How does everyone match so well for fellowships??

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curioux

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So far I have been to about 10 interviews and every program I go to seems to match really well for fellowships. The majority of programs have been touting the same programs like MGH, NYU, Cornell.. so on.. It just does not seem logistically possible.. what is going on? Are there more fellowships then there are residency positions? Do PDs have connections at high places? Am I just being played for a fool?

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So far I have been to about 10 interviews and every program I go to seems to match really well for fellowships. The majority of programs have been touting the same programs like MGH, NYU, Cornell.. so on.. It just does not seem logistically possible.. what is going on? Are there more fellowships then there are residency positions? Do PDs have connections at high places? Am I just being played for a fool?

The name here is not important. The key question is which fellowship and also which program.

- The number of fellowship spots are slightly more than the number of residency spots. However, most of the fellowships are in big name programs. Let's say Hopkins or MGH or UCSF. They have about 10-14 residents per class. However, they have about 30-40 fellows. So Even if all of their residents want to stay, then only 25% of their spots go filled. The other 75% will not fill with applicants from top programs since most of them also stay at their home program for fellowship. As a result, every program has someone who is going to MGH or UCSF for some kind of fellowship.

- On the other hand, the type of fellowship is very very very important. 10 years ago MRI and MSK fellowships were very competitive. These days IR and mammo are competitive. So a Chest fellowship @ UCSF or a body fellowship @ BWH does not impress me. However, IR at Miami vascular or Mammo at MGH have much more value.

- Heard recently from friends that Body and Neuro are easy these days. IR and Mammo are difficult. MSK is relatively easy, but tougher than body or Neuro. Chest and Nucs are very easy.

- Some institutions that are considered brand name, are not considered top notch in the world of radiology. For example, Cornell or Yale are considered big names, however their MSK fellowships are considered second tier. On the other hand, UCSD or Univ of Wisconsin are not as name brand as Hopkins, but both have top notch MSK fellowship reputation. Miami vascular, Brown, UVA, Wisconsin, .... are not as big names are MGH, but all have (much) better IR programs.

If you go to the worst (I don't know what that means) residency program, still they have a resident that is going to Hopkins or UCSF or Harvard or Duke for his fellowship. Don't let PDs sell this to you. It mean NOTHING.
 
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Also, while most seem to go into fellowship, not everyone does, so in addition to what is mentioned above, slightly fewer people applying.
 
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Cornell's MSK fellowship is HSS, most consider it a top tier program. Most of the other things said are accurate.

The name here is not important. The key question is which fellowship and also which program.

- Some institutions that are considered brand name, are not considered top notch in the world of radiology. For example, Cornell or Yale are considered big names, however their MSK fellowships are considered second tier. On the other hand, UCSD or Univ of Wisconsin are not as name brand as Hopkins, but both have top notch MSK fellowship reputation. Miami vascular, Brown, UVA, Wisconsin, .... are not as big names are MGH, but all have (much) better IR programs.
 
Cornell's MSK fellowship is HSS, most consider it a top tier program. Most of the other things said are accurate.

Ops. I didn't know HSS is related to Cornell. Yes, It is a big time MSK fellowship. I though it is affiliated with Columbia. Most people say they were trained at HSS and don't mention the name of university.

Thanks for correction.
 
Fellowships vary greatly from institution to institution and subspecialty to subspecialty.

Some fellowships, say nuclear and ped's, are universally noncompetitive, as NM has its own residencies filled with unemployable doctors; and there are only 2 or 3 sought-after pediatric fellowships that are not that competitive nonetheless. Cincinnati, for instance has no name in radiology otherwise but apart from Boston Children's or CHOP, it is the place for ped's.

It should be noted that the majority of radiology fellowships are not accredited by the ACGME, so they don't really require direct supervision or hour regulations. As such, they can look much better on paper than they are. I have heard reports of MSK fellowships that aren't even completely funded, even at the vaunted house of Reznick which is located in one of the more expensive cities. You are supposed to ooh and ahh over some of these places, but I have been less than impressed. UCSF and Stanford both have plenty of fellows who are just trying to remain employed, a couple on their second fellowship that I know of. They are just so large that they have plenty of slots. I met a fellow at UCSF who didn't even complete an American residency.

I have yet to meet residents at any program that have issues getting fellowships that they want, save for maybe vascular at places that don't offer the fellowship locally.
 
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