How to Apply for Fellowships
Special Thanks
 To our Panel of Soon-To-Be Fellows, Fellows, Fellowship Directors, and other wise attendings
 To the Chief Residents and Residency Leadership, for their help preparing this session
What Fellowships/Second Residencies/Subspecializations exist in Pediatrics?
ACGME Accredited Pediatric Specialties (2007-2008)
# Programs
Adolescent Medicine
26
Anesthesiology
45
Cardiology
49
Child Abuse (joined in 2009)
Critical Care
62
Development/Behavior
33
Emergency Medicine
46
Endocrinology
68
Gastroenterology
51
Hematology/Oncology
64
Infectious Disease
61
Neonatology (joined in 2009)
Nephrology
36
Neurology
67
Pulmonology
47
Rehabilitation
11
Rheumatology
26
Sports Medicine
8
# Positions Filled
63
142
305
358
76
261
215
209
352
162
105
251
120
9
64
11
data from www.acgme.org
ACGME Accredited Combined Adult/Pediatric Specialties (2007-2008)
# Programs
# Positions Filled
Allergy and Immunology
71
303
Dermatology
109
1077
Genetics
48
90
Preventative Medicine
73
346
Toxicology
4
11
data from www.acgme.org
Other Pediatric Fellowships
• Academic General Pediatrics
• Pediatric Hospital Medicine
• Robert Wood Johnson
• CDC-EIS (Epidemiologic Intelligence
Service)
Created by Becky Blankenburg, MD, MPH
Associate Program Director, Advising and Career Development
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Alternative Medicine
Environmental Health
Palliative Care
Pain Management
LPCH/Stanford Career Development Series
6/9/2010
How to Identify Career Goals
Some things to think about…
• Particular passion
• Specific areas of interest
• Intellectual Content of the subspecialty (variety of medical problems, ages, exotic vs. common)
• What combination of Clinical Work, Clinical Research, Laboratory