At our institution, you will be working side by side with Advanced Practice Providers as a Cardiology Fellow. Would you have any issues in doing so?

"During residency training, I got to work very closely with APP staff in the hospital, clinic, and ICU setting and they were amazing to work with. They greatly improved patient access, which is a benefit to all. They are also very knowledgeable in procedures and can be the second set of eyes in many situations. In the state where I trained for residency, they did not have a full scope of authority, and physicians needed to sign off on any prescriptions they wrote. Can you talk about your state's scope of practice for APP staff?"

Over the years, there has always been some hesitation for physicians to work alongside APPs in their practice. But the reality is that most large institutions have made the financial decision to employ and use more APPs in practice and your interviewers need to be assured that you are comfortable training in this situation and that you will be a great team player with Nurse Practitioners and Physician Assistants.

Your answer to this question can be a pretty short and sweet 'no' that you wouldn't have any issues in working closely with APP staff while training during Cardiology Fellowship. To further solidify your response to this question, try to highlight some of the positive aspects that Nurse Practitioners and Physician Assistants can bring to a practice.

"No, I have worked with Physician assistants and Pharmacists in ICU. They have always been very helpful in providing suggestions and correcting our medication orders. They are just like a pair of second set of eyes. I have always appreciated their presence."

"Absolutely not. Some of my best learning during residency has come from working alongside NPs and PAs. Often they have a lot of experience in their specific niche that they are more than willing to share with residents. NPs in particular have good insight into the nursing perspective and help make me a better doctor by showing me how to order things in a way that set nurses up for success."

"None. I believe that to provide the best possible care to our patients we must approach medical care in a multidisciplinary fashion. In the perfect scenario, a team should be composed of residents, fellows, attendings, pharmacists, PA/NPs, and SW/CC. I also believe that you can learn from anyone, despite of their title."

"Throughout my residency I found APPs to be very helpful. Because they generally practice in a very specific area, they gain mastery of it very quickly. For example, working in ICU nights the APPs were invaluable in helping us residents place central lines, hemodialysis lines, arterial lines, and so on. By having providers who are highly trained in an area that residents /fellows have only familiarity with, the learning experience is enhanced as well as patient safety."

"Not at all. During residency, I've worked very closely with NPs and PAs, and I've learned how to learn from each provider."

"During my residency training, I have worked alongside APPs and learned and shared medical knowledge. I think they are a great addition to the team, to deliver patient care successfully. I enjoy discussing the latest advancements and nuances of medicine with everyone on the team."

Tell me about a time you received constructive criticism from an attending physician or senior resident during your residency training. How did you handle that situation?

"During my elective oncology rotation during my 2nd year of residency, I was told that I spent too much time with patients during both initial and follow-up consults. As a result, I was causing delays in the clinic. Seeing new cancer patients was a new environment for me and my nurturing inhibitions took over in most situations. After some coaching from my attending physician on how to best handle consults, I got a very good feel and flow of patient consults moving forward in that environment. I didn't take the criticism personally and knew it was for the best in my professional development."

It should be abundantly clear as you enter Cardiology Fellowship training, that your work will be scrutinized to the nth degree by the senior fellows and the faculty of the program you join. Your interviewers want to know that you can take any constructive criticism you receive and turn it into a positive learning opportunity.

Choose an example that does not highlight a significant or persistent deficit in your ability to provide care. How you handled this criticism should show your devotion to providing optimal care and willingness to use the criticism to shape how you approach patient care moving forward. Don't hesitate to reiterate to your interviewers that you would join their Cardiology Fellowship program ready to accept any constructive criticism that would come your way.

"As an intern, I used to get flustered when attendings asked me questions on rounds that I didn't know the answer to. I received very useful feedback early in my intern year that I really took to heart and based on many new interns myself as a senior resident: "Talk through what you do know, admit where your knowledge gap lies, and ask to learn more. And do it all calmly and confidently."

"During my first rotation as a senior, my attending gave me feedback on keeping the handoffs updated, and that they should be updated daily. I realized that doing it was not part of my daily workflow consistently, after listening to her I modified my daily workflow to update handoffs every day after running the list with the interns and attending in the afternoons."

"During my ambulatory clinic week, I used to take a great amount of time addressing as many issues as I could. I received feedback during my clinic evaluation that a skill that I would need to work on is time management and addressing pertinent issues to not hinder the clinic workflow. I took this feedback and was able to triage issues that needed to be addressed during this visit."

"During my second year of residency training, I received feedback from my attending physician, to incorporate family's opinion to make patient care-related decisions. As a budding doctor, I spent a lot of time collecting history and evaluating patients but allotted little time to discuss the care with the patient's family. As I evolved in my training, I started to update the daily changes in patient care and new findings with the patient's family. They felt included in decision-making and felt more satisfied with the care provided to their dear ones."

If I asked your friends, what would they say are your strengths and weaknesses?

"If you were to ask my core group of close friends, they would tell you that my strengths are my communication and motivational skills. I have an infectious spirit that is able to connect with any type of personality and help me work well as a team. They would also tell you that my weakness is self-criticism. I frequently reflect on my words and actions and wonder if I should have said or done something different. I have learned to call my patients to provide new information about important issues that I may have neglected to discuss during their appointment."

You will likely talk about your strengths and weaknesses throughout your Cardiology Fellowship interview. This question is unique because they request that you answer from the perspective of your friends, rather than your current resident colleagues or the attending physicians you've worked with in the past.

Give a strength that is unique to you and applies to the field of medicine. It is a common strategy to offer a weakness that is actually a strength (e.g., "My weakness is that I work too hard"). The interviewers will recognize this as a transparent tactic. For this reason, you must provide an example of a legitimate weakness that you have worked to improve. You should not offer more weaknesses than strengths in your answer.

"I have a unique ability to bring people together. Socially, I seamlessly integrate friends from different parts of my life and help them find common ground with each other. This is useful in the hospital, where having friendly relationships with patients, doctors, nurses, and ancillary staff is key to having a successful team dynamic. In terms of weaknesses, I have a tendency to overcommit. I get excited about new research projects, or teaching opportunities that seem "up my alley" and take them on even when I have a very full plate. I am learning that less can be more. Recently, I decreased my involvement with a research project in the ED so I could focus on my cardiology research more. The result was that I could devote more of my protected research time to the cards project and ended up making enough progress that I was able to submit an abstract to PAS and present a poster at the conference this spring."

"Regarding my strengths, I strongly believe that people who know me will tell you that I am structured, efficient, and always smiling. Regarding my weaknesses, I believe that if you asked people close to me they would tell you that I am hard on myself and that it is hard for me to forgive past versions of myself."

"Honestly, my friends would say that I am great at bringing people together. I have a very infectious spirit that makes me create an environment that is fun and happy. I love bringing people together and creating safe spaces for everyone. My biggest weakness they would say is that I am a perfectionist and sometimes put a lot of pressure on myself. I have learned that it is important to take a step back and sometimes take a deep breath and triage on important things so I don't get overwhelmed."

"One of my friends would say that one of my strengths is my ability to quickly be able to triage medical situations and recognize which patients need immediate/emergent care. A weakness of mine would be at times what I call "decision paralysis". This stems from difficulty dealing with uncertainty. I have worked on making well-thought-out decisions and going forward with them in a timely manner."

"My friends and coworkers say that I am someone who likes challenges. I thrive in challenging environments with successful results. For example, I was the only resident who went to away electives, with writing assignments, presented 2 posters at AHA, and wrote 1 case study for JACC case reports. I enjoy talking about the latest advancements and research findings during reports."

Is there a personality type that you find most difficult to work effectively with?

"I am most often challenged by staff who are poor communicators. As an Internal Medicine Resident, I found that communication lines should always be open between residents, faculty, and the care team. If someone on my team wasn't communicating properly during residency training, I never hesitate to respectfully approach them to explain what I need from them concerning communication. If the problem persisted, I would take it up the proper chain of command. I would use this same approach in training in your Cardiology Fellowship program."

As you enter Cardiology Fellowship training, you will work side by side with a very diverse group of fellows and faculty, each with their unique personality and work style. Your interviewers ask this question to understand your ability to work with even the most difficult personality styles.

Pick a quality that doesn't reflect poorly on you. Talking about demanding personalities may make you seem lazy or unable to work with demanding faculty at the program. Instead, choose a quality that impairs the ability of even the most competent and hard-working doctors from delivering high-quality care or working as part of a high functioning team.

"Most of the time, I don't have problems or difficulty working with any personality. I am easygoing and can adapt to a lot of personalities. But I kinda have difficulty working with the staff or attending who are always in my way and not agreeable with any other plans. In the management of many medical conditions, there are no clear right or wrong answers. And sometimes if the attending is not agreeable with any other plans and I have to go back to him for every detail, sometimes cause delay meant in the medical care."

