I am a current Ca-3 Mt Sinai resident and would love to shed a little light on the topic of fellowship.
For a lot of anesthesiology graduates, the idea of doing further subspecialization is a tough sell, even if it is just another year. You slaved away in undergrad, medical school, and then residency, and now, finally, you see the finish line and the lure of your impending attending salary and decide you have no desire to stick around another year as house staff. When I was a first year resident, most of the graduating class went right out into academics or private practice. Hardly anyone chose to do a fellowship.
However, in the 3 years that I have been here, those that have decided to go into fellowship have done very well. Remember, just like in applying for residency, there are a multitude of factors that affect which program you have your heart set on. Some had to be on the west coast for a spouse's job, some wanted to move "back home," while others wanted to go to THE hospital for x,y, or z, whether it is HSS for regional, or Brigham for OB, or Duke for cardiac., etc... so, just because we don't all end up at Harvard for fellowship, doesn't mean it was because we couldn't get a spot there. More than likely, we had no interest in going there.
I applied for peds. I was offered interviews at every place I applied (Hopkins, Boston Childrens, CHOP, etc), but for myself, the most important thing for me was being near my family for a year. I interviewed at my #1, LOVED the program, the next day they offered me a spot and I took it. It is at a top tier children's hospital and I couldn't be happier. The same goes for the other residents in my class. Almost without exception, they all received interviews at every place they applied, and they are all extremely happy with their fellowship spots. And yes, we sent someone to Harvard.
So, we do not have trouble getting quality fellowships outside of nyc, especially since I was actually unaware that there were really any quality fellowships IN nyc.
Furthermore, the department is very supportive if you do decide to apply for fellowship, even if you want to go outside the nest to do it. People are more that willing to pick up the phone and be your biggest cheeleader. They'll call on your behalf, sometimes even before you have approached them about calling, almost before you yourself have even decided to do a fellowship.
As for those that have chosen to stay at Sinai to do fellowship, they did so because they wanted to stay at Sinai afterwards. plain and simple. We are very happy here as residents, and a lot of us would love to stay on as faculty when we are done training. The hiring policy as of late has been either you must be fellowship-trained or a Sinai chief resident. So, those people that have stayed at Sinai to do fellowship do so because they are guaranteed a spot here when they are done.
Hope that somewhat answers your question. I am happy to answer any other questions, so please feel free to post.
