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Other than the interview parts this forum is pretty dead which is a shame compared to the other specialty forums. It is annoying that people come out of hiding to post interview dates but nothing else. I recently matched into fellowship and I thought I would post some advice on matching into a fellowship to help pay it forward. This is not a definitive guide for matching and some of the advice can differ based on the sub specialty. Any replies from other attendings/fellows are more than welcome.
For med students who are in the process of interviewing and have a choice of programs:
-If you are dead set on matching a certain fellowship, going to residency program that has that fellowship is generally very helpful for a few reasons. Most programs for REI, Gyn Onc, MFM, Urogyn have 1 spot. A fair amount of these will go to internal candidates and some won't even participate in the match while others will still go into the matching knowing that their home candidate is most likely going to go there. It's not fair, but it's how the game works.
In addition, programs with fellowships tend to have connected faculty. In all of these specialties, the sub specialist community is generally very small so phone calls and letters of rec play a big role, especially when they come from prominent/known people.
Not everyone will match at an academic program that has the fellowship they wanted to match in or any fellowship since there are not that many for each sub specialty. If you are still interviewing for residency and didn't get any interviews from places that have a fellowship you want, look at where there graduates have gone the last 5 years. That can give you a decent idea on what is feasible. There are plenty of strong programs that have no fellowships but consistently send people to various fellowships.
The fortunate/unfortunate thing also is the name/reputation of a program can be very helpful. I saw it firsthand with residents from UTSW or Pitt with weaker CVs/similar CVs get more interviews and more attention because of their program strength/connected faculty.
For current residents:
If you are certain on the fellowship of choice, seeking out a mentor is important. I knew during intern year I wanted to do FPMRS and met with faculty to get a game plan for my residency career. I was at a community program and had a bit more leg work to do so coming up with a timeline was important.
I think the biggest piece of advice I can give is trying to be a strong resident. If you don't like OB or Gyn is irrelevant as a resident. Trying to be strong in every area is important. A strong general background will make you a better fellow regardless of the sub specialty you are applying for. Plus you still have to take the written and oral boards.
Research: Most fellowships have a year of protected research time and want to see some scholarly activity. It's good to try to get a project going during your residency career that you can at least present at a conference as a poster. Oral presentations are a plus. Publications are of course a major plus. Even if you plan on going into private practice, fellowships are generally at academic centers and there is a requirement for a thesis in general.
My advice for this is to work on projects that are doable and you can complete in a timely manner. Most residencies do not have protected research time. I worked on my projects when I was post call or on free weekends. They don't have to be huge game changers. They just have to be clear, to the point, and well designed with a reasonable thought process.
Meetings: Most of the specialties have yearly meetings (AUGS, SMFM etc). Try to make it a point to go and network. Meet fellows and have your faculty introduce you to other attendings/fellowship directors. Networking is important and gets your name out there.
CREOGs: This is fellowship dependent. Some sub specialties don't place as much importance on this (MFM) versus REI/FPMRS/Gyn Onc. There is also a myth out there that fellowships can't ask you for your score or can't consider your scores. I'm not sure where this came from. As far as I know, CREOG scores cannot be used in seeing if a resident can move on from each year, but for fellowship appointments, I am not aware of such a restriction. Regardless, 95% of the programs for FPMRS asked for CREOG scores for PGY1-3. It is in your best interest to study for these tests and to try to do well, especially when coming from community based programs. There is a bias against community program residents that they aren't as "academic/smart" as residents from university programs, so doing well on CREOGs will help counter this. I had an interviewer tell me that point blank, knowing that I was coming from a community program.
Letters of Rec: You will need 3-4 letters of rec. Count on a letter from your PD, Chair, and 2 attendings. Get this done sooner as you don't want this to delay you.
ERAS: It's a pain but review the process later during your second year/early third year. You will have to review the application cycles for each fellowship. FPMRS is a bit earlier compared to Gyn Onc or REI. Stay on top of the timeline and submit your first day possible to have your application in the pool. Places have limited number of invites and an even more limited number of slots. You will also need to get your medical student transcripts/Deans letters to the EFDO for upload as well.