"I find it difficult to work with physicians who treat others with disrespect. No matter how smart you are and how well you know the medicine, you cannot be a good doctor if you don't treat your patients and colleagues with respect. As a senior resident, I made it a point to advocate for my juniors when I felt they were not being treated fairly. I also think that no matter how acute the environment, you must make clear, respectful communication with patients and families your first priority."

"I particularly find it difficult to work with people who try to put themselves up by bringing everybody around them down. Or with conformist people."

"It would have to be someone with a rigid non-flexible way of thinking. This is especially difficult to work with because it is very hard to change their initial assessment and opinions which may lead to anchoring bias and failure to appreciate that many situations in medicine are complex and not black or white."

"I find it hard to work with coworkers who are unable to express their thoughts and actions clearly, like verbalizing with effective communication, for example, language barriers, to begin with."

How do you think you will perform under pressure as a Cardiology Fellow?

"Just a few weeks ago, I was working a night float rotation in a maximum capacity hospital unit. Given that several units, including our general ICU, were full, our workload was increased greatly. Knowing that there was no time for small talk, I buckled down and handled every patient one at a time and worked my way through the patients on the 12-hour shift. I made sure to take the time after each patient to document my notes as I normally would. Communication during this shift was vital, ensuring that all providers and nursing staff were on the same page. The attending physician and I worked through some hiccups with ease by staying in constant communication. This experience further helped me prepare for fellowship training and gave me the confidence to handle any situation with ease."

Your interviewers need to know that you have the tools and skillset needed to face the pressure that comes with training in their Cardiology Fellowship program. In asking this question, they're looking to hear you describe the tools, resources, and mindset you use to navigate the most pressure-packed situations as a physician.

To best prove your ability to handle the pressures of fellowship training, it is best to provide an example of a time you were challenged by a difficult workload or a pressure-packed situation as an Internal Medicine Resident. This can be a time you were managed several critical patients or you had a difficult workload. Discuss how you reacted in that situation, what you learned from this experience, and if you would do things differently next time. Don't forget to talk about the resources you used to ensure that you paid close attention to the fine details as well.

"Just a few weeks ago, I have been working in the CCU as a night float resident and we have been working at a maximum capacity at that time and getting a lot of transfers to our facility."

"I have always done my best work under pressure. Before med school, the two roles that most defined my personality were a soccer goalie, and a musician - often onstage performing solos in front of an audience. I have continued to demonstrate excellence under pressure during residency, excelling most in my high acuity rotations like the ICU and ED. High stakes motivate me to work my hardest."

"I am no stranger to working under pressure. Since the early stages of my, so far short, career when I worked in a COVID ICU or during my multiple MICU rotations (4 so far) during residency I have been subjected to working under pressure. This has allowed me to develop skills such as compartmentalising, dividing big tasks into smaller ones and always keeping a checklist to approach this scenarios. I believe that I am well equipped with tools to perform under pressure as a cardiology fellow."

"I believe that my internal medicine training has adequately prepared me to handle complex medical situations under pressure. My program was very heavy on ICU rotations and I remember that one night as a senior resident in the ICU I had a patient who came in with variceal bleeding and was unstable. While stabilizing the patient and initiating the appropriate medical treatment I also had to place a central line to secure access and delegate tasks for my interns to call the appropriate consultants to further the care of the patient."

"When I started my residency training, the first year was extremely stressful. When I was trying to figure out how to achieve my targets and actively learn at the same time, the initial few days were hard. I try to approach it one day and one hour at a time. I never shy away from asking for help. I never hesitate to seek advice when I am overwhelmed. Acknowledging is my power. At the end of the day, I meditate and assimilate all my learning to improve my experience for the upcoming days."

A recent patient survey comes back, and you find out that you did not meet a patient's expectations as their physician. What are the next steps you would take to improve as a Cardiology Fellow in training?

"I was faced with this situation as an Internal Medicine Resident and I didn't let it get me down. Our administrator approached me and I saw it as an opportunity to improve. The patient that submitted the feedback anonymously said that my approach was not personal. I took the time to analyze the feedback and remember which patient encounter it came from. It was really a turning point for me in the approach I now take with patients and appreciated the feedback in the end. I would take the same approach with patient surveys at your institution."

Patient satisfaction surveys are commonplace in any healthcare institution and are put in place to ensure that the best possible care is provided to every patient of the institution. During your time in Cardiology Fellowship training, your patients will fill out satisfaction surveys about your performance, and your team of interviewers poses this question to understand how you will take constructive feedback from a patient's survey and learn from it.

If you were to ask any physician if they have ever received critical feedback on a patient survey, the answer would be a resounding yes. The goal in answering this question is to demonstrate to your interviewers that you can take the feedback, analyze it, and use it as motivation to improve the care you provide moving forward. Keep in mind that most patient feedback is anonymous, and you may not be able to pinpoint the exact interaction that resulted in the feedback from the patient.

"I would try to understand how I could turn criticism into an opportunity for learning and improvement. As an intern, a patient complained about an inappropriately long wait for the CT scanner overnight specifically named me in the complaint. From this experience, I learned both what channels I had for escalating delays of care overnight, and I learned how to give a sincere apology."

"First, I would make sure that I find myself in the right state of mind to objectively analyze and assess the situation. Then, I would try to reflect on the reasons why the patient's expectations were not met and define if those were related to me vs a system issue. After that, I would approach one or multiple of my mentors to ask for advice on what they have done in similar scenarios."

"The next step I would take is to review the patient's evaluation carefully in an objective manner. I would then turn to my other patients' evaluations to see if there is a pattern. If there is a pattern in my capacity to meet expectations I would find the root cause of the problem and try to fix it. If this was an isolated event I would try to look at the situation from the eyes of the patient and take to heart not to repeat this in subsequent times. I would assume the evaluation is anonymous."

"I reviewed the survey myself and tried to understand the perspectives of the patient. Any modifiable behavioral pattern that I think would change patient satisfaction, I would be happy to implement it. For example, sitting down with patients and explaining their health condition and evaluation findings would be my first priority."

As a fellow, how will you explain a complex cardiovascular diagnosis, procedure, or other medical term to a patient using verbal instructions?

"I read once that most newspapers are written at a 5th-grade level so most people can understand the message. I think that today we are inundated with verbal and written messages, so what we choose to say should be prime real estate. Because of that, I strive to speak in a way that the patient or family can understand without filler or fluff words. I fully understand that I will be relied upon to educate patients as a Cardiology Fellow, and I'm very excited to do this. During my residency training, I took a simplistic and step-by-step approach to the patient and their family. I would stop along the way and ask them to repeat what I'm teaching them and use language and terms that best suit their educational level."

Your team of interviewers wants a full team of Cardiology Fellows who can be world-class educators. In your later years of fellowship training, you will be responsible for educating patients and junior residents. A question like this allows your interviewers to see how you would handle educating a patient on a complex diagnosis or procedure using only verbal dialogue.

Healthcare is increasingly complex, so it makes sense that the instructions can be as well. This question provides a chance to showcase your talent to take a complicated idea and explain it without losing the integrity and dumbing it down. Explain to your interviewers your step-by-step approach to ensure that the complicated subject is understood by your audience.

"I am particularly skilled at breaking down complex medical ideas into simple, jargon-free explanations. First, I give a brief overview, check for understanding with a teach-back, and then ask questions. Once I gauge the patient's level of understanding and level of interest in details, I can start filling in the description with more nuance, but it is important to lay the groundwork first."

"During my residency one approach that has been very useful and effective has been using drawings/diagrams/figures to try and match the concepts that I am trying to explain, using non-scientific terminology, to an image. Also, I always ask the patients to try and explain back to me what I have told them to make sure they understand it."

"I believe that one of my strengths is explaining medical terms in a simple way. The reason is that when I came to the United States when I was 1, English was my second language and I appreciated when other people would take their time and explain to me difficult words that I did not understand. I usually try to explain everything as simply as possible and I also like to draw diagrams and show pictures and videos online."

"Simple terms, without medical jargon, are my way of delivering information. Especially, at the time of discharge or during follow-up in the clinic, I explain to them what is happening with their health and what they need to do to modify their risk. I ask them to repeat, to estimate their understanding. I incorporate motivational interviewing prior to suggesting lifestyle modifications."

Tell us about a time you had to work with new technology during medical school or residency training. What did you do to ensure proficiency as quickly as possible?

"First and foremost, I want you to know that I understand that today's physicians need to embrace technology to provide the best patient care possible. I've always been enamored by great technological advancements in healthcare. More recently during the pandemic, one area that physicians need to embrace is telehealth, and I was fortunate to be exposed to this during my clinical rotations. Learning technologies like Zoom and other video conferencing apps was a new concept to me. Before beginning their use, I watched training videos and practiced having virtual consults with my classmates to ensure that there wouldn't be any technical glitches when I worked with patients. I am fully confident in my ability to use video for telehealth consults with patients."

