Factors Determining Fellowship

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otis86

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for people that are residents or have completed their fellowships, what are the factors that help get a fellowship in a specialty like cardiac anesthesia? besides the name of your institution and contacts what else is involved in getting a competitive fellowship at a top place? thanks.
 
The chiefs at most interviews I went to usually matched at more competitive places than their co residents
 
otis86 said:
for people that are residents or have completed their fellowships, what are the factors that help get a fellowship in a specialty like cardiac anesthesia? besides the name of your institution and contacts what else is involved in getting a competitive fellowship at a top place? thanks.
Click to expand...

I wouldn't suggest choosing a residency based solely on fellowship opportunities, but a lot of fellowship programs will preferentially take their own residents if they're interested and not a total screw-up. Better the flaws you know than the ones you don't, or something like that.
 
I interview people for a competitive peds fellowship.
Because there are so many applicants for each spot, much more than we can interview, there are some fairly arbitrary non fixed cut offs right off the bat. This is all done by the fellowship directors and their admin assistant. The match changed things a lot over the last few years. We have to interview a lot more people now to have a reasonable list. Previously it was just interview the best first. If we liked them, give them an offer immediately. We'd fill up fast with the applicants we liked and be done.
Anyway-
Marginal in service exam scores and the possibly of not passing the boards? Pass. Failing the boards and not getting a job is your problem, we don't want it to be our problem.
Incomplete application/ docs? Pass. If you want a fellowship, you'd take care of this. Don't expect a call.
Applying very late? Pass. It raises concerns about your motivations, and have reviewed others already. If you're a super star, you can overcome this with a good letter IF we have availability.
Visa issues, etc. Pass. Another potential headache we don't need.
Other big red flags, drug or alcohol problems, training extensions, etc. not related to something like an accident, pregnancy, etc. Pass. Someone else can take a chance on you. I came from a real honor code so I will hold you to a higher standard for those kinds of offenses if I see them in your record. If you don't like it, tough.
Obvious questionable mastery of the English language? Pass.

What matters the most? Pedigree. We get most of our fellows from the same handful of known strong programs in our general area year after year. Why? Because we know that they turn out high quality well prepared fellows. There are also a couple dead man walking applicants that have no chance due to problems with previous applicants/fellows from their residency. "They don't even know that they're dead." Blame your attendings for graduating marginal residents and then selling them as superstars.

How they go about splitting hairs on the bulk of the applicants is a mystery. Scores matter. I would expect LORs make a very very big impression. For the most part, all the LORs I've read are outstanding, so the average, read between the lines, "this guy is ok" letters must be coming in, but not making it to my mailbox. That's great that you're polite, trainable and aren't killing patients, but what else have you got? These LOR writers know you well, or should, if they have nothing glowing to say about you that says a great deal. We want great fellows with great potential, that's not you.

Being a chief or having a few years of experience and being board certified will also help. You're bringing more leadership and/or experience and/or maturity to the table. That's appreciated. A minority worry about how you will be able to handle giving up control and being a trainee again. I don't, as I did myself, but a few may raise this concern and potentially hold it against current attendings if they don't like the answer you give to these questions.

Research. Everyone loves some good research. If you want to find success in academia, get started early. All the big programs have some kind of academic requirement, and we want to know you can succeed. We are also a fairly academic bunch, with lots of publications, posters, lectures, etc. every year. Are you a good academic fit here? Will you be involved in these things?

So, now you've got the interview. Now what?

Do you have obvious personality disorders, communication problems, strange mannerisms, etc. Are you completely socially inappropriate? You would be surprised how many people are great on paper and bad in person. Really bad. If I don't even want to complete the interview, why would I want to work with you for a year? I wouldn't, and don't have to. Hide this stuff really well if you're dealing with these issues.

If you have supposedly done research, presentations, posters, etc. you better be able to explain what you did, intelligently, and the results. Again, you'd be surprised. It is a huge red flag for me. I used to do some research and scholarly activity back in the day. I can explain what it was about and what I did 20 years ago in medical school. If you can't explain what you did last year, you obviously didn't really do anything. How can applicants not expect this question? It's baffling.

Do your stated career goals match your history and what you want to do with us? If you say you want to be a big time academic anesthesiologist and be a future chairman and have done essentially zero research at a place with ample opportunity, that is a problem. Not our problem though.

Your ability to coherently answer "why here?" is extremely important. We want a good fit. Why do you want to be here and where do you want to go? How can we get you there? All important.

