Fellowship Applications - Multiple Specialties A Problem?

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Since many fellowships do not use the same application service, it is impractical if not impossible to apply for multiple specialties at once. For example many if not most surgical fellowships do not use the NRMP, And the matches are held at different times throughout the year. Thus, you cannot apply for a surgical oncology fellowship at the same time you apply for a vascular surgery fellowship.
 
I think it would be interesting to know the thought process of the interviewer in terms assessing your true interest for the specialty. I thought that if you tell them you're applying for 5 different fellowships you become less desirable than someone who goes "all in" on one specialty.
 
I think it would be interesting to know the thought process of the interviewer in terms assessing your true interest for the specialty. I thought that if you tell them you're applying for 5 different fellowships you become less desirable than someone who goes "all in" on one specialty.

I applied to one back in the day, before any match. I think most only apply to one.
Now I interview candidates for fellowship. If you said that you applied for fellowship to several different sub specialties, I would recommend against giving you a position.
 
This sentiment is widespread and a sentiment of arrogance that only those in power have the luxury to have. Back in the day was a different world where students would walk into the plastic surgery chairmens office and say "hey I need a spot" and they'd get it. It's a different world now.

You're rewarding people for risking their career and punish those who can't afford to go "all in". How does that change the qualifications of someone for a fellowship?

How does that ensure the best quality of care for the patient?

Is that really the best way to find the best person for the job?
 
I'm not applying for fellowships anytime soon, but I would imagine telling a program that you're applying to multiple subspecialties is like shooting yourself in the foot. To me it sounds indecisive. How would you feel if you were a PD and an applicant says "Well I really love cardiology (for example) and I'm sooo passionate about it, but I applied GI, Heme/onc, and pulm critical care b/c those are just as great?" You should wait until you know what you want to do then apply for that fellowship. You'll be done with residency so it's not like you're really risking your career as you'll be able to get a job in whatever you did your training in while you figure things out.
 
People are losing their jobs because of conditions in this country. Look at these residents in radiology:

http://www.nytimes.com/2013/03/28/h...-specialties-see-dream-jobs-disappearing.html

They've invested 200K, 5 years of their lives, and now they're on the street sending out their resumes. They're gonna do have they have to do and no one has the right to judge them if they apply to multiple specialties.

Do you think they should take a chance and apply to other specialties? Maybe you see that a sign of weakness and indecision but I see it as survival. These PDs are asking people in debt to be passionate and roll the dice but won't risk anything themselves.

For a PD to judge them based on that is criminal. They're driving their fancy cars to carry out their responsibilities in an unbiased manner. If they can't do that a red flag needs to be raised. Those that make it past the "finish line" seem to forgive and forget the long journey.
 
It's unfortunate what happened to the St. Barnabas residents; however, that situation is different from your original question/query. Those residents need to complete a residency in order to be BE/BC to practice in this country. They should apply to whatever they want to apply to in order to get that training and ultimately attain a job. Radiology is competitive, so if they were to choose to apply to IM or something else as a backup then that's reasonable. You, on the other hand, are asking about fellowships. No one is REQUIRED to do a fellowship. You will have already completed residency training, so you can just go practice whatever specialty you trained in and make money if you want. You're not risking your career at all. I don't think it's unreasonable for a PD with an extremely limited number of fellowship spots to want to ensure those spots go to people who are passionate about that field. Applying to a bunch of different subspecialty fellowship programs is indecisive and unnecessary when you can simply work in your field of training until you know what you really want.
 
This sentiment is widespread and a sentiment of arrogance that only those in power have the luxury to have. Back in the day was a different world where students would walk into the plastic surgery chairmens office and say "hey I need a spot" and they'd get it. It's a different world now.

Its been a "different world" for decades.

You're rewarding people for risking their career and punish those who can't afford to go "all in". How does that change the qualifications of someone for a fellowship?

How does that ensure the best quality of care for the patient?

Is that really the best way to find the best person for the job?

The best candidate for the job and the best quality of care for the patient is someone who is decisive and passionate about their choice of specialty and is qualified to do so, not the candidate who doesn't really care what specialty they do.

As noted above, no one is required to do a fellowship. They aren't being penalized for being asked to choose one subspecialty nor are you asking poor medical students to spend thousands of dollars in application fees. No one is "risking their career" by not doing a fellowship as they are already fully trained via residency.
 
You're making a lot of assumptions and decisions on behalf of the applicant. You're telling them work as a hospitalist for a while and keep shooting for X specialty each year when subsequent applications will be less and less attractive and they're doing something they don't want to do. So YES you are risking your desired career.

The truth is that most people are exploring multiple specialties and my question is whether the PDs are even minded enough to hear the truth. It's clear to me they aren't and have no empathy for the conservative approach. Everyone loves to say "Back in the day I only applied to X specialty because I loved it." If you asked them "back in the day" I guarantee you they had thoughts of other specialties but now on the other side of this debate they sit back, put their feet up and judge others.
 