Technology in the medical field has been evolving and will continue to evolve year after year. While you may be academically gifted, your interviewers need to know that you can pick up and master any new technologies in cardiovascular care during your time with them. During your Cardiology Fellowship training, you will likely work with many pieces of equipment you haven't had the opportunity to in the past.

Think of a time you had to learn new technology and choose an example that proves your ability to study, learn, and master its use in short order. Then, discuss with your interviewing team the fact that you know you will be learning a new EMR and other medical equipment during your fellowship training and are willing and ready to be a great learner of any new technologies thrown your way during your time with them.

"This spring on my cardiology senior rotation we had a patient with a total artificial heart be transferred from the ICU to the floor while she waited in-house for a transplant. As the senior, I made sure our team had adequate teaching before we arrived. I requested a lecture from one of our heart transplant doctors, and also a hands-on session with the device as well. I also made contingency plans for our team so that we all knew the proper channels for escalation 24/7 if there was a problem with the device that was not simple to troubleshoot."

"Having completed med school in Costa Rica one of the first things that I had to learn coming to the US was using the EMR. Before starting residency I made sure to complete the teaching modules to at least familiarize myself with the interface, during my first week I was asking my senior for a lot of guidance and questions to make sure that I became proficient as soon as I could."

"During my residency training, I had to learn how to work with the ultrasound. It was challenging at first because I had to learn how to recognize artifacts vs pathologies. To become proficient, I worked with sonographers to master manual skills. For the theoretical aspects, I read echos with my attending, read the American Society of Echocardiography guidelines, and watched lectures."

"During my away rotations at a university hospital, I had to work with EMR, which I never had experience with before. Initially, trying to do the mocks and training helped a little bit. As time went on, spending a few extra hours to gain information and arriving early to prepare for rounds helped much."

How would you deal with a disagreement among other fellow colleagues or senior fellow as a trainee with our program?

"It would depend on the disagreement. If the disagreement was with a senior fellow, I would defer to their opinion as they have more experience than I do. However, if I was concerned that they were making the wrong decision regarding patient care or providing subpar patient care, I wouldn't hesitate to discuss it with them respectfully. If necessary, I would go to the chief resident. For more serious issues, such as ignoring patient care responsibilities, I would go directly to the attending physician because these actions, or inactions, would be done under the umbrella of the attending's medical license."

Disagreements requiring outside help are inevitable during your time in Cardiology Fellowship training. Your team of interviewers wants to know that you would join their program with the ability to be respectful and diplomatic when you face a disagreement with your immediate colleagues.

For a colleague disagreement, you should go to your senior on the team. For disagreement with your senior, you should go to the chief fellow. If there is a significant and imminent risk of harm to the patient, you should go to the attending physician. Walk your interviewers through how you would first try to handle the disagreement among yourselves and then take it up the chain of command as necessary.

"First, I think it is always best to speak to the other person directly and see if a consensus can be reached. If not, disagreements can be escalated up the chain of command to senior fellows or attendings as appropriate. If there is a chance of patient harm, this escalation needs to happen faster."

"I feel that disagreement by itself is not a problem, it is an opportunity to approach a situation from different perspectives. What I believe could be a problem is if during the said discussion the respect, cordiality, and the level of the conversation is lost. Communication is key and having open channels of communication will aid in resolving disagreements, also you do not have to solve problems in isolation, you can always approach your chief fellows, APD, PD, and such."

"I believe that communication solves all problems. I would typically like to settle whatever disagreement in private as I believe that would create an environment that would most likely facilitate conflict resolution. I would hear what the other person has to say and also table my post and hopefully, we can come to a compromise. I had a time in the unit where my intern wanted to do the procedure later in the day and I suggested we do it earlier in the day. They wanted to get their work done before doing the procedure but I explained that I understood why they felt that way and that we should do the line first because it would delay patient care and I offered to help them with a few of their discharges to lessen the work."

"I would first and foremost try to see the problem through my colleague's point of view. My experience has taught me that even when I am convinced I may be right, I eventually discover that my approach could be improved. Moreso as a trainee, I believe that active listening is crucial. I feel that my willingness to admit when I am wrong and receive feedback makes it possible for me to resolve arguments very quickly."

"Evidence-based medicine has always been my approach. If my co-fellows have a different opinion than mine, I try to understand their perspective. I tend to look up the latest research and guidelines on the topic and discuss about my findings and learnings. If there is any data I am missing, that would be a great opportunity to learn."

What invasive procedure are you most excited to learn during Cardiology Fellowship training?

"During my residency training, I feel like I got very good exposure to stenting and performing angioplasty and I'm looking forward to expanding and mastering those minimally invasive procedures here. I'm most excited about performing catheterizations of the heart because this procedure is so vital in evaluating a patient's blood flow to and from the heart and determining the best course of action for them."

Coming out of Internal Medicine Residency and in hopes of landing a great Cardiology Fellowship position, you are well aware of all of the invasive procedures that you will be learning over the next three years. With this question, your interviewers are looking to hear what invasive procedure is most exciting to you and learn a bit about what you will be trying to accomplish during your time training with their program.

Come to your interview prepared to openly discuss the one or two invasive procedures that excite you the most. With no right or wrong answer to a question like this, your interviewers will be keying in on your passion and drive for the procedure you are most excited about and you'll want to display both passion and drive as you answer.

"I'm very excited about the cath lab. As a med student, I shadowed an ablation for a patient with WPW in the cath lab and thought it was amazing how the electrophysiology doctors and the cardiac cath doctors worked together to figure out exactly where the aberrant pathway was located. It's amazing that a minimally invasive procedure can fix such a potentially serious problem."

"I believe that to be good at anything, you have to begin with building a solid foundation. I am looking forward to becoming very proficient at obtaining vascular access for invasive hemodynamic monitoring and circulatory support."

"I am very excited about the ICD placement. The reason is that since medical school this device was the subject of my research. Through this research, I was amazed by its effectiveness in the prevention of sudden cardiac death. To be able to place one and know that this device would probably save someone's life one day would be a privilege."

"Cardiac catheterization. During my residency training, I was always behind the doors, trying to understand the images and learn from them. I want to perform my first PCI, for a STEMI. I am looking forward and most excited about it."

Talk about the most interesting case you were exposed to during your residency training. What made it so interesting to you?

"The most intriguing case I was exposed to during residency training was a teenage patient presenting with vaccine-related myocarditis. After experiencing chest pain for multiple days following the second dose of the COVID-19 vaccine, lab results show elevated inflammatory markers in the patient. For me, this case was so interesting because it was really new and unfamiliar to the attending physician I was rotating with. Getting to see how the physician walked through communications with other professionals in the field and networked with others was an experience I'll take with me for the rest of my career."

Your interviewers want candidates who have a great overall passion for medicine as they consider who to match into their Cardiology Fellowship program. This conversational-based question is intended to get to know the types of cases that you find most interesting.

Before your interview, think of what you consider the most intriguing and thought-provoking case you saw during your residency training. The cases that are most interesting to you should pertain to the specialty you want to pursue. As you answer, take a few minutes to set the stage for the case, name a couple of points that intrigued you, and explain why. If you know the outcome of the case, discuss that briefly as well.

"I am fascinated with congenital heart disease. I remember my first delivery as a resident was, coincidentally, for a patient with transposition of the great arteries. Fully aware that this was previously a life-limiting condition, I was in awe of the major impact prenatal diagnosis and early surgical correction have made in the lives of many patients with congenital heart disease. I watched the bedside balloon atrial septostomy be performed shortly after birth and had the privilege of watching the parents receive the news that all had gone well. Seeing the extreme relief on their faces made me appreciate the important role pediatric cardiologists play in patients' lives."

"One of the most interesting cases that I saw during my residency training was a case of euglycemic DKA in a patient with severe interstitial pancreatitis. He was intubated, on CRRT, and was requiring a lot of postfilter bicarb. This led me to suggest that maybe he was suffering from euglycemic DKA, and if we corrected it with an insulin drip we might be able to scale back on the CRRT. So we checked a BHOB, confirmed the diagnosis, started an insulin drip, and were able to transition to HD."

"The most interesting case I was exposed to was dilated ischemic cardiomyopathy in an 83-year-old patient years after CABG who had patent graft vessels on an angiogram. Initially, the concern was for Coronary subclavian steal syndrome but the cause of ischemia was not subclavian steal as there was antegrade flow through the LIMA. The cause of the ischemia was poor retrograde flow through the left vertebral artery with a pressure of 50 mmHg. The patient had ultimately undergone a right to left axillary-axillary bypass surgery."

"The most interesting case during my training was a young lady who came in with IE. This is the case I wrote a case report on. I was partially accepted, with changes made and re-submitted. Young lady with IE, how the team utilized a noninvasive intervention to debulk the vegetation, before valve replacement."

Do you have any thoughts on how would you like to see the delivery of healthcare evolve in the coming years?