Are you faculty partner potential? If you say you want a job here, great! But are you really a good fit? Fellowship is also a year long interview. There is a reason most faculty hires come out of the fellowship.

Enough ramblings.
I wouldn't rank me if I gave this answer.
Any specific questions?
(Don't ask which residencies suck, I'm not answering that, and it should be fairly obvious. They're not surprises. Look around. Are you a horrible applicant? Are your faculty a bunch of hacks? Do you walk around wondering how y'all aren't killing more patients? If no, it's probably not your place.)
 
If you're a superstar resident with strong scores, and great LORs from a reasonably good program, who cares where you went to medical school?
You have to get into a decent residency though. Once that hurdle is overcome, it's all in the rear view mirror. Maybe it comes back to haunt you in the rank order? It's hard find ways to separate people to rank. Kill the interview and have everyone wanting to spend a year with you. You'll probably match.
 
if you train at a program that is new and not known as well right now is that a negative factor? thanks for your detailed response!
 
IlDestriero said:
I interview people for a competitive peds fellowship.
Because there are so many applicants for each spot, much more than we can interview, there are some fairly arbitrary non fixed cut offs right off the bat. This is all done by the fellowship directors and their admin assistant. The match changed things a lot over the last few years. We have to interview a lot more people now to have a reasonable list. Previously it was just interview the best first. If we liked them, give them an offer immediately. We'd fill up fast with the applicants we liked and be done.
Anyway-
Marginal in service exam scores and the possibly of not passing the boards? Pass. Failing the boards and not getting a job is your problem, we don't want it to be our problem.
Incomplete application/ docs? Pass. If you want a fellowship, you'd take care of this. Don't expect a call.
Applying very late? Pass. It raises concerns about your motivations, and have reviewed others already. If you're a super star, you can overcome this with a good letter IF we have availability.
Visa issues, etc. Pass. Another potential headache we don't need.
Other big red flags, drug or alcohol problems, training extensions, etc. not related to something like an accident, pregnancy, etc. Pass. Someone else can take a chance on you. I came from a real honor code so I will hold you to a higher standard for those kinds of offenses if I see them in your record. If you don't like it, tough.
Obvious questionable mastery of the English language? Pass.

What matters the most? Pedigree. We get most of our fellows from the same handful of known strong programs in our general area year after year. Why? Because we know that they turn out high quality well prepared fellows. There are also a couple dead man walking applicants that have no chance due to problems with previous applicants/fellows from their residency. "They don't even know that they're dead." Blame your attendings for graduating marginal residents and then selling them as superstars.

How they go about splitting hairs on the bulk of the applicants is a mystery. Scores matter. I would expect LORs make a very very big impression. For the most part, all the LORs I've read are outstanding, so the average, read between the lines, "this guy is ok" letters must be coming in, but not making it to my mailbox. That's great that you're polite, trainable and aren't killing patients, but what else have you got? These LOR writers know you well, or should, if they have nothing glowing to say about you that says a great deal. We want great fellows with great potential, that's not you.

Being a chief or having a few years of experience and being board certified will also help. You're bringing more leadership and/or experience and/or maturity to the table. That's appreciated. A minority worry about how you will be able to handle giving up control and being a trainee again. I don't, as I did myself, but a few may raise this concern and potentially hold it against current attendings if they don't like the answer you give to these questions.

Research. Everyone loves some good research. If you want to find success in academia, get started early. All the big programs have some kind of academic requirement, and we want to know you can succeed. We are also a fairly academic bunch, with lots of publications, posters, lectures, etc. every year. Are you a good academic fit here? Will you be involved in these things?

So, now you've got the interview. Now what?

Do you have obvious personality disorders, communication problems, strange mannerisms, etc. Are you completely socially inappropriate? You would be surprised how many people are great on paper and bad in person. Really bad. If I don't even want to complete the interview, why would I want to work with you for a year? I wouldn't, and don't have to. Hide this stuff really well if you're dealing with these issues.

If you have supposedly done research, presentations, posters, etc. you better be able to explain what you did, intelligently, and the results. Again, you'd be surprised. It is a huge red flag for me. I used to do some research and scholarly activity back in the day. I can explain what it was about and what I did 20 years ago in medical school. If you can't explain what you did last year, you obviously didn't really do anything. How can applicants not expect this question? It's baffling.

Do your stated career goals match your history and what you want to do with us? If you say you want to be a big time academic anesthesiologist and be a future chairman and have done essentially zero research at a place with ample opportunity, that is a problem. Not our problem though.

