EP fellowship program issues
Hey guys, need some advice on the EP fellowship program I'm in. My co-fellow and I are pretty unhappy with our setup, but I'm not sure if we're being too critical. I'd like some perspective from others.
Program is at a large University hospital. Fellows do 4 lab days a week, 1-2 cases each, sometimes 3. (2 fellows/year; total of 4 fellows). 3 labs. Fellows do all the consents, pre-op orders, procedure notes, etc. The faculty are heavily dependent on the fellows - if there is no fellow to get consent for a particular case or do orders, it's a huge deal. Having said that - this part is not a big gripe. We want to be involved with and do as many cases as there are available. Although the case volume per fellow seems low at times, perhaps this is standard. I do think we have a good mix of cases with healthy complexity.
The one full clinic day we do is a big grievance. It's routine to see 35-45 patients. The EP fellows prep all the notes, see all the patients, and finish all the notes afterwards. If a fellows needs to take a clinic day off, he/she needs to arrange coverage by another fellow. The same goes for the lab - each of the three labs needs to be covered by a fellow at all times. If you need to be away, you either need to get another EP fellow to cover for you, or find a gen cards fellow to cover. My PGY7 co-fellow is doing the clinic coverage next week for a PGY8 fellow who will be out and therefore has two back to back clinic days of 35-40 patients each. We're stuck spending most of our downtime prepping or completing clinic notes when we should be studying EP.
Additionally, we don't do any consults, device clinic, or device interrogations. This seems like necessary education for an EP fellow. I'm not sure how one can finish an EP fellowship without having any structured device education outside of learning how to implant and extract. We do some device management in clinic, but at 40 patients/day, there's only so much you can do or learn there.
We have no structured didactics. 90% of the talks or discussions we get are from industry reps, with the other 10% being inconsistent education from two early career attendings (who are excellent educators but not incentivized in any way for their mentorship).
It sometimes feels like we spend more time prepping and writing notes, consenting, and putting in orders than we do scrubbed into cases or otherwise learning EP.
Perhaps I'm being too harsh, I don't know. Would appreciate any perspective and advice.