"CV medicine has been such a trendsetter in modern medicine for innovation and I can't wait to see how it evolves throughout my career. I look at how minimally invasive procedures like CABG have helped prolong the lives of patients and are now done through a simple procedure. I would really like to see imaging in cardiology continue to evolve and advance to bring 3D imaging to a new level."

Your interviewers want to better understand how you feel healthcare can evolve for the better, specifically for cardiovascular care. Demonstrating a forward-thinking and innovative vision will set you apart from the other candidates competing for a spot in this Cardiology Fellowship program.

Put some thought into questions like this before your Cardiology Fellowship interviews so you are prepared to talk in an educated manner about how the delivery of healthcare can improve over time. Perhaps you feel that healthcare can best evolve through more patient-centric attitudes. Maybe you think that care coordination and synergy within the administration is the fastest way to improve care. Maintain a positive attitude and describe how you feel healthcare is currently evolving.

"I think the most important trend in medicine is empowering patients with the knowledge to make their own decisions. Through innovations like open notes and myChart are contentious among physicians, I think they are rooted in the right impulse - transparency."

"I feel like today's healthcare is very fractioned. In my experience, patients are usually seen by multiple specialists for multiple problems which sometimes creates a lot of gaps in the patient-physician relationship. I would like for care to be provided in a more unified approach where the patient's PCP has a more prominent role."

"I would like the delivery of healthcare to utilize more telemedicine. I believe that telemedicine bypasses barriers to patient care in underserved areas as patients tend to miss appointments due to lack of transportation, job/family obligations, and disability. Being able to participate in telemedicine can provide great continuity and allow a multidisciplinary approach to patient care."

"Community reach. I come from a medically underserved area, where patients are so poor, they could not afford to 2-hour trip to a tertiary care facility, for advanced care. More practitioners in training and delivering efficient patient care to the community. Utilizing allied health care professionals and improving education for primary prevention of cardiovascular disease."

Are you considering or interviewing with any other Cardiology Fellowship programs?

"I have formally applied to many of the reputable Cardiology Fellowship programs across the country because I want to give myself the best chance of matching into a program with a reputable academic and research center. No matter the number of interviews I complete, I hold your program in the highest regard because of the academic and research success that your past trainees are now having in practice."

It is no secret that hopeful Cardiology Fellows are encouraged to apply to many programs to better their odds of matching. This number of applications can often exceed 40. It always puts a little bit of fire under the interviewers if they are aware that you are actively pursuing many opportunities, especially if you are a top candidate of theirs.

Talk openly about the applications you submitted, but emphasize your interest in this particular Cardiology Fellowship program. Give the specific reasons you want to complete your training with this program and explain how the program will benefit you in the pursuit of your dream career as a physician.

"I am interviewing with a handful of cardiology programs in the New York area. My personal life is firmly rooted here and I am not able to move, so I am very serious about each of the New York programs. I am particularly interested in Mount Sinai as someone who plans to pursue general cardiology and advanced imaging since that is a particular strength at Sinai. I also think there is value to training in different hospital systems for residency and fellowship so you can develop a fuller perspective of the field."

"Yes, the data suggests that applicants with 8 or more interviews have the highest chance of matching into a cardiology fellowship. Because of this, I have applied to multiple reputable programs to increase my chances of matching my dream specialty. Having said this, my priority is to match into your program as I believe that it would provide me with the best education, tools, and environment to achieve my goals."

"The reason I am considering interviewing for other fellowship programs has to do with the uncertainty of the match process. I have two goals: to train in cardiology and be close to my family. Applying to a broad range of programs in the area will increase the odds of achieving both goals."

"Yes, I am considering interviewing in other programs, and I have applied broadly. However I would like to stay in this area as I live close to my home program, and I have connections with the area."

How would you stay on top of trends and changes in the field of cardiology during your time as a fellow with our program?

"Knowing two years ago that my dream was to pursue Cardiology Fellowship training at a reputable institution like yours, I immediately became a member of the American College of Cardiology and the American Heart Association. I currently subscribe to the JACC journals and would plan to fully immerse myself in CME opportunities with the organization during my time in training and throughout my career."

Your interviewers want to know that you will fully immerse yourself in your field as a Cardiology Fellow with their program. This includes keeping up to date on new trends and having a great understanding of the challenges the industry faces, both now and in the future.

Talk about a couple of the resources you use to stay on top of medical industry trends. You might also ask the interviewers if they have any recommendations for you. This can start a conversation that will be helpful to you! Before your interview, look into the Internal Medicine and subspecialty groups, journals, and publications you are interested in to be able to talk about them more.

"Cardiology and medicine in general are evolving at an astounding rate. This is super exciting for me as an applicant. To stay on top of trends, I like to scan JACC and the AHA journal to try and keep up with the emerging trends."

"To stay on top of trends I try to attend conferences to learn about innovations in the field of cardiology. I also listen to podcasts from experts in the field. Finally, when I see patients in the hospital I make sure to read about their condition on update to make sure that I providing the optimal care according to today's guidelines."

"I keep myself updated by reading the latest articles and research work published by reputed journals like JACC and JAHA. Also, I listen to podcasts by famous cardiologists, and channels like Cardiacwire, etc on my phone, while I drive and work out."

We are always looking for our fellows to participate in, and even lead, code teams at our facility. Are you willing to participate during Cardiology Fellowship training?

"I would jump at any chance to participate on the code blue or code yellow teams at your facility as a fellow. I am well versed in cardiac arrest situations and love the quick thinking and fast-paced environment of saving a patient's life. As you can see, my residency training is in New York City at a very busy metropolitan hospital. Code teams were a marvel to watch in action the few times they came to units I was rotating on."

Cardiology Fellows that are fortunate enough to be invited to and participate in code teams during their training gain invaluable experience that they can bring to any future practice after training. It is a highly desirable skill and experience by many employers. Your interviewer ideally wants to hear that you would jump at an opportunity to participate in code teams.

For the first part of your answer, it is a good idea to let your interviewers know that you are familiar with the code teams in any hospital type setting. Be sure to elaborate on the fact that Cardiologists typically participate on the code blue and code yellow teams within the hospital and express any code teams that you would relish being a part of.

"Of course. Leading a code effectively is a very important skill and one I have been working on honing during residency. We have a mock code curriculum twice a month and I never miss a lecture and always jump up to participate. I also was selected to be on our Sim Olympics team and competed with a team of 5 Chony residents, coming in first. I also have a lot of experience responding to rapids and codes as a senior resident at Columbia."

"Absolutely. During my senior year of residency, I was in charge of leading codes in the hospital during my call days. These gave me a lot of exposure to them, allowing me to feel comfortable leading and participating in them."

"Absolutely, I would love to participate in and run code teams, I was part of the strong team in my facility as well. As part of my training, I am required to run codes on Internal medicine services, typically 4-6 months every year, during my 3-year training."

How would you describe your personality using just three words?

"If I could describe my personality to you in three words, I would say that I am compassionate, intelligent, and fluid. My personality is well suited for the cardiovascular care environment as my patients' well-being is always at the top of my mind. My intelligence will carry me through my fellowship and into my career as a physician focused on both clinical care and translational research. My ability to adapt and change with any situation sets me apart from most people because I thrive in environments where things don't remain constant every day."

Your interviewers pose this question for two reasons. First, they want some insight into your personality to get a feel for how you will fit in with their Cardiology Fellowship program. They also want to hear how you view yourself. Notice they do not ask how others would describe you but how YOU would describe yourself.

Since you only have three words, make sure the words that you use will make a lasting impact on your interviewers. Some possible words to use include adaptable, brave, compassionate, respectful, helpful, positive, thoughtful, and versatile. As you prepare for a question like this, try to avoid giving the same answer other candidates give. Explain your reasons for choosing these words to describe yourself.

"Determined, emotionally-intelligent, curious."

"Structured, efficient, and joyful."

"I am enthusiastic to learn, responsible, and committed to pursuing my dreams."

Would you have any hesitation referring a patient to another cardiovascular specialist or another specialty practice?

"I certainly plan to practice along the lines of cardiology and any subspecialty I'm qualified for as a fellow and future Cardiologist, when I can and when it's appropriate. I will make liberal use of consultation for the best health impact on my patients. If another specialist does something better or is more qualified from a regulatory standpoint, I will willingly defer to or partner with him or her on the case at hand."

In a large group practice, like you will be joining in this Cardiology Fellowship, the ability to refer a patient to another provider really puts the needs of the patient first. Your interviewers need to be assured that, once you make the correct diagnosis or need an extra set of eyes, you wouldn't hesitate to refer a patient to the proper specialist.

Make sure that you discuss your own awareness and personal feelings on providing the best care possible to patients. This will entail coming to realize that you can't do it all for every patient and you'll have to rely on the help of other provider colleagues at times. Your answer should be centered on what is best for your patient, not winning some turf battle.

