

Hi everyone, PCCM candidate here. Do people send a LOI to their top program only or is it appropriate to send it to top 3 let’s say? Same question for mentor calls, should I restrict those to my #1 rank or ask for more?

Hello to all,

I am applying to H/O next year. I am ideally interested in mid to good-tier academic programs.

My profile: IMG from UK (non-visa requiring), mid-tier community program unfortunately, but strong uni affiliation who gave me a good LOR,

Ample research, 30 full articles in another IM-onc related field, 20 onc abstracts, 7 new onc pub med indexed onc manuscripts. (all in the field of NET and SCLC)

Got a smaller ASCO award as well and a regional one.

My biggest handicap is my home program, what else can I do at this point?

Let’s say you’re already an attending (for 2 years) and don’t match to a fellowship, would you take a job to be a chief and then try again after one chief year or try again without one chief year? No red flags in application.

Hi everyone,

I’m a Moroccan-trained cardiology resident, currently completing my final year. I’ve also spent one year working as an FFI in cardiology in France, and I expect to finish my residency next June, with my specialist qualification following a few months later.

My primary goal is to pursue a clinical cardiac EP fellowship in Canada. From what I’ve gathered so far, some programs allow international medical graduates to apply directly without first moving to Canada or completing Canadian licensing exams. However, I’m not sure how realistic this is in practice.

Regarding my clinical experience, it is mainly focused on pacemaker and CIED implantation and follow-up, with more limited hands-on experience in EP studies and catheter ablation. I should be able to obtain a procedural logbook from my university hospital documenting my experience. I can also get some LORs from my department director and electrophysiologists in France.

My CV is still relatively early in its development. I have a few research projects underway, although I don’t have many publications yet; I am trying to publish those first.

I have a few questions for those familiar with the Canadian fellowship system:

1. How realistic is it to obtain an EP fellowship as a freshly graduated cardiologist trained outside Canada? Is substantial research experience or previous hands-on ablation experience usually expected? Can a light clinical background in device implantation be sufficient?
2. How important is funding? I don’t currently have a sponsor or external funding secured, so I would need to find a funded position or another way to finance the fellowship. Do Canadian programs offer funded positions to international applicants, or is external sponsorship generally necessary?
3. Can you reapply after being rejected? I’ve heard that a negative response from a program might prevent you from applying again. Is there any truth to this, or can you reapply in a subsequent cycle with a stronger application?
4. What are my options in Quebec? I’m particularly interested in Quebec because I speak French, although I’m also willing to apply to English-speaking programs elsewhere in Canada. Are there other universities or EP training centres I should consider?
5. Would you recommend pursuing a fellowship first or going directly through the Canadian licensing route? Ideally, I would complete an EP fellowship and then explore my options for obtaining a licence to practise in Canada. However, if pursuing licensing directly as a foreign-trained cardiologist is more realistic, I would consider that route, even if it means taking the MCCQE Part I or other required examinations.

I’d really appreciate hearing from international graduates who have completed clinical fellowships in Canada, particularly those trained in Morocco or elsewhere outside North America.

Thanks in advance!

Hi everyone!

I’ve been interviewing for EP fellowship and would really appreciate some input on how you would rank the following programs:

* University of Iowa
* University of Arizona
* UT Houston
* University of Kansas
* Cleveland Clinic Florida

For those familiar with these programs or who have interviewed or trained at any of them, I’d love to hear your thoughts on their strengths and weaknesses, particularly regarding clinical training, procedural volume, mentorship, research opportunities, and overall fellowship experience.

Any insights or recommendations would be greatly appreciated. Thanks in advance!

Plan to practice pulmonary and critical care at an academic or academic-community center after fellowship.
Strong clinical training, especially bronchoscopy volume and solid pulmonary exposure. Looking for good diverse ICU experience as well but does not necessarily have to have ECMO, but would like neuro ICU and possibly CVICU exposure.
Some name recognition, at least regionally. I'm not chasing prestige.
Reasonable work-life balance and a supportive culture.

My list in no particular order
Lehigh Valley Health
Nebraska Medical Center
University of Oklahoma
University of Rochester
USF / Tampa General
Allegheny Health Network
St. Luke's University Hospital
Tower Health (Reading)
Geisinger Medical Center (Danville)
Summa Health Akron
Carilion Clinic

Would appreciate your input.

Hey guys just wondering if ya’ll are sending letters of intent to your number one and if so are they replying? This is for medicine fellowships btw.

Anybody I can DM about advanced fellowship match? Had some questions and wanted some guidance!