I reward people who are genuinely interested in their career choice, are passionate about training here, are academically competitive, and are a good fit with the department. If you want to apply to 2 or 3 different fellowships (different sub specialties altogether, not different training programs in the same field), how does that show any commitment to the field you claim to want to practice for the rest of your career? It doesn't. So you're not getting a spot ahead of anyone competitive who is committed to that field.
We have had fellows leave training after a few months because it "wasn't for them". By then it's impossible to find a replacement, so the spot remains open and all the other fellows have to work harder. Is that fair? No. Who is likely to leave a fellowship? Someone who is not fully committed to that career choice.
Is that really the best way to find the best person for the job?
Yes.
 
I reward people who are genuinely interested in their career choice, are passionate about training here, are academically competitive, and are a good fit with the department. If you want to apply to 2 or 3 different fellowships (different sub specialties altogether, not different training programs in the same field), how does that show any commitment to the field you claim to want to practice for the rest of your career? It doesn't. So you're not getting a spot ahead of anyone competitive who is committed to that field.
We have had fellows leave training after a few months because it "wasn't for them". By then it's impossible to find a replacement, so the spot remains open and all the other fellows have to work harder. Is that fair? No. Who is likely to leave a fellowship? Someone who is not fully committed to that career choice.

Yes.
Who is likely to leave a fellowship? Someone who is not fully committed to that career choice.

Do you have any statistics on that? Unlikely. A more capable candidate can excel far past a less capable candidate who just loves loves loves that specialty. Just because you love to do X doesn't meant you're going to put in the time and effort to be the best and advance the field. You can enthusiastically land a fellowship and then coast your way through which I've seen many people do. If you're using that as a major determinant in your decision you are compromising your duties to the educational system and to the patient.
 
If you come to your pediatric anesthesia fellowship interview and tell me that you're also interviewing for pain and cardiac anesthesia, you're not getting my recommendation. You would actually get my recommendation not to offer you a spot. That's pretty much the kiss of death for an applicant.
I want to train people committed to a career in pediatric anesthesia. That's the best thing for me, the program, the institution, the field, and the patients.
If you're not decided what you want to do, that's fine. Take another year or two and apply when you have decided on your desired career path. That's what I did. I considered my options for a few years, banked some loot and made my decision.
I'm not sure what is controversial about that. Preference is given to people who clearly articulate commitment to their supposedly preferred field. It's also given to people with superior LORs and people that are nice, well spoken, and seen easy to get along with. I'm sure you'll have a problem with that as well. When there are >10 applicants per spot, and you offer clinically and academically outstanding training, you don't have to settle for anything less than the best candidates. If you're not an outstanding resident, you won't even get an interview offer.
 
People are losing their jobs because of conditions in this country. Look at these residents in radiology:

http://www.nytimes.com/2013/03/28/h...-specialties-see-dream-jobs-disappearing.html

They've invested 200K, 5 years of their lives, and now they're on the street sending out their resumes. They're gonna do have they have to do and no one has the right to judge them if they apply to multiple specialties.

Do you think they should take a chance and apply to other specialties? Maybe you see that a sign of weakness and indecision but I see it as survival. These PDs are asking people in debt to be passionate and roll the dice but won't risk anything themselves.

For a PD to judge them based on that is criminal. They're driving their fancy cars to carry out their responsibilities in an unbiased manner. If they can't do that a red flag needs to be raised. Those that make it past the "finish line" seem to forgive and forget the long journey.

Someone losing their residency spot because their program closed down has nothing to do with fellowship applications or selection.
 
1. This is wrong. You clearly underestimate how important motivation is in order to succeed. Fellowship is not a conveyor belt job.
2. If you are "more capable", just go to fellowship you love. Are you so capable that you did research/excelled in five fields and you can get strong LORs for each of them?

Do you have any statistics on that? Unlikely. A more capable candidate can excel far past a less capable candidate who just loves loves loves that specialty. Just because you love to do X doesn't meant you're going to put in the time and effort to be the best and advance the field. You can enthusiastically land a fellowship and then coast your way through which I've seen many people do. If you're using that as a major determinant in your decision you are compromising your duties to the educational system and to the patient.
 
You talk about love and roses. In the real world, I'm talking about students because this is SDN, getting a residency or fellowship isn't that simple. There's a lot of people with research and strong LORs. Unfortunately this system rewards enthusiasm over capability.

IlDestriero himself just said he considered other specialties and waited while he "banked loot". Not everyone can do that or wants to have that uncertainty in terms of specialty and geographic location. Very professional by the way(see his other posts) as an attending on a forum predominantly full of debt ridden students and residents.
 
Cool down.
Think twice.
Good luck.
You talk about love and roses. In the real world, I'm talking about students because this is SDN, getting a residency or fellowship isn't that simple. There's a lot of people with research and strong LORs. Unfortunately this system rewards enthusiasm over capability.

IlDestriero himself just said he considered other specialties and waited while he "banked loot". Not everyone can do that or wants to have that uncertainty in terms of specialty and geographic location. Very professional by the way(see his other posts) as an attending on a forum predominantly full of debt ridden students and residents.
 