"Never. As a physician one the qualities that you must relish is humbleness and respect. You have to be very aware of what your tools, capabilities, and limitations are to make the best decisions for the patient's sake. If there is an instance where your capabilities are not enough to adequately take care of a patient, you are in the obligation to refer them to a place/practice/hospital that can effectively do so."

"Absolutely not. During residency training, our facility had 3 interventional cardiologists and one diagnostic cardiologist, unfortunately, we did not have a cardiothoracic surgeon. We were unable to take care of patients requiring valvular interventions, and several other cardiac pathologies requiring CTS support. In such instances, we referred our patients to a tertiary care setup in this city."

Do you believe telehealth is an effective form of healthcare delivery, specifically as it relates to cardiovascular care?

"I believe that telemedicine in cardiovascular has its place, but it's not for every patient care situation. I know that many large institutions are using it with their smaller community hospitals before making the decisions to transfer patients to larger centers. As long as baseline readings can be taken and interpreted, a physician on a virtual visit can make the call to transfer or to not stress the patient and keep them remote."

While telehealth principles have been applied to patient care for years, it has come to the forefront in recent years. Your interviewers want their future Cardiology Fellows to have a positive outlook on telehealth and a vision for where it will go in their future down the road as physicians in practice.

Although telehealth has limitations, including the inability to do a physical exam and obtain vitals, it is a useful way to reach out to patients who otherwise would not be able to get care when needed. For this reason, any future physician in practice must embrace telehealth platforms while recognizing that they are not ideal. Your answer should provide the pros and cons of telehealth as it relates to cardiovascular care, along with any direct examples of its use you are familiar with.

"Though it is limited in some respects, it has amazing potential to increase access to care. There are certain questions that can be answered over video chat and lowering barriers to care is important for families with time or transportation limitations."

"I do believe telehealth has a role in delivering healthcare, and we should not make the mistake of thinking that it will substitute for physically seeing a patient. It can be really useful in connecting with patients after a physical visit to discuss certain test results, certain changes in plans, or even follow-ups to evaluate a response to certain treatments, persistence of symptoms, etc."

"Telehealth is a great way to follow up with patients, especially in cities, where it takes a long time to travel to doctors' appointments. Also, for patients who require assistance with driving, telehealth is a great option. I believe it improves adherence to follow-up appointments, no matter the specialty."

What is motivating you to pursue Cardiology Fellowship training?

"Early on in medical school, I learned firsthand that practicing as a general cardiologist would be a perfect blend of fast-paced acute care and the opportunity to build long-term care relationships with patients. I love the fact that I will get to work with patients that I can build a long-term relationship with and also help them live healthier, happier, and more fulfilled lives practice cardiology."

Coming out of Internal Medicine Residency, many are tempted to hit the workforce and go directly into practice for the financial gain and to practice medicine after many years of education and training. Your decision to pursue a Cardiology Fellowship training program hopefully means that you have a career path planned out. Your interviewers want to hear your ultimate career goals following your training or any additional fellowship that you want to pursue.

Come to your interview prepared to talk about your ultimate career goals as a physician and why this program is the best option for your pursuit of those goals. No matter what your motivations and goals are, make sure to speak with passion about where you see your career taking you. Don't hesitate to talk about your own personal motivations as well as your answer.

"I went into medicine to help patients and families navigate difficult illnesses over time. I have always been drawn to the complexity and acuity of cardiology because I feel my strengths as a clear communicator, an effective teacher, and my ability to make an emotional connection with patients/families are particularly impactful. I also want to be in a field that is growing and changing so I can always continue learning."

"I think that every specialty in medicine would have given me the opportunity to take care of patients, build long-lasting relationships with patients, and also allow me to further develop my research skills. But cardiology is the only one that I find myself going back to the physiology books to be amazed by the basic physiology and pathophysiology principles, the only one that I think about reading in my spare time, and the only one that makes me excited to practice for the rest of my life."

"My drive comes from 2 sources. Motivation within me, to pursue the goals I have set for myself is one-half. The other half is my environment, I was trained in a place where cardiology cases account for nearly 80% of the patient population, and my mentor is an interventionist, who had influenced me heavily to pursue the most fulfilling career."

What are your thoughts on the relationship between physicians and the pharmaceutical industry?

"While I recognize that financial incentives provided by pharmaceutical companies are not acceptable and should be restricted, I see value in pharmaceutical sales representatives as useful sources for information about a new drug, including data from clinical trials, samples for my future patients, and information about the manufacturer's program. This can make their drugs more affordable for patients who struggle financially, particularly those who don't have health insurance."

As an Internal Medicine Resident, you were hopefully exposed to the relationships that physicians have with reps from the pharmaceutical industry. This relationship will continue in the field of Cardiology. Your interviewers will want to hear that you can see the positives in your relationships with the pharma industry.

Due to the tendencies of these companies to financially reward physicians for using or prescribing their products, it is important to realize that sales representatives of pharmaceutical companies are an important ally for physicians and provide essential information. Assure your interviewers that you are open to listening to the reps and learning about new treatment options for your patients.

"In principle, the relationship between physicians and the pharmaceutical industry is something essential for healthcare. Unfortunately, over the past years, this relationship has somewhat become less transparent, with some groups of physicians, with a very good reason, perceiving that the pharmaceutical industry has focused its efforts on generating profits rather than focusing on better outcomes for patients."

"Pharmacists are a strong pillar of healthcare. They are highly efficient allied health professionals, who know medical data and the latest research very well. I learned a lot from them during my residency training, especially the emerging trial data regarding anticoagulants, antibiotics, duration of treatment, etc, to scratch the surface."

What does the perfect day during Cardiology Fellowship training look like for you?

"My perfect day as a Cardiology Fellow starts with a two-mile run, a shower, and a fresh cup of coffee as I head into the clinic for the day. The morning has me seeing a wide variety of patients in the clinic and working under a world-class attending Cardiologist. Following a quick lunch and finishing up patient charting, the afternoon would entail a couple of hours of protected research time, where I would ideally be focusing my research on novel therapies for advanced heart failure. The workday would ideally end on a great note with a grand rounds of attendance to learn from different faculty members from around the world. After getting home, the perfect day would end with a light dinner and reading for an hour before bed."

Physician stress and burnout have become a much more prevalent issue among doctors in every specialty. The same also applies to Cardiology Fellows that undergo a strenuous training program for three years. In asking a question like this on your ideal day, your interviewers are looking to hear what an ideal looks like for you that will help keep you engaged and stress-free. In turn, your answer will really help them gauge how you will fit with their program and curriculum.

You can certainly have some fun when answering this question and be very frank with what your ideal day would look like when training as a Cardiology Fellow. No matter how you answer, you want to speak with passion and try to match your perfect day to the offerings of the program you are interviewing with.

"I would say the best day would be one in which I attend didactics, acquire new knowledge/skills, provide direct patient care, and participate in the education of residents/students."

"An early day rounding on patients, followed by procedures until noon. A didactic lecture and discussion with my fellow coworkers regarding the latest trials."

Take some time to tell us about yourself.

"I grew up with six brothers and sisters, so patience was a necessary virtue. They shaped my experiences and exposures. For example, when my sister needed hip surgery, we spent a week in the hospital and learned how doctors and nurses cared for her, including operating on her and controlling her post-operative pain. In college, I was required to take a human anatomy course, which I loved. I started shadowing a surgeon and took more classes relating to the human body, eventually completing my premedical requirements and solidifying my interest in becoming a physician. In medical school, I was immediately drawn to cardiovascular medicine due to the intimacy of care provided to patients and the true differences made in extending and bettering lives."

Cardiology Fellowship programs see a wide variety of applicants each matching season. In asking this question, your interviewers are looking for insight into your personality to ensure that you would be a great fit with the culture and staff at their institution.

This is a great chance to give your ultimate sales pitch and tell your interviewers what makes you one of the top candidates for their program. While there is no right or wrong answer to a question like this, there are a couple of directions that you can take to have the greatest impact on your interviewers. This isn't the time to discuss your future career plans; you'll have time to do that with other questions. It is much wiser to focus on the infectious personality, teamwork, and work ethic you will bring to this Cardiology Fellowship.

"I was a humanities major in college in addition to being premed. I feel it is important to have a humanistic approach to medicine and to make clear, empathic communication with patients my primary goal. I thrive under pressure and from a young age pursued high-stakes hobbies - soccer goal, solo violinist. I also don't shy away from a challenge - as evidenced by my marathon running hobby. This mentality also extends to my professional life where I constantly excelled in my high acuity rotations - PICU, EM, and cards."

"I am the older of 6 siblings. This has inspired me since childhood to be the best version of myself and to be a positive role model for my brothers and sisters. This desire to be the best version of myself led me to acquire very good habits such as exercising and studying regularly, but most importantly being a very approachable person. Since I can remember I work out at least 5/week, this has allowed me to better perform in other areas of my life like the academic/professional one where I have translated my discipline and will to become a role model to med students/interns. I will continue to be someone who leads by example and who is always happy to be of help to everyone around me."

