Been practicing for almost 5 yrs now. IMO, CHIP fellowship is a waste of time. If you really want to learn super complex CTO stuff, you can learn it on the job. But I can tell you that majority of places in the US does not want this. If you are fortunate that admin wants this from you, it is easily a learnable skill, just read up about it, watch youtube. It is just an extension of IC skills, and does not need an extra year of training for this. I am confident if you take the well known "CTO" operators in the nation and pluck them into my hospital as is, and they practice like they are at their home institution, they would not last. It is not so much godlike skillset that nobody else possess, but more the ability to do that kind of thing at the institution. Outcomes matters a lot to hospitals, and some tertiary centers say screw the outcomes, we are the best, and we have bad outcomes because we tackle complex cases. If that is the administration point of view at your institution, then you can be the high volume CTO operator.
This should be warning to fellows. I know watching CTO videos and live cases are cool and all, and coming out of fellowship I wanted to be that CTO operator. Reality really sets in when you get your first job. I myself almost lost my job (more due to politics than complications), and had to adapt significantly. I also know of 1 other friend who had to leave his job because of doing what he felt was right (but very very aggressive when compared to his partners). Be careful out there. IMO, CTO should only really be considered for proximal LAD, proximal dominant LCx/RCA with a large territory. In many high volume CTO places, I find that they are tackling CTO left and right for everything, vessels that really don't make that big of a difference. Many doesn't even make sense, and does little for the patient, and worst when they restenose. You don't see this as a fellow, but definately when you are an attending following a patient for years.
Interventional field is fraught with a lot of subjective assessment, and if you are not on the right side of politics, things could end very badly for you.