Things to look for in a GI fellowship program?

[robertnadan]

What factors do you look for in a GI fellowship program when you rank it high? ( leaving location preference aside). In other words how do I make me GI fellowship rank list?

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[nycscope]

Well, here was my thought process:

I REALLY want to do GI. Well, more like I HAVE to do GI.
Send applications far and wide...seriously, send 100 and maybe, if you are competitive, you get something like 15-20 invites. Go to your interviews, decide which places you like. Of course, before that research the programs that offer you an interview:

- who is a faculty member? what are they good at? what do they spend their time investigating?
- what do YOU want to do? advanced? ibd? hep? some places are better equipped to deal with your interests than others. I wouldn't prefer a program without it's own transplant program if I wanted to be a transplant hepatologist for example.

It's pretty much about who's going to give you a shot to begin with.

(P.S. I'm not poking fun, but I read your post in a pirate voice after "how do I make me rank list" )

 

[robertnadan]

Thank you for your reply. Can you please define what ' competitive' means for GI?

 

[nycscope]

It's a loaded word for sure:
- board scores - not THE most important, but it D O E S matter for filters. Scored a 211 on your Step 1 but a 250 on Step 2? Well, if the filter is set on minimum 225 for example, sorry, you are out of luck. If it's an AVG 225, then hey, guess what, your app gets a look
- networking - single most important factor. who do you know? who will vouch for you with a telephone call? how much does your home program like you?
- residency performance - if you do the bare minimum, who will want to hire you? if you show up every day and are consistent in fulfilling your responsibilities and are pleasant while you do it, this will go a long way
- research - the more you contribute, the more you are "interested" and likely to produce for your program. They are thinking: "we will train you to be a gi. what will you do for us?"
- pedigree - where do you come from? university trained by and large = more consistent product in the eyes of the PD. Same thing with US vs Caribbean grads.

Very generally, in my experience, it's something like:

networking > residency performance > pedigree > research > board scores.

 

[robertnadan]

what to look for in programs before joining it?

 

[nycscope]

what to look for in programs before joining it?

Hey, you asked this in another thread as well. Please correct me if I'm wrong, but it seems like you are coming from the viewpoint that you will have your pick of the litter in terms of programs...this really isn't the case for the most part. Apply to as many as it takes for you to feel comfortable to match.

For example, I'll use my profile. Let's break it down using the criteria we stated above:

1. networking - you better believe I did everything just short of washing the PD's car at my home program (and would've if he/she asked). Late nights on elective? no problem. Type up that IRB for you? You bet! I attended whatever meetings I could...grand rounds/local/national and shook hands with lots of people that way. Long story short, I did my very very very best here, and I believe firmly that it had a huge hand in matching. Me 1/ Odds against 0.
2. residency performance - I like to think I did my best. Did I know everything? Absolutely not. Did I do what I thought was the BEST I could for my patients? Yes. Day in, day out, don't leave work for others. Smile, be polite and helpful...I wasn't always successful at all of this, but again, I did my utmost. Me 2/Odds against, 0.
3. pedigree - mid-tier university program, towards the end of the list on "US News Top 50" Gastro programs. I didn't come from an MGH/Hopkins/UCSF etc etc, so I've got to give this to the "odds against" category...applicants from many prestigious places are your direct competition. Me 2/Odds against 1.
4. research - again, did my best. 2 pub (1st author), 5 case reports (4 1st author), 9 poster all-together (national and local). enough to show I care, not enough to blow anyone's socks off. You'd better believe there are some "W O W" applicants out there in this category...I was certainly not one. Me 2/Odds against 2.
5. Board scores - we never escape the sins of our past, do we? My less-than-even-mediocre scores caught up with me here, and I had a number of programs let me know that I was filtered out based on this (I called, "Hey did you guys get my app?" kind of thing). I even had a doc on one of my interviews say that they were not good compared to other candidates and that this was a serious red flag against me...I think that's an extreme but hey, it happened.
So, Me 2/odds against 3.

All in all, I think I had a DECENT profile. My residency performance and networking were certainly my best attributes, and the fact that they are weighted heavily in the process ultimately tipped the balance in my favor ever for slightly. Why did I type all that? So that when I mention that I applied to 100 programs and got 10 invites, it should mean something. I filtered out the programs based on family location. They are in NY/NJ/PA area, so I applied to pretty much every program from Maine to Florida and as far west as Ohio,maybe a bit beyond that. Frankly, I didn't care so much if I ended up at Community Hosp X or University Hosp Y...I just wanted a chance to be a GI doc. I ended up liking community places more actually, since fewer fellows meant more procedures per fellow...that changes wildly depending on where you go though.

What do YOU want to do? Where do YOU see yourself? What matters to YOU? Location? Weather? Family-friendly? None of us can answer these questions, so it's up to (you guessed it) YOU to decide where you want to apply and why. Perhaps by sharing my thought process I gave you an example of how I ended up where I did.

 

[robertnadan]

Thank you for your reply. I agree with all that you said.
few qs?

1. You said there are some W O W applicants in this ( research) category. Can you define WOW?
2. Suppose I get to pick the program. Which one do it pick? ( just program centered factors). ignore the location, weather , family-friendliness. JUst purely based on the programs....

 

[nycscope]

Thank you for your reply. I agree with all that you said.
few qs?

1. You said there are some W O W applicants in this ( research) category. Can you define WOW?
2. Suppose I get to pick the program. Which one do it pick? ( just program centered factors). ignore the location, weather , family-friendliness. JUst purely based on the programs....

