"Fellow-driven" programs

[Hedge Trimmer]

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When people say that a residency program is fellow-driven, what exactly do they mean? I've heard people use this phrase with negative connotations. My perception is that the fellows end up doing the procedures, meaning the residents don't get much exposure.

Are there other factors to this? Is it always a negative for a program to have lots of fellows?

 

[maxxor]

It really depends on if there is enough work to go around. If a program is literally overflowing with clinical work to be done, then the balance between education and clinical service tilts far in the direction towards cleaning the lists with little time available for resident education. This is one area where Fellows help the resident experience by churning the volume so residents can go at a slower pace and allow attendings to teach on readout.

On the other hand, if there's not enough volume, the presence of a fellow can significantly detract from the resident experience because the fellow is faster and will churn cases way faster than a resident will be able to, never allowing them sufficient exposure to build competency or proficiency.

As an example:
MSK Imaging fellows

Probably a negative in that they can read a larger volume of MSK MRI/CT than junior residents can.

However, also a positive if they can churn radiographs keeping the residents from having to slog through the volume.