"I am a highly motivated individual, passionate about what I do, always willing to give to my patients, and wanting to learn from my fellow coworkers and superiors. My philosophy of life is to never give up and I believe that there is always light at the end of the tunnel. During my training, I told myself every single day that there is room for improvement in every aspect of my job and life, to keep myself motivated."

What are some key things that you are looking for in a Cardiology Fellowship program?

"Right now, I'm focusing my career path in electrophysiology at an academic center where I can teach, conduct research and maintain a clinic schedule. My ideal program has a strong EP staff to begin initial training with and also gives fellows ample research opportunities. From what I have learned about your program, you have great opportunities for your fellows in these areas and I'm very excited to learn more."

The matching algorithm for residency and fellowship programs takes an applicant-centered approach, meaning it looks to rank medical students with their top choice as long as the program holds the candidate as a top choice. Knowing this, your interviewers want to ensure that their Cardiology Fellowship program fits your needs.

Your interviewers are ultimately asking why you want to enter their program. Explain how the program meets your needs and your ultimate goals for training as a Cardiology Fellow. Research the program before your interview and identify a few unique features of the program that are important to you when ranking the programs that you interview with.

"I am looking for comprehensive clinical training as well as a research opportunity. And I am sure with this vastly diverse patient population and the world-renowned mentors, this program far exceeds my expectations."

"The key things I am looking for in a cardiology program are a nourishing environment where I can become a great cardiologist, continue to develop my research skills, and be able to create positive relationships with mentors and mentees."

"Adequate training in all aspects of cardiology, to take of my patients with cardiovascular pathologies. Good mentor to direct me and educate me to make wise choices. To form relationships and build a team."

Would you have any concerns about relocating to join our Cardiology Fellowship program and living in this city for the next three years?

"I have only visited New York City during my freshman year of my undergraduate program, but I would be super excited to come and train here for the next three years. I would look forward to visiting Times Square, seeing Madison Square Garden, and enjoying the wide variety of dining options here in the city. I wouldn't have any concerns about relocating here."

Every year, graduating Internal Medicine Residents compete to match into a wide array of fellowships to further their careers. This includes the very competitive process for matching into Cardiology Fellowship programs. As you are likely applying to and interviewing with programs all over the country, your interviewers need to know that you are willing to relocate for their program.

If you have lived or visited the city or adjacent cities, you should mention this fact. If you know anyone there, talk about the good things they have told you. If it is an unfamiliar city/region, pick traits that are unique to the city that would intrigue you and explain why an applicant may be open to living in the area. Ensure that your interviewers understand that you have done your homework on the city and can see yourself thriving there.

"As much as I would like to be near my family, I would also like to pursue my love for cardiology. I will happily spend another 3 years pursuing my passion. My family understands this and is very supportive."

"I would not have an issue with relocating. As an IMG, relocating is an expected part of my career for which I have prepared accordingly during the past three years of residency."

"I am from this area, and I will have enough support if I live in the area. This is home, and I would love to stay here for 3 years."

What would you say is the biggest challenge you faced in your residency training program?

"For me personally, the biggest challenge of residency training happened in the first year and that was handling the stress and managing a delicate work-life balance. Coming out of medical school, I was taught that stress management skills were important but I never knew how true those words were until I faced them in-person. I admit that I did have some breakdowns during my first year and it was some great senior residents and attending physicians that lifted me up and gave me encouraging advice. Throughout the remainder of my training, I learned some great tactics to manage busy clinical loads and have a happy home life."

There are many challenges when coming into a program as a new Cardiology Fellow, from learning new faces to taking on a whole new subset of patients for the first time. Your interviewers are aware that you likely faced a few challenges as an Internal Medicine Resident and need confirmation that you can face challenges head-on, embrace them, and learn from them throughout your time with their program.

Pick a challenge that is commonly faced by residents rather than focusing on a potential deficit in your ability to perform as a Cardiology Fellow. You can also pick something unique to you that is not the result of your actions (e.g., a family member passing away). Then, explain how you took steps to manage this challenge and prepare for similar challenges in the future.

"The biggest challenge that I faced was to overcome my year of graduation gap and to be at par with my colleagues in medical knowledge. I did work very hard towards it and now I can proudly say that I have bridged that gap as per my attendance feedback."

"The biggest challenge I faced in residency was finding a work-life balance. I chose to stay in NYC because this is where my friends and family are located, but it was hard to be so close, but also have to miss out on so many milestones. I learned to prioritize what was important to me, set boundaries on my work when appropriate, and how to make sure to take care of myself so I could feel my best."

"I would say that the biggest challenge was adapting to the workflow of the American healthcare system and maintaining a healthy balance. Fortunately, I had great seniors and mentors who guided me through the process. I relied on my disciplined, and structured mindset to find effective and efficient ways of completing my tasks, taking excellent care of patients, assisting with the didactic sessions, and teaching my mentees daily. Outside of the hospital, I have found the gym and restaurants great options to clear my mind after busy days."

"Being the first graduating class, was a challenge to me. Navigating the training, without seniors to guide us, and encountering challenges with several rotations in a hospital, which was not exposed to residents before our time was a challenge. We paved the way for future classes, in almost every rotation."

How do you feel about the 80-hour workweek limit for residents and fellows?

"I understand this system is in place to prevent poor performance of residents and fellows due to exhaustion. There were times during my Internal Medicine Residency training where I know the line was toed pretty quickly and by the end of the 6th day in a row working 12 hours shifts, I was exhausted. But, I know that the next three years in training as a Cardiology Fellow will entail a great time requirement and I'm ready to take on whatever time is needed in training with your program."

In the early 2000s, the ACGME created rules that limited work hours for all medical residents and fellows, including the 80-hour workweek. Your interviewers mainly want to hear that you are aware of the work hour limits that are in place and to know if you have any concerns or opinions on this.

A lot of people are opinionated about this topic, and this could include one or more of your interviewers. For this reason, it is important to focus on the pros and cons but not take a strong stance on this topic. State that you are aware of the rules, why they are in place, and the impact they can have on every Cardiology Fellow in training at their program.

"I personally feel that training in residency is for a short time and is supervised. One should make maximum use of this time to learn even if it is at an expense of hard work. But I understand all this is to prevent resident burnout. But as A fellow I am ready to make full use of these 3 years, these work-hour limits don't count for me."

"I believe that the 80-hour limit is a positive change in the medical field. It is an intervention that reflects the commitment of the field to the learner's well-being. It allows residents/fellows to practice medicine and learn in optimal conditions to safely make decisions that have an impact on patients. Every change that will impact positively patient care must be applauded."

"I feel comfortable with an 80-hour work week, as I did in my residency training."

What do you like to do for fun?

"My two main hobbies are woodworking and horology and these two hobbies combine to make a great pair. My inspiration in horology came from my grandfather at a young age, when I used to watch him construct beautiful timekeeping apparatuses. I'm currently building a grandfather clock for my brother that has carvings of ducks in the corners and marsh reeds along the side."

Your interviewers will pose some questions to get to know you personally throughout your time with them. They want to get a feel for who you are and what motivates you. They also ask this question to make sure that you will partake in activities outside of your Cardiology Fellowship training that help recharge, both physically and mentally.

This question is more likely to be asked by senior residents than attendings. This question asks what is unique about you as a person. Pick some popular activities to show that you would get along with the current fellows, as well as some uncommon activities to project yourself as a unique and memorable person. Expect follow-up questions about your interests.

"Well, I am a full-time mom of teenagers who like to eat, so I love to cook for them. I also like to watch movies and go for walks. I am a fitness freak so I love to exercise, I do pilates, Yoga, and strength training."

"Running and music. Marathons, half-marathons. Get outside, stay in shape, set goals, and meet them. Music is a release - a big family activity for me."

"Outside of the hospital, I enjoy my time working out every day. If I am not on-call, I cook with my wife (we love perfectioning traditional Costarican recipes) and trying new restaurants. I also try to call my parents and brothers at least weekly and have conference calls with my friends from Costa Rica at least monthly. I would not forgive myself if I did not mention that I am an avid Chelsea FC fan, and I try not to miss a match, and if I do I try to watch the extended highlights when I get home."

What aspects of our Cardiology Fellowship program interest you?

"The major appeal of your program is the mentored research that your fellows receive. I have a strong interest in research in the areas of preventive medicine and women's heart disease. I also love the fact that your prior fellows have gone on to have productive and thriving careers at some of the top academic institutions throughout the country."

This is a question asked by most Cardiology Fellowship programs to understand what specifically interests you about their program. Your interviewers need to be assured that their program is a match for you and candidates that show passion and interest often get ranked near the top of the list.

Think about two or three features of this particular program that interest you and how the program can help you achieve your personal goals. Before your interview, thoroughly research the program. More often than not, you can find a lot of great information on the program's website. This can include the mission/values of the program and institution, the curriculum, and where alumni go after their time with the program.

