How does one get a fellowship in cardiology?

[Guest physiology]

I know that once you get matched into IM, and you do your however many years, how do you match into a competitive fellowship like gastroenterology or cardiology?

 

Is it another CaRMs all over?

 

If you matched into IM at U of A, do you stay there for your cardiology fellowship? Or is it better to go to another teaching hospital?

 

And once you're completely licensed, and written all your exams, and you've completed your "x" number of years of residency, since you're not exactly raking in 6 figures yet, do people stay at the SAME hospital where they've done their residency for the past years?

 

I would imagine setting up your own private practice right away to be difficult.

 

In general, I just want to know how the transition is from residency to the "real-world."