Fellowship After Service Requirement

[jwilli709]

I’m currently a fourth year medical student at an allopathic medical student in Tennessee and am in the process of applying for residency in categorical General Internal Medicine. I’d like a little advice from anyone who can help provide me with more information.

I have the Georgia Board for the Physician Workforce Scholarship which requires me to practice General Internal Medicine (primary care) in rural or underserved area of Georgia or at a facility under the jurisdiction of the Georgia Department of Community Health or the Georgia Department of Corrections immediately upon the completion of residency. I have every intent to fulfill my requirement, which will be 3 years in length.

I’d like to further sub-specialize in General Cardiology and would like information about how to best match in a cardiology fellowship upon the completion of my service requirement. I already know that I’ll be forfeiting a pretty good salary but cardiovascular medicine has always been my passion within the grand scheme of Internal Medicine.

The Board may approve for me to establish a contractual agreement with a rural hospital or with a practice to begin my service requirement upon the completion of a fellowship in cardiology, but I understand that such rarely happens and I’d rather pursue fellowship after my service requirement is complete to avoid being obsolete in my level of knowledge based on relatively little practice of actual cardiology.

Any advice you can provide would be great appreciated. Thank you all so much.

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[dragonfly99]

I agree with your plan to do the service requirement first, and then fellowship. Don't get too down in the mouth about it because actually it's not THAT long, and things that you learn in practice will help you a bit in fellowship...just the actual attending/clinical experience helps. My advice would be to try to get some job that involves at least some hospital and/or ER work (not only 100% outpatient clinic stuff) for the 3 years. Some cardiology fellowships might have concerns if you haven't taken care of any inpatients in 3 years by the time you start fellowship (though I don't think it would be a deal breaker).
I would try to get a publication or abstract while you are in residency, because research really helps to get a fellowship, and you may not have the time or resources to do any once you're in practice/doing primary care.

Another piece of advice I would give you is that I wouldn't broadcast during the fellowship application process that you want to do general cardiology. There are places that won't care (and you should definitely look into applying to those types of places especially if they seem to have a good clinical cardiology training program), but a lot of places want to be seen as very "academic" and like to take fellows who say they want to do interventional, EP, CHF or other subspecialty fellowships. Sometimes during the interview process they are looking to "fit" people into their program (such as taking a couple interventional type guys, one who wants to do EP, and one who likes basic research, etc.). If they perceive that you just want clinical training (which is actual main goal of most applicatns) they might be less likely to accept you. This isn't true of all fellowships, but definitely is true of some of them.

The other thing u have to think about is letters of rec. How are you going to get them while you're doing primary care? My suggestion would be to collect them during the last year of your medicine residency, and tell the people writing them what your situation is (that you can't apply now, but wanted to get the LOR's from people when they actually remembered working with you). Then 2 years later when you are actually applying, you go back to those same docs and you say, "You wrote me this letter of recommendation a couple of years ago, but I was wondering whether you could update the date and update it with x, y, z [brief information about what you've been up to the past couple of years]".

 

[jwilli709]

Thank you SOOOOO much! This has been the most thorough and most informative feedback I've received on this inquiry. I will keep all of this in mind and apply it as appropriate. I truly appreciate your willingness to take the time to answer my question. Thank you, again.