Your ability to coherently answer "why here?" is extremely important. We want a good fit. Why do you want to be here and where do you want to go? How can we get you there? All important.

Are you faculty partner potential? If you say you want a job here, great! But are you really a good fit? Fellowship is also a year long interview. There is a reason most faculty hires come out of the fellowship.

Enough ramblings.
I wouldn't rank me if I gave this answer.
Any specific questions?
(Don't ask which residencies suck, I'm not answering that, and it should be fairly obvious. They're not surprises. Look around. Are you a horrible applicant? Are your faculty a bunch of hacks? Do you walk around wondering how y'all aren't killing more patients? If no, it's probably not your place.)
Click to expand...

Applying for Peds Fellowships now... thanks for the input.
 
otis86 said:
if you train at a program that is new and not known as well right now is that a negative factor? thanks for your detailed response!
Click to expand...
It's not going to do you any favors. Be the best and make chief resident. Be memorable. Work harder than everyone else. You'll earn the good LORs. That's the best you can do and it will lead to fellowship interest.
 
If you receive an interview only after your chairman/PD call on your behalf (aka using personal connections), are you already at a disadvantage when it comes to ranking? Or is it possible that your application was only initially overlooked because of the number of applicants/application completed later/etc.?
 
IlDestriero said:
I interview people for a competitive peds fellowship.
Because there are so many applicants for each spot, much more than we can interview, there are some fairly arbitrary non fixed cut offs right off the bat. This is all done by the fellowship directors and their admin assistant. The match changed things a lot over the last few years. We have to interview a lot more people now to have a reasonable list. Previously it was just interview the best first. If we liked them, give them an offer immediately. We'd fill up fast with the applicants we liked and be done.
Anyway-
Marginal in service exam scores and the possibly of not passing the boards? Pass. Failing the boards and not getting a job is your problem, we don't want it to be our problem.
Incomplete application/ docs? Pass. If you want a fellowship, you'd take care of this. Don't expect a call.
Applying very late? Pass. It raises concerns about your motivations, and have reviewed others already. If you're a super star, you can overcome this with a good letter IF we have availability.
Visa issues, etc. Pass. Another potential headache we don't need.
Other big red flags, drug or alcohol problems, training extensions, etc. not related to something like an accident, pregnancy, etc. Pass. Someone else can take a chance on you. I came from a real honor code so I will hold you to a higher standard for those kinds of offenses if I see them in your record. If you don't like it, tough.
Obvious questionable mastery of the English language? Pass.

What matters the most? Pedigree. We get most of our fellows from the same handful of known strong programs in our general area year after year. Why? Because we know that they turn out high quality well prepared fellows. There are also a couple dead man walking applicants that have no chance due to problems with previous applicants/fellows from their residency. "They don't even know that they're dead." Blame your attendings for graduating marginal residents and then selling them as superstars.

How they go about splitting hairs on the bulk of the applicants is a mystery. Scores matter. I would expect LORs make a very very big impression. For the most part, all the LORs I've read are outstanding, so the average, read between the lines, "this guy is ok" letters must be coming in, but not making it to my mailbox. That's great that you're polite, trainable and aren't killing patients, but what else have you got? These LOR writers know you well, or should, if they have nothing glowing to say about you that says a great deal. We want great fellows with great potential, that's not you.

Being a chief or having a few years of experience and being board certified will also help. You're bringing more leadership and/or experience and/or maturity to the table. That's appreciated. A minority worry about how you will be able to handle giving up control and being a trainee again. I don't, as I did myself, but a few may raise this concern and potentially hold it against current attendings if they don't like the answer you give to these questions.

Research. Everyone loves some good research. If you want to find success in academia, get started early. All the big programs have some kind of academic requirement, and we want to know you can succeed. We are also a fairly academic bunch, with lots of publications, posters, lectures, etc. every year. Are you a good academic fit here? Will you be involved in these things?

So, now you've got the interview. Now what?

Do you have obvious personality disorders, communication problems, strange mannerisms, etc. Are you completely socially inappropriate? You would be surprised how many people are great on paper and bad in person. Really bad. If I don't even want to complete the interview, why would I want to work with you for a year? I wouldn't, and don't have to. Hide this stuff really well if you're dealing with these issues.