This sentiment is widespread and a sentiment of arrogance that only those in power have the luxury to have. Back in the day was a different world where students would walk into the plastic surgery chairmens office and say "hey I need a spot" and they'd get it. It's a different world now.

You're rewarding people for risking their career and punish those who can't afford to go "all in". How does that change the qualifications of someone for a fellowship?

How does that ensure the best quality of care for the patient?

Is that really the best way to find the best person for the job?

How is applying and getting/not getting a fellowship risking a person's career? Like others have mentioned, a graduate from a residency can practice without any issues.

I guess I don't understand your issue with this.

How does that ensure the best quality of care for the patient?

Is that really the best way to find the best person for the job?

I do think it is the best way to find the best person for the job. A fellowship director want someone who is invested in the field and has a genuine interest in it. Applying to a bunch of fellowships doesn't show that level of dedication.
 
This past year, I applied to both nephrology and heme/onc. Got 5 interviews in nephrology, none for heme/onc. A few times, interviewers brought up the fact that one of my LOR writers said I would make a great nephrologist or heme/onc specialist. Did not match this year. Next time I apply, I will only go for one type of fellowship.
 
You talk about love and roses. In the real world, I'm talking about students because this is SDN, getting a residency or fellowship isn't that simple. There's a lot of people with research and strong LORs. Unfortunately this system rewards enthusiasm over capability.

IlDestriero himself just said he considered other specialties and waited while he "banked loot". Not everyone can do that or wants to have that uncertainty in terms of specialty and geographic location. Very professional by the way(see his other posts) as an attending on a forum predominantly full of debt ridden students and residents.

We're discussing fellowships here, not residencies. If you don't want to go and work for a few years after residency, that's your decision. Most people just go straight through. However, anyone can get a job and practice while they decide if they want to pursue a fellowship. During that time you do get paid, generally quite well compared to one's resident income. You too can bank some loot. I set aside a significant amount of money to subsidize my decreased income during fellowship as I had a family to continue to support. I live in the real world, had a family during training, bills to pay, etc. Waiting can certainly enhance your application as you bring your attending experience, board certification, leadership, maturity, research, etc. to the table. I did change my mind on which fellowship I wanted to pursue during that time. If I had not waited a few years, I'd be doing something else right now. Though that's not why I waited.
And yes, one's enthusiasm, likability, interview skills, charisma, the "x factor", etc. all factor into decision making regarding hiring. Get used to it. That's the real world. SDN is the land of love and roses, where everyone is a superstar and where you train doesn't matter, etc.
Your capability (skills, experience, standardized test scores, etc) is certainly a very large factor, but I'd rather train and work with a person who is a "good fit" 9.5 out of 10 candidate than an arrogant or difficult or "insert negative adjective here" 10/10 applicant. So would everyone else, in medicine or business or Starbucks.
 
With regards to rewarding enthusiasm over capability, I venture that's a gross overestimation.

In fact, one of the frequent complaints on these boards is that students/residents with below average scores, LORs, etc. feel that their enthusiasm gets short shrift because of the emphasis on "numbers". Programs use those scores as a measure of capability, fair or not.

As IlDestriero notes, when faced with 2 applicants of nearly equal "numbers" the faculty is always going to choose the applicant with a strong commitment, passion, good personality and a good fit over someone who seems indecisive.

Most residents have sufficient experience with subspecialties to make a decision regarding fellowship training. I would guess that Top Gun's decision to apply to two widely disparate
specialties is unusual, but that his experience of failing to match is not.
 
The answer is simple - apply to your ideal subspecialty (or if truly ambivalent, the more competitive one) this year with a hospitalist position as backup.

If you don't get a spot apply to a less competitive fellowship next year.

Only apply to one at a time, and stop being so melodramatic - worst case scenario is you become a generalist.
 
I would think it would be hard to get substantial research and mentorship if you tried to apply to multiple fellowships though, right? From what I've heard, you have to start early and most residents find it difficult to find time with just one subspecialty in mind.
 
This isn't a hard concept. Don't make it more difficult than it is. Pick your pony and ride it. Done.
 
You talk about love and roses. In the real world, I'm talking about students because this is SDN, getting a residency or fellowship isn't that simple. There's a lot of people with research and strong LORs. Unfortunately this system rewards enthusiasm over capability.

IlDestriero himself just said he considered other specialties and waited while he "banked loot". Not everyone can do that or wants to have that uncertainty in terms of specialty and geographic location. Very professional by the way(see his other posts) as an attending on a forum predominantly full of debt ridden students and residents.

You can understand if you're an IM resident why "I don't want to an internist" is not a compelling argument for being accepted into a fellowship program, right? In terms of uncertainty, that's life. If you're not competitive in your desired subspecialty in your region, you either need to look at a broader range of programs outside of your area or pick a less competitive subspecialty. And it varies by specialty, but outside of the most competitive fellowships most are readily available to docs that have been in practice after residency (there's less of a stigma than time passing between med school and residency). Plenty of residents do a chief year or work as a hospitalist because it took them an extra year to decide on a fellowship. And in terms of debt, you'll make far more in private practice then you will as a fellow. So I'm not quite sure what your actual issue is.
 
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