[eyoab2011_711]

There are tremendous challenges in translating what the academics believe to what is actually possible.  Technologist ability and availability of radiologists capable and willing to read studies are in short supply particularly as envisioned as a 24/7 service.

[Unknown Member]

No.

[ranweiss]

Would avoid cardiac fellowship. Sure, can get a job. But at most private practices, there wont be much for you to do. At many places a good chunk of what falls under cardiac imaging goes to the cardiologists. 
 
You’re far better off doing a body fellowship that has some cardiac included. 

[Unknown Member]

There is a need for cardiac imagers, but for the most part it is in the bailiwick of cardiology.
I just dont see a future in it for radiology.
The heart is not our strong point, thats just the truth. To have a rad read it in between chest Cts and brain MRIs is unrealistic.
Megagroups can afford to have dedicated readers, but most cannot.
Listen, a cardiologist with an imaging fellowship is going to have a huge advantage over the vast majority of radiologists.
There is some turf that we need to let go. Those that stubbornly hold on to cardiac imaging are in a losing battle.
Honestly, I want a cardiologist reading my cardiac imaging. A good one, of course.

[radiologistkahraman_799]

I kinda dissent here.  We have seen an explosion in cardiac imaging and I think this is just the tip of the iceberg.  We still hold on the all the cardiac (excluding nucs and echos) and plan to going forward.  Does it warrant a full 1 year fellowship, probably not.  IS someone who can read CCTA and cardiac MRI marketable, sure, as long as you can slog through a fair share of body and likely PET. 

[Unknown Member]

Well, the reality is that I see few colleagues who want to dedicate the time to master cardiac imaging in general. I think you really need to understand and be able to interpret all relevant cardiac modalities to be taken seriously; o/w you’re like a nucs who doesn’t do radiology. You have to be able to integrate all modalities, including echo, nucs, cath, cta and mri.
 
In my experience, there are a minority of rads that want to make the effort. If they truly become champions and are available whenever needed, it can take off. But in reality, most only want to do it at their convenience, which never ever works. You need horses willing to sweat and aggressive in their management of the imaging. It can’t be a hobby.
 
 

[aldoctc]

Here’s a plausible scenario:  
 
You do a cardiac imaging fellowship, then go to a PP that has a big hospital that wants to up it’s cardiac service.  
 
So you put in the time and effort to optimize protocols, train techs, encourage referrals, etc.  Things start slowly but after a few years, it’s a pretty busy service.  
 
The cards notice and at their next hiring cycle, loudly complain that they just can’t hire another card unless he can do cardiac imaging.  Admin will ALWAYS listen to cards so the new card is hired and starts doing cardiac imaging.  
 
Within 5 years, there will be at least a couple more cards hired that “just have to” be able to read cardiac imaging.  Your volumes drop to almost zero.  
 
This is basically what happened to cardiac NM and is what I’ve personally seen regarding cardiac CT and MR.  
 

[Unknown Member]

I read Cardiac daily in PP, and take all comers:  Nucs, MR, CT.
 
I do it because I enjoy it.  Don’t let the naysayers stop you, if you enjoy it.  But I mainly do it as niche imaging, a little carve out on the side, so to speak.  I am primarily a general diagnostic rad, which is what most any group will hire you to do.
 
Rather than a dedicated Cardiac fellowship, I would go with Chest imaging instead, so you can do HRCT and the like (even Mammo, if so inclined).  You will still probably do general imaging in most PP, for the most part, but it’s good to have something you enjoy.
 
I did 3 months training at Northwestern in Cardiac, and that was more than enough.  I had already done Nucs, and had the cardiologist’s credential in Nucs (very important should you go this route), and found MR and CT to simply be complementary modalities.
 
The real key to Cardiac, I think, is knowing which switch to throw when.  Know which modality answers the question at hand.
 
From what I’ve seen coming down the pipeline, I believe coronary CTA will pretty much be replacing most modalities, including the negative cardiac caths.

[grandhsu]

Agree with shumes. Do a chest/cardiac. We are are a medium size PP and have enough for 1.5 FTEs of just that. CCTA, echo, minimal nucs, tons of chest CT. Right now cardiac MR difficult to keep viable due to table table and reimbursement but those change all the time.

As was said before, if it brings you professional satisfaction, go for it. Realize we cannot predict the future. Ive been doing cardiac CTA since we had 4 slice scanners at the turn of the millennium

[smfst7_929]

Juice isnt worth the squeeze. Especially for cardiac mri. Time spent per rvu is in the realm of fluoro. Just not worth it financially for most PP.

[satyanar]

Fellowship not necessary. Just declare it an interest and spend some time learning. Thats how all of the academics became experts. Any hospital will be happy to have the new expert read the cases. So will the cardiologists.
 
I wouldnt worry about them trying to take the turf. If they are busy like ours they want to do the big ticket items. Its a drag on their work day to sit and read cardiac CT/MR. At least thats been our experience.