What worries you the most about joining a reputable Cardiology Fellowship program?

"I have all of the confidence in the world in the clinical skills that I've developed over the last three years of Internal Medicine training. I know that I will be mastering new skills in clinical and procedural practice during Cardiology Fellowship training and I'm not worried on that end. The only things that would risk keeping me up at night coming into your program would be quickly learning an unfamiliar EMR and integrating quickly with the existing team of senior fellows. These are pressures that I put on myself to do in a timely manner and I would make them both a priority in my initial days with your program."

Your interviewers ask this question for two reasons. First, they want to ensure that any common myths about becoming a fellowship are debunked for any prospective fellows that have worries that aren't true. Second, they want to hear how you are working on the areas in which you are not confident.

Rather than focusing on a potential deficit in your ability to perform as a Cardiology Resident, pick a common weakness. Then, explain how you have taken steps to prepare for this hurdle throughout your residency training.

"It's difficult to learn a new hospital system. I am at the point where I take for granted that I know how the EMR works, common workflows, where everything is, and who to call when I need help. It is a big cognitive load to relearn all of this, but ultimately worth it for the richness that training in a new hospital system would add to my development."

"Joining a new program would be a great opportunity to learn how cardiology is practiced in different places and would broaden my perspective of the field. I think that the biggest challenge I would face would be getting accustomed to a new healthcare system and a new EMR. But that would not be something new for me and I believe that I have the tools (adaptability, discipline, flexibility) to excel wherever I go."

What are some challenges that the field of cardiovascular medicine is currently facing?

"From a patient care perspective, I know that lifestyle tracking apps become increasingly popular and Cardiologists must be diligent in tracking the great ones from the poor ones to recommend to patients. If I wanted to recommend an app that tracks caloric intake and exercise, I would want to ensure that the apps I recommend are providing good information and feedback to my patients and this would take a great deal of time to filter out. I'm well aware that burnout and stress are big issues for providers in the field due to a plethora of reasons. With the right attitude and focus, I'm ready to handle the pressure that will come with my training in your fellowship."

This question assesses your familiarity with the field of cardiovascular medicine and that you've done your homework on what issues are currently occurring in the field. Your interviewers hope the candidates they interview are prepared to talk about the issues the field faces.

Before your Cardiology Fellowship interviews, research this question so you can come to your interview prepared to talk about a couple of the issues. Remember that the unstated question is how to fix the issues. You are more than welcome to give your own educated opinion on this as you answer.

"Many ethical challenges. Just because we have the technology - VADs, transplants, fetal surgeries - is it appropriate for the patient? Important to be transparent with patients and families and effectively educate them about all risks and benefits involved. On a totally separate note, as someone who is interested in imaging, I worry about AI."

"I think the biggest challenges in the field are driven by social inequalities. I have noticed that there are notably negative differences in outcomes in vulnerable and underrepresented populations who usually receive treatment that deviates from the standard of care due to biases, or lack of access to the healthcare system, medications, interventions, etc. One of my goals is to fight this inequality, and underrepresentation and improve outcomes in these populations."

Talk about a time you showed initiative by taking the lead in a situation during your residency training. Why did you take action as the leader and what was the outcome?

"Growing up and into my college years, I was a natural leader to my peers. This is evident in my years participating in team sports and being a captain of my teams. During my residency training, I was excited to get voted as chief resident during my third year and I've taken advantage of this opportunity. While recently rotating in our ICU, I took charge of a critical patient situation on a night shift and guided our nursing staff to help stabilize a patient. It felt very gratifying to be the physician in charge of directing care and feeling comfortable and confident in doing so. This is an experience that I will carry with me to your Cardiology Fellowship program."

Your interviewers want to see that you are confident enough to take the initiative when the opportunity arises as a fellow with their program. Most medical training programs don't provide formal leadership training, so your interviewers want to know that you are a natural leader. As you advance to the final year of your Cardiology Fellowship, you will lead teams of junior fellows and your interviewers will want to hear that you can lead others with success.

Carefully describe a situation during your residency training where you saw a chance to lead and took advantage of it. Talk about the success of the moment and your biggest takeaway from the experience. You'll want to highlight your ability to communicate effectively and lead others as you answer this question.

"Intern year I was struck by the profound influence peri-transplant hospitalization has on patients and families. I wanted to better understand the challenges facing this population so I designed a qualitative research study interviewing parents of kids who recently completed a heart transplant. I developed a research team of mentors and collaborators, wrote the IRB, conducted the interviews, analyzed the transcripts, and presented the data at PAS. I shared my findings with the heart failure department and hope they can use them as the basis for future QI work."

"I remember one time while in the ICU as an intern we received s/o from the ED team about a patient with undifferentiated shock who was fth complete supra iliac aortic occlusion (that appeared to be chronic on CT) and the ED team was convinced that her ppt was related to this finding. Looking more into her case I was almost certain that she had an ACS and that was driving her ppt. I went to see the patient in the ED, I communicated my thoughts to my senior and the ED staff and after assessing the patient as a team we reached out to cardiology who agreed and promptly activated the cath lab where she was fth significant x3v dz. This experience enforced in me the importance of keeping an open mind, not being biased, and teamwork."

How timely would you say your charting and dictations were during residency training?

"Although I've been occasionally remiss in keeping all sign-offs and dictations current, I feel it is important for me to be diligent in keeping current. It is not lost on me how reimbursement by third-party payers can be affected by incomplete charts. Just as important is the need for accuracy, and attempting to remember specifics from a procedure or rounds can become spotty if too much time has passed. For these reasons, I agree that keeping current is important and would always strive to be timely in my charting as a Cardiology Fellow."

Getting behind on charting after a long and busy day happens easily in any practice, and this is especially true for residents and fellows in training. Your interviewers ask a question regarding the timelines of your charting and dictation to hear how you prioritize these tasks during a busy and that you can do what is necessary for a patient's record, even on the busiest of days.

Speak openly and honestly about how your prioritized your patient charting during residency training and push your answer further by highlighting any direct feedback you received on your great charting skills from faculty. If you had experienced a time where your charting/dictation wasn't timely, it is okay to bring that situation up as long as you can express what you learned from it moving forward into Cardiology Fellowship.

"During residency, one thing that I prioritized was effective efficiency. This led me to check charts on my clinic/ward patients every night before going to bed to be able to take on every day as informed as possible. This also allowed me to sign my notes on time while I was in clinic (the same day), part of a primary team, and while I was on consulting teams."

As a new trainee in our Cardiology Fellow, how will you respond when asked to do a procedure or task that you were unfamiliar with and uncomfortable handling?

"I am confident in my medical knowledge and the skills that I developed during my cardiology rotations in residency training, but I also know that I will be tackling some things that will be very new to me. When faced with this situation, I wouldn't hesitate to ask a senior fellow or faculty member for guidance. My goal is to leave the fellowship with all of the skills necessary to be a confident and competent physician, and I greatly look forward to these learning opportunities with your program."

As you enter Cardiology Fellowship training out of residency, you know that you will be tackling many new procedures and tasks in practice that you haven't been directly exposed to before. In proposing a question like this, your interviewers will be looking to hear that you would take a collaborative and learning approach and that you aren't afraid to ask for help when you know your shortcomings.

This is not the time to say that you would jump in with both feet and potentially risk the safety and wellbeing of a patient. Your interviewers are not looking for someone who jumps when someone says jump, but someone willing to jump with confidence and competence. Provide an answer that illustrates this difference. As you answer, talk about your willingness to ask for help and learn in the process.

"It's important to know what you know and know what you don't know. I am comfortable with certain procedures coming out of residency, but would not be afraid to ask for help with unfamiliar procedures. I would do my best to self-educate and troubleshoot as appropriate, but I always put patient safety first and wouldn't be afraid to ask for help."

"I will respond with nothing but honesty. I would never be deceiving about my skills/abilities and I would never shy away from asking for help when things are getting out of hand. Patient safety takes priority. I will be more than happy to perform new procedures under adequate supervision and will never shy away from acquiring new skills anytime the opportunity presents itself."

Tell us about a time you had a conflict with a patient during your residency training. How was it resolved in a healthy manner?

"During my time rotating in a busy outpatient IM clinic during my second year, I had a patient that was very irritable about the waiting time. As I was examining the patient, he became very vulgar with this language about our staff and nobody caring about the wait time he had experienced. First and foremost, I didn't take his foul language personally and decided to let him air his thoughts out. Once he was done and I was still performing my examination, I apologized for the wait time and assured him that all staff was doing their best to handle a busy clinic schedule. I reiterated that all of our providers were committed to providing focused care to each and every patient, including him. This comment alone really settled him down and I know that simply letting him talk out his grievances without getting defensive was important in this situation."