1. Example: One of my fellow applicants mentioned that she was second author on a number of publications in NEJM and first author for a big-time pub in Nature. Furthermore, she was invited to be a key speaker at national meetings and won a couple of awards at international meetings for her work in genetics. I'd say that's a pretty impressive resume...and I'm sure there are even better ones out there.

2. Again, nobody can answer this but you. This is like asking us what kind of car you want assuming you can have any car. What if I say Ferrari? It's fast, flashy and fun. It won't matter a lick though if you live in the Northeast come winter time. If you say "well, there is heavy snow where I live and I need cargo space to shop at Costco but I want something sporty too" then we can discuss the details of a Jeep vs Range Rover vs Whatever.

Some of the more "prestigious" places I went to quoted fellow procedure numbers from 800-1000 by the end of fellowship. Some of the lesser recognized places had higher numbers than that...one quoted 2000. Although this wasn't my only criterion, it was a very big one as I want to be an excellent endoscopist and feel I need the hands on training to be one. This lead me to rank the lesser known program higher whereas I would have had no clue to do so earlier.

The way I'm reading this question is "which program will open doors for me and let me do whatever I want later on?" Prestige does not equal clinical acumen. It DOES give you brand recognition. The general public doesn't know what the heck a Fazioli is but they sure know what Steinway is (but given the choice, I'd take Fazioli 10/10 times). I think what you are asking is: which programs are the most prestigious. US News will give you that info.
http://health.usnews.com/best-hospitals/rankings/gastroenterology-and-gi-surgery

Again though, that doesn't make them the best for you, just the most easily recognized. If you are great at what you do, you will open your own doors.
Finally, I know I said this before, but I'll say it again: If this is what you want to do, apply far and wide. There are roughly 170 programs out there for almost 450 seats. That's not all that many. Consider applying to all of them if money isn't a factor. If it is, then use whatever criteria you want to filter (you haven't told us what career goals are...if you want to do academics or something super sub specialized, maybe don't apply to Nowhere, USA Community Hospital X).
After you get your limited number of interviews, you can compile a list of pros and cons based on what you want out of the program specifically and make your rank list.

 

[ChessMaster3000]

1. Example: One of my fellow applicants mentioned that she was second author on a number of publications in NEJM and first author for a big-time pub in Nature. Furthermore, she was invited to be a key speaker at national meetings and won a couple of awards at international meetings for her work in genetics. I'd say that's a pretty impressive resume...and I'm sure there are even better ones out there.

2. Again, nobody can answer this but you. This is like asking us what kind of car you want assuming you can have any car. What if I say Ferrari? It's fast, flashy and fun. It won't matter a lick though if you live in the Northeast come winter time. If you say "well, there is heavy snow where I live and I need cargo space to shop at Costco but I want something sporty too" then we can discuss the details of a Jeep vs Range Rover vs Whatever.

Some of the more "prestigious" places I went to quoted fellow procedure numbers from 800-1000 by the end of fellowship. Some of the lesser recognized places had higher numbers than that...one quoted 2000. Although this wasn't my only criterion, it was a very big one as I want to be an excellent endoscopist and feel I need the hands on training to be one. This lead me to rank the lesser known program higher whereas I would have had no clue to do so earlier.

The way I'm reading this question is "which program will open doors for me and let me do whatever I want later on?" Prestige does not equal clinical acumen. It DOES give you brand recognition. The general public doesn't know what the heck a Fazioli is but they sure know what Steinway is (but given the choice, I'd take Fazioli 10/10 times). I think what you are asking is: which programs are the most prestigious. US News will give you that info.
http://health.usnews.com/best-hospitals/rankings/gastroenterology-and-gi-surgery

Again though, that doesn't make them the best for you, just the most easily recognized. If you are great at what you do, you will open your own doors.
Finally, I know I said this before, but I'll say it again: If this is what you want to do, apply far and wide. There are roughly 170 programs out there for almost 450 seats. That's not all that many. Consider applying to all of them if money isn't a factor. If it is, then use whatever criteria you want to filter (you haven't told us what career goals are...if you want to do academics or something super sub specialized, maybe don't apply to Nowhere, USA Community Hospital X).
After you get your limited number of interviews, you can compile a list of pros and cons based on what you want out of the program specifically and make your rank list.

How reliable is the data that programs quote? They can say whatever they want--I am not saying they would lie, but they may use old information that's appears better, or only quote 3rd year procedure rates, etc....I mean how confident were you in using that as a ranking criterion (however much you chose to weight it)?

 

[nycscope]

How reliable is the data that programs quote? They can say whatever they want--I am not saying they would lie, but they may use old information that's appears better, or only quote 3rd year procedure rates, etc....I mean how confident were you in using that as a ranking criterion (however much you chose to weight it)?

I chose to take it at face value...and made sure that the fellows backed up the claims

Pretty much anything they tell you is a leap of faith if it isn't written in the contract...if I don't believe them then that's probably not a place I want to have a hand in the development of my career!

Your point is well taken...they can say "Last year we had a fellow launched into space by NASA" and I can't refute it...but I can sure look for the footage or at least an article about it online.

 

[Elixir6]

Thank you for your reply. Can you please define what ' competitive' means for GI?

1. You said there are some W O W applicants in this ( research) category. Can you define WOW?

Depends on what your definition of "is" is...