Value of heme/onc fellowship guarantee

[TCR255]

How valuable is the guarantee of fellowship in heme/onc for the ABIM physician-scientist track? Some programs offer a guarantee and others do not. The Harvard programs, for example, do not guarantee fellowship, but they all argued on interview day that MD/PhDs coming out of a top residency program match for fellowship in heme/onc wherever they want anyway. Is this true?

How easy is it then to match into a top heme/onc fellowship as a fast-tracker with one fewer years of clinical training under your belt (especially to fellowship programs not affiliated with your residency)? I’ve heard people on the interview trail say that a lot of fellowship programs don’t consider fast-trackers from outside of their institution, but on this message board I read that Mount Sinai recently sent two fast-trackers to UCSF and MSKCC for heme/onc fellowship. Not too bad!

I have found that the places I am most interested for fellowship are not always where I would like to train for residency. Trying to decide whether I should take it one step at a time (rank based solely on preference for residency and think about fellowship when the time comes) or rank solely based on where I would like to end up for fellowship… i.e. MGH/Brigham with no fellowship guarantee vs. Cornell with guaranteed spot at MSKCC?

What are other fast-track applicants doing? How has it worked out for those of you a few years ahead of us in the process?

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[Rumit]

It sort of depends on what you want and where you want to be and how risk-averse you are. For instance, if you're sure you want to do fellowship at MSKCC and you won't be happy with your life if you do fellowship anywhere else then take the guaranteed spot. You may have a great shot at MSKCC coming from MGH or a similar program but it's definitely not guaranteed, no matter what they say.

It's not impossible to short-track to an institution other than the one you do your residency in, but it's not trivial either (although better now that they moved the fellowship application dates back). It's mostly just a hassle to get another application together so soon and arrange coverage so you can fly to interviews as a junior resident.

Personally, I'd recommend either short tracking with a guaranteed spot or going somewhere you want to do residency for the full three years. If you short track it's because you want to get back to the lab as soon as possible. Otherwise, take the three years to really learn internal medicine, and give yourself the extra time to decide what you want to do for the rest of your life. That's the decision I made, at least.