Physicians need to be able to handle patients who are stressed, in pain, or angry respectfully and healthily. As you interviewer with Cardiology Fellowship programs, your interviewers need to know that you can handle patient conflicts with ease, and asking about a time you had to do this during residency training gives them a great indication of how you will handle conflict.

Describe a simple scenario briefly, focusing on your response to the challenge rather than describing the details of the conflict. When you discuss how you handled it fairly, emphasize that clear communication was instrumental. Describe what you took from that situation that you will put into practice as a Cardiology Fellow.

"Overnight, the mother of an oncology was very angry about the long wait time for CT. She filed a complaint and named me specifically as the resident on call. I learned both how to escalate delays of care overnight, and how to give a sincere apology. I met with her the next day I was back at work and told her "My job as her doctor was to make her life easier, not more difficult, and I am very sorry I failed to achieve that. I cannot imagine how hard it is to have a child with cancer, and I am impressed by her fierce advocacy for her son." I felt it was important to preserve the therapeutic relationship so I could continue to care for her effectively throughout my time in service."

"I had a patient in the clinic who had severe and diffuse OA whose pain was very difficult to control. On multiple occasions, we would ask for prescriptions/interventions I was not comfortable doing and in one of our visits, he said that he was thinking about not seeing me again. This was not something I liked but we had a productive conversation where I presented him with multiple options including a referral to the integrative pain clinic for a new assessment, and if he wished having him see one of my colleagues going forward. After our conversation, he decided to keep being my patient and trying my recommendation. This encounter was very positive for me because it allowed me to rebuild bridges with him and look for the best alternative for him."

Tell us about a difficult patient experience you had during your residency training. How did you handle the situation in a professional and respectful manner?

"During my rotation in the outpatient clinic setting my second year, I had a new consult with a patient that became very rude and belligerent when I started discussing his obesity and ways to help him lose weight. I immediately apologized to him and let him know that I had his best interest in mind. Following the appointment, I got some great advice from my attending physician that I could have provided more education to him in the moment. During his next follow-up appointment, I continued to provide education to the patient and recommended a consultation with a dietician. He agreed to see them the following week."

Coming out of your Internal Medicine Residency training, you have had the opportunity to work with patients in a wide variety of settings. This likely has included handling very difficult patients. This question allows your interviewers to assess the patience, communication, conflict resolution, and stress management skills that you would bring to their team as a new fellow with their program.

Talk about a simple scenario you experienced during your residency training so you don't spend too much time describing details of the patient's story. Instead, spend your time describing your thoughts and actions. Your answer should demonstrate your ability to remain calm, patient, empathetic, and logical while still helping the patient to the best of your abilities.

"In my experience, patients who are labeled as difficult are those who have learned, through experience, to distrust the healthcare system and second-guess all decisions. I had a patient listed for transplant whose mother would not let any lab be drawn, or medicine be given, no matter how minor it may have seemed to the medical team, without thorough explanations. I took the time to explain everything in detail to this family and earned their trust."

Cardiology Fellowship Interview Questions

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1. At our institution, you will be working side by side with Advanced Practice Providers as a Cardiology Fellow. Would you have any issues in doing so?
2. Tell me about a time you received constructive criticism from an attending physician or senior resident during your residency training. How did you handle that situation?
3. If I asked your friends, what would they say are your strengths and weaknesses?
4. Is there a personality type that you find most difficult to work effectively with?
5. How do you think you will perform under pressure as a Cardiology Fellow?
6. A recent patient survey comes back, and you find out that you did not meet a patient's expectations as their physician. What are the next steps you would take to improve as a Cardiology Fellow in training?
7. As a fellow, how will you explain a complex cardiovascular diagnosis, procedure, or other medical term to a patient using verbal instructions?
8. Tell us about a time you had to work with new technology during medical school or residency training. What did you do to ensure proficiency as quickly as possible?
9. How would you deal with a disagreement among other fellow colleagues or senior fellow as a trainee with our program?
10. What invasive procedure are you most excited to learn during Cardiology Fellowship training?
11. Talk about the most interesting case you were exposed to during your residency training. What made it so interesting to you?
12. Do you have any thoughts on how would you like to see the delivery of healthcare evolve in the coming years?
13. Are you considering or interviewing with any other Cardiology Fellowship programs?
14. How would you stay on top of trends and changes in the field of cardiology during your time as a fellow with our program?
15. We are always looking for our fellows to participate in, and even lead, code teams at our facility. Are you willing to participate during Cardiology Fellowship training?
16. How would you describe your personality using just three words?
17. Would you have any hesitation referring a patient to another cardiovascular specialist or another specialty practice?
18. Do you believe telehealth is an effective form of healthcare delivery, specifically as it relates to cardiovascular care?
19. What is motivating you to pursue Cardiology Fellowship training?
20. What are your thoughts on the relationship between physicians and the pharmaceutical industry?
21. What does the perfect day during Cardiology Fellowship training look like for you?
22. Take some time to tell us about yourself.
23. What are some key things that you are looking for in a Cardiology Fellowship program?
24. Would you have any concerns about relocating to join our Cardiology Fellowship program and living in this city for the next three years?
25. What would you say is the biggest challenge you faced in your residency training program?
26. How do you feel about the 80-hour workweek limit for residents and fellows?
27. What do you like to do for fun?
28. What aspects of our Cardiology Fellowship program interest you?
29. What worries you the most about joining a reputable Cardiology Fellowship program?
30. What are some challenges that the field of cardiovascular medicine is currently facing?
31. Talk about a time you showed initiative by taking the lead in a situation during your residency training. Why did you take action as the leader and what was the outcome?
32. How timely would you say your charting and dictations were during residency training?
33. As a new trainee in our Cardiology Fellow, how will you respond when asked to do a procedure or task that you were unfamiliar with and uncomfortable handling?
34. Tell us about a time you had a conflict with a patient during your residency training. How was it resolved in a healthy manner?
35. Tell us about a difficult patient experience you had during your residency training. How did you handle the situation in a professional and respectful manner?

Cardiology Fellowship Interview Questions

1. At our institution, you will be working side by side with Advanced Practice Providers as a Cardiology Fellow. Would you have any issues in doing so?

2. Tell me about a time you received constructive criticism from an attending physician or senior resident during your residency training. How did you handle that situation?

3. If I asked your friends, what would they say are your strengths and weaknesses?

4. Is there a personality type that you find most difficult to work effectively with?

5. How do you think you will perform under pressure as a Cardiology Fellow?

6. A recent patient survey comes back, and you find out that you did not meet a patient's expectations as their physician. What are the next steps you would take to improve as a Cardiology Fellow in training?

7. As a fellow, how will you explain a complex cardiovascular diagnosis, procedure, or other medical term to a patient using verbal instructions?

8. Tell us about a time you had to work with new technology during medical school or residency training. What did you do to ensure proficiency as quickly as possible?

9. How would you deal with a disagreement among other fellow colleagues or senior fellow as a trainee with our program?

10. What invasive procedure are you most excited to learn during Cardiology Fellowship training?

11. Talk about the most interesting case you were exposed to during your residency training. What made it so interesting to you?

12. Do you have any thoughts on how would you like to see the delivery of healthcare evolve in the coming years?

13. Are you considering or interviewing with any other Cardiology Fellowship programs?

14. How would you stay on top of trends and changes in the field of cardiology during your time as a fellow with our program?

15. We are always looking for our fellows to participate in, and even lead, code teams at our facility. Are you willing to participate during Cardiology Fellowship training?

16. How would you describe your personality using just three words?

17. Would you have any hesitation referring a patient to another cardiovascular specialist or another specialty practice?

18. Do you believe telehealth is an effective form of healthcare delivery, specifically as it relates to cardiovascular care?

19. What is motivating you to pursue Cardiology Fellowship training?

20. What are your thoughts on the relationship between physicians and the pharmaceutical industry?

21. What does the perfect day during Cardiology Fellowship training look like for you?

22. Take some time to tell us about yourself.

23. What are some key things that you are looking for in a Cardiology Fellowship program?

24. Would you have any concerns about relocating to join our Cardiology Fellowship program and living in this city for the next three years?

25. What would you say is the biggest challenge you faced in your residency training program?

26. How do you feel about the 80-hour workweek limit for residents and fellows?

27. What do you like to do for fun?

28. What aspects of our Cardiology Fellowship program interest you?

29. What worries you the most about joining a reputable Cardiology Fellowship program?

30. What are some challenges that the field of cardiovascular medicine is currently facing?

31. Talk about a time you showed initiative by taking the lead in a situation during your residency training. Why did you take action as the leader and what was the outcome?

32. How timely would you say your charting and dictations were during residency training?

33. As a new trainee in our Cardiology Fellow, how will you respond when asked to do a procedure or task that you were unfamiliar with and uncomfortable handling?

34. Tell us about a time you had a conflict with a patient during your residency training. How was it resolved in a healthy manner?

35. Tell us about a difficult patient experience you had during your residency training. How did you handle the situation in a professional and respectful manner?