After Rounds
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After Residency, Should You Pursue a Medical Fellowship?

Is a medical fellowship the right path for you after residency? Here are the questions you should ask yourself as well as how to find a fellowship.

What will you do with the rest of your life?

You’re in a residency program, so it’s safe to say you’re going to be a doctor. But now you have another decision: Where will you go after residency? Will you pursue a job or a medical fellowship?

If you’ve been thinking about seeking additional training before you hit the job market, you already know the process is highly competitive, with a limited number of fellowship positions available each year. But so much depends on your specialty. For example, nearly 100% of cardiology fellowship spots were filled in 2019, but only about half were filled in geriatric medicine, according to National Resident Matching Program data.

No matter how competitive the field, if you’re interested in a medical fellowship, you should pursue it. First, however, make sure it’s what you really want.

Ask Yourself Some Questions

Start by reflecting on your interests and goals. Here are some broad questions to ask yourself to help you weigh the pros and cons and determine your next steps.

  • Are you interested in research? Most medical fellowships include some element of research.
  • Will the fellowship help you reach your long-term career and personal goals? For instance, are you interested in a career in academia? If so, a fellowship is definitely for you.
  • Does your area of interest require a fellowship? Many medical subspecialties, such as pediatric neurosurgery, do.
  • Do you want to start the fellowship immediately after your residency, or do you want to wait a year or two?
  • Do you know enough about the subspecialty you’re considering?
  • Do you have a deep interest in or passion for a particular medical subspecialty, and are you willing to give up the other elements of your specialty to focus on that subspecialty?
  • Does a fellowship make sense financially? A fellowship can mean one to three years of additional training, during which you’ll be making considerably less than you would as a physician.
  • What are the financial advantages and disadvantages of taking a fellowship, and how do they balance out for you? (The White Coat Investor discusses how to calculate the ROI of a fellowship to help you think through this.)

Exploring the answers to questions like these will mean a fair amount of research, soul-searching and asking around. Give yourself adequate time to make an informed choice.

Follow Through on the Decision

You’ve considered the variables and assessed the pros and cons. If a fellowship is the right path for you, get to work. Most residents decide whether to pursue a fellowship by their second year of residency. If you know now, don’t wait.

Early in your residency, talk to a staff member in the subspecialty, your program director and your chair. This has two important benefits. Since the medical fellowship application process could affect the scheduling of rotations and residency activities, the earlier you’re able to adjust for this, the better. Second, they can help you make the right contacts. You want to have advocates in your corner to write letters of recommendation or connect you with their networks.

Along those same lines, find a mentor by your second year. A mentor can introduce you to others in the field and be a source of knowledge and insights. Use these resources not only to find a residency but also to learn what’s involved. You want to know exactly what you’re signing up for.

Mentors can also help you find potential research projects. Posters, case reports and — especially — publications in peer-reviewed journals will help your fellowship application shine. Many medical societies encourage resident participation at their national and regional meetings. Presenting at these meetings can also boost your application. So try to identify an area of interest early in residency so you can gain exposure in your field through clinical rotations and research projects.

Find a Match

So, where do you find medical fellowship positions? Your mentor and your program director, among others, can point you in the right direction.

Many specialty organizations, including the American College of Surgeons, provide information on related fellowship opportunities.

The American Medical Association’s FREIDA database allows you to search for fellowship programs accredited by the Accreditation Council for Graduate Medical Education (ACGME). You can narrow your search by geography, salary and other considerations. The AMA also lists non-ACGME-accredited fellowships and residencies.

Resources abound. All that’s left is for you to decide whether a fellowship is for you.

Roxanna Guilford-Blake

Roxanna Guilford-Blake

Roxanna Guilford-Blake, award-winning writer with expertise in health, healthcare and the business of healthcare, makes complex concepts clear. Recent topics include healthcare law, HIPAA, Stark, cardiovascular health, value-based care, clinical trials, Alzheimer's disease, precision medicine and behavioral health. Guilford-Blake has been a full-time professional writer for more than 20 years. As a journalist, she learned to write a good, tight story; she's been published in Cardiovascular Business News, the Christian Science Monitor, the Atlanta Business Chronicle, BioWorld and several HealthLeaders Media and CCH publications. As a director of strategic communications, she used that expertise to help clients tell compelling stories and engage their audiences, crafting blog posts, white papers, articles, webcopy and other materials for clients. Commercial clients include McKinsey & Co., WCG and Health2 Resources.

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