Application to Multiple Fellowships

[rikku]

Hello!

I am an european trained doctor. I am currently applying for a fellowship. I want to do gyn onco which in Europe includes breast, so I'd have to do 2 fellowships. I would prefer to start with breast because I did my last year or resident training exclusively in the breast department so I feel very confident and comfortable about it. However the application process for gyn onco is in december cycle while the breast application doesn't even start until may. I understand that the match is legally binding, which means if I match at gyn onco I need to withdraw my breast application? Or should I only apply to breast? However that way I'd have less chances to match. Am I picturing things correctly? Thanks!

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[Winged Scapula]

I'll answer here as well in your PM because you've provided more information here.

I'll presume you have verified that doing US based fellowships will allow you to reach your employment goals when you return to the EU.

First, gyn does not do breast in the US. As a matter of fact, most breast fellowships will not take OB-Gyn trained physicians, and some will also not accept applications from non US general surgery trained physicians, so please check whether or not you are even eligible. None of us here can comment on Gyn Oncology fellowships as it is a subspecialty under OB-Gyn.

Timing:

SSO accredited breast fellowships in the US open in May of your 4th/second to last year (about 14 months before you start); you will interview during the summer of your final residency year and match in December of your final year, starting fellowship about 8 months later (in July). I have to wonder if you thought applications were due in May of your final year.

While I don't know about Gyn Oncology, it appears that you apply about 18 months before you start you apply (i.e., December of your second to last year).

If you match to Gyn Oncology before the Breast match or vice versa, you must withdraw. The match is a binding agreement, although that may be meaningless for a non US citizen.

So depending on when you were planning on starting, you're right on time to apply for Gyn Oncology fellowship to start July 2019 but you're too late to apply for Breast surgery starting July 2018 although you could apply in May 2018 to start July 2019.

 

[vhawk]

Huh, I never really thought about it before but...why don't most breast fellowships take obgyn candidates? On first blush it seemed odd but the more I think about it the more reasonable it seems. Sure the training isn't identical nor are the skill sets but there is still a lot of operative experience in obgyn residency, enough that I would feel they'd meet any basic minimal technical standards. And I could see that making sense as a practice mix in the right setting. Yeah doing robot hysters and ax dissection don't have a ton in common but then again neither does lap chole and ax dissection

 

[Winged Scapula]

Huh, I never really thought about it before but...why don't most breast fellowships take obgyn candidates? On first blush it seemed odd but the more I think about it the more reasonable it seems. Sure the training isn't identical nor are the skill sets but there is still a lot of operative experience in obgyn residency, enough that I would feel they'd meet any basic minimal technical standards. And I could see that making sense as a practice mix in the right setting. Yeah doing robot hysters and ax dissection don't have a ton in common but then again neither does lap chole and ax dissection

Two reasons:

1) some programs include/require Gen Surg or Surg Onc call which an OB trained fellow wouldn't be capable of doing
2) the fellowship isn't really about learning to do breast surgery "from scratch" but rather honing skills and frankly, learning about management, interdisciplinary practice etc. I have heard privately from some faculty that they did not want to teach OBG residents how to do a lumpectomy or mastectomy and found it much easier to train GS fellows. Its not technically hard, but much of the year is spent on Rad Onc, Med Onc, PRS and other non-breast surgery rotations so there is not a lot of time to learn how to do those procedures when starting from zero. Some were concerned also that OBG fellows would not have enough cases between residency and fellowship to meet criteria when getting OR privileges out in practice.

Third possible reason (which remains to be seen): as ASBS moves toward either a CAQ or BC in Breast Surgery, the initial eligibility requirement will be GS training