If you have supposedly done research, presentations, posters, etc. you better be able to explain what you did, intelligently, and the results. Again, you'd be surprised. It is a huge red flag for me. I used to do some research and scholarly activity back in the day. I can explain what it was about and what I did 20 years ago in medical school. If you can't explain what you did last year, you obviously didn't really do anything. How can applicants not expect this question? It's baffling.

Do your stated career goals match your history and what you want to do with us? If you say you want to be a big time academic anesthesiologist and be a future chairman and have done essentially zero research at a place with ample opportunity, that is a problem. Not our problem though.

Your ability to coherently answer "why here?" is extremely important. We want a good fit. Why do you want to be here and where do you want to go? How can we get you there? All important.

Are you faculty partner potential? If you say you want a job here, great! But are you really a good fit? Fellowship is also a year long interview. There is a reason most faculty hires come out of the fellowship.

Enough ramblings.
I wouldn't rank me if I gave this answer.
Any specific questions?
(Don't ask which residencies suck, I'm not answering that, and it should be fairly obvious. They're not surprises. Look around. Are you a horrible applicant? Are your faculty a bunch of hacks? Do you walk around wondering how y'all aren't killing more patients? If no, it's probably not your place.)
Click to expand...



Do you think fellowship programs will closely look at the basic board exam scores ?
 
Kiss a lot of a$$.

Most of the time, if you tell me you were chief, there is a 50% chance you are not the kind of human being I enjoy having around.
 
Isnt being chief resident essentially just doing a bunch of scut work? I would also be in favor of having someone in my practice willing to do the scut work. Okay I get it.
 
Oh boy. So, to highly increase chances of landing a great gig, you have to be chief. To be chief you have to be a weasel.

I don't want to be a weasel! But I do want to maximize opportunities and trying to make chief one day is part of that. Maybe there are some who are great at administration and aren't weasels too 😀
 
Do the step 1, 2, 3 board scores matter? Or just that you pass on 1st attempt?
 
cocokoko said:
Do the step 1, 2, 3 board scores matter? Or just that you pass on 1st attempt?
Click to expand...

I'm not in a position to know, but what I've been told by a couple of PDs is that the USMLE and ITEs matter more for people who are applying as residents, because it's the recent (only) objective data. For those who have been out in practice for a bit and have taken the actual written exam, that score carries the most weight.

I took Steps 1-3 between 2000 and 2002 and scored OK; ITEs and the real thing between 2006-2009 and scored great; will probably be applying to fellowship in 2016 due to Navy shenanigans. I'd like to think my uninspiring Step 1 from 15 years prior wouldn't get me cut from consideration at top programs ...

Maybe IlDestriero can comment on this. (And thanks for your earlier great post in this thread!)
 
IlDestriero said:
Someone posted some statistics last year, but I don't know where they are. It was peds or cardiac as I recall. I think it was 80%?
Click to expand...


From SFMatch, last year's CT data:

Adult Cardiothoracic Anesthesiology FellowshipJune 2013
APPLICANT DATA
Applicant registrations267
# Applicant Rank Lists Submitted230
Matched Total166
Unmatched Total64
Applicant Matching % (Overall)72%
Total # of Withdrawals9
PROGRAM DATA
# of Participating Programs54
Positions Offered168
Positions Filled166
Unfilled Positions2
 
jbl16 said:
From SFMatch, last year's CT data:

Applicant Matching % (Overall)72%
Click to expand...

From the NRMP data, Pain is 65% overall with 70% for US allopathic grads.
Peds is like ~80% I think.
 
I guess it depends on how chiefs are elected at your program. At my program the residents vote for who they'd think would do the best job and the faculty have veto power. Perhaps kissing butt could win over an academic attending, but I would think that most of your peers would see through it and not elect a weasel as chief. FWIW, in my experience, those that campaign hard for a chief position, kiss butt, or do shady weaselly things are the ones that don't elected. The easy going, likable, and responsible residents with no clinical or academic deficiencies are the ones who usually get elected as chief.

A private practice attending recently told me that being chief shows that you are responsible, likable, and can play well with others. He said that being a chief is one of the few things you can do during residency that can improve your CV and separate you from the crowd, especially for private practice. Most PP groups could probably care less about your interleukin and cytokine research or your fantastic poster presentation at the Midwest anesthesia resident conference. I know of one PP group that has a history of only hiring chief residents or board certified attendings that have been in practice of a while. Being a chief can help you in both PP and academics/fellowship.

Yes, it is a bunch of extra scut work intermingled with endless complaints and requests from attendings and residents, but if you're elected it's probably worth your time to accept the position and do a good job.
 
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