What to do if you are at a community program with no known faculty:
I ran into this situation at my residency. I ended up doing an away rotation for a month at a well known program. I got a very strong letter of rec from a prominent attending in the field which was huge on interviews. This letter got mentioned numerous times and was cited as a reason for getting an interview at a few programs. This can be a pain to set up but if you are in this boat, it may be your only way to get a solid letter from a prominent attending. You'll need the support from your administration which can be hit or miss. In addition, it is important to see if your malpractice coverage will extend so you can actually do stuff on your away rather than it just being an observership which is pretty useless. For Gyn Onc, there is the Galloway and Rutledge fellowships for residents during their third year at Memorial Sloan and MD Anderson.
Interviews:
Generally laid back. I know for Gyn Onc you will have to give some type of a presentation on a topic. For FPMRS some programs had intense situational questions while others had you do laparoscopic skills. Dumb stuff. Most will ask about interests and any research you did. Why you want to come here. What you are looking for in a program. Etc.
I had one program ask me a bunch of medically related questions on certain clinical situations. I learned afterwards, they had just asked me those questions because I came from a smaller, less known program while the other residents they were interviewing were coming from UTSW, Mayo etc and they were gauging my academic strength even though my CREOG scores are in the 90th percentile. I was not happy to learn about that.
Post Interview:
I sent thank you emails to nearly everyone I interviewed with. Sending actual cards is a pain in the ass and nearly all communication between applicants and programs is via email anyways. Programs are not so subtle in wanting to hear post interview communication to know that you are still interested. It's really not in the spirit of the match but this was nearly universal. Prior to rank list time I sent out some emails of interest. I never sent anyone a number 1 rank email. This is also the time to have faculty make phone calls on your behalf. Again, these are small groups of physicians and a known person making a call goes a long way. It can be a little shady but the fellowship game is like that.
It can be a grind but once you do match it is worth it. Main thing is making a clear gameplan. The match rates for the various subspecialties is 60-70%. Not a gimme for anyone but with a solid CV a resident can match.
For med students who are in the process of interviewing and have a choice of programs:
-If you are dead set on matching a certain fellowship, going to residency program that has that fellowship is generally very helpful for a few reasons. Most programs for REI, Gyn Onc, MFM, Urogyn have 1 spot. A fair amount of these will go to internal candidates and some won't even participate in the match while others will still go into the matching knowing that their home candidate is most likely going to go there. It's not fair, but it's how the game works.
In addition, programs with fellowships tend to have connected faculty. In all of these specialties, the sub specialist community is generally very small so phone calls and letters of rec play a big role, especially when they come from prominent/known people.
Not everyone will match at an academic program that has the fellowship they wanted to match in or any fellowship since there are not that many for each sub specialty. If you are still interviewing for residency and didn't get any interviews from places that have a fellowship you want, look at where there graduates have gone the last 5 years. That can give you a decent idea on what is feasible. There are plenty of strong programs that have no fellowships but consistently send people to various fellowships.
The fortunate/unfortunate thing also is the name/reputation of a program can be very helpful. I saw it firsthand with residents from UTSW or Pitt with weaker CVs/similar CVs get more interviews and more attention because of their program strength/connected faculty.
For current residents:
If you are certain on the fellowship of choice, seeking out a mentor is important. I knew during intern year I wanted to do FPMRS and met with faculty to get a game plan for my residency career. I was at a community program and had a bit more leg work to do so coming up with a timeline was important.
I think the biggest piece of advice I can give is trying to be a strong resident. If you don't like OB or Gyn is irrelevant as a resident. Trying to be strong in every area is important. A strong general background will make you a better fellow regardless of the sub specialty you are applying for. Plus you still have to take the written and oral boards.
Research: Most fellowships have a year of protected research time and want to see some scholarly activity. It's good to try to get a project going during your residency career that you can at least present at a conference as a poster. Oral presentations are a plus. Publications are of course a major plus. Even if you plan on going into private practice, fellowships are generally at academic centers and there is a requirement for a thesis in general.
My advice for this is to work on projects that are doable and you can complete in a timely manner. Most residencies do not have protected research time. I worked on my projects when I was post call or on free weekends. They don't have to be huge game changers. They just have to be clear, to the point, and well designed with a reasonable thought process.
Meetings: Most of the specialties have yearly meetings (AUGS, SMFM etc). Try to make it a point to go and network. Meet fellows and have your faculty introduce you to other attendings/fellowship directors. Networking is important and gets your name out there.
CREOGs: This is fellowship dependent. Some sub specialties don't place as much importance on this (MFM) versus REI/FPMRS/Gyn Onc. There is also a myth out there that fellowships can't ask you for your score or can't consider your scores. I'm not sure where this came from. As far as I know, CREOG scores cannot be used in seeing if a resident can move on from each year, but for fellowship appointments, I am not aware of such a restriction. Regardless, 95% of the programs for FPMRS asked for CREOG scores for PGY1-3. It is in your best interest to study for these tests and to try to do well, especially when coming from community based programs. There is a bias against community program residents that they aren't as "academic/smart" as residents from university programs, so doing well on CREOGs will help counter this. I had an interviewer tell me that point blank, knowing that I was coming from a community program.
Letters of Rec: You will need 3-4 letters of rec. Count on a letter from your PD, Chair, and 2 attendings. Get this done sooner as you don't want this to delay you.
ERAS: It's a pain but review the process later during your second year/early third year. You will have to review the application cycles for each fellowship. FPMRS is a bit earlier compared to Gyn Onc or REI. Stay on top of the timeline and submit your first day possible to have your application in the pool. Places have limited number of invites and an even more limited number of slots. You will also need to get your medical student transcripts/Deans letters to the EFDO for upload as well.
What to do if you are at a community program with no known faculty:
I ran into this situation at my residency. I ended up doing an away rotation for a month at a well known program. I got a very strong letter of rec from a prominent attending in the field which was huge on interviews. This letter got mentioned numerous times and was cited as a reason for getting an interview at a few programs. This can be a pain to set up but if you are in this boat, it may be your only way to get a solid letter from a prominent attending. You'll need the support from your administration which can be hit or miss. In addition, it is important to see if your malpractice coverage will extend so you can actually do stuff on your away rather than it just being an observership which is pretty useless. For Gyn Onc, there is the Galloway and Rutledge fellowships for residents during their third year at Memorial Sloan and MD Anderson.
Interviews:
Generally laid back. I know for Gyn Onc you will have to give some type of a presentation on a topic. For FPMRS some programs had intense situational questions while others had you do laparoscopic skills. Dumb stuff. Most will ask about interests and any research you did. Why you want to come here. What you are looking for in a program. Etc.
I had one program ask me a bunch of medically related questions on certain clinical situations. I learned afterwards, they had just asked me those questions because I came from a smaller, less known program while the other residents they were interviewing were coming from UTSW, Mayo etc and they were gauging my academic strength even though my CREOG scores are in the 90th percentile. I was not happy to learn about that.
Post Interview:
I sent thank you emails to nearly everyone I interviewed with. Sending actual cards is a pain in the ass and nearly all communication between applicants and programs is via email anyways. Programs are not so subtle in wanting to hear post interview communication to know that you are still interested. It's really not in the spirit of the match but this was nearly universal. Prior to rank list time I sent out some emails of interest. I never sent anyone a number 1 rank email. This is also the time to have faculty make phone calls on your behalf. Again, these are small groups of physicians and a known person making a call goes a long way. It can be a little shady but the fellowship game is like that.
It can be a grind but once you do match it is worth it. Main thing is making a clear gameplan. The match rates for the various subspecialties is 60-70%. Not a gimme for anyone but with a solid CV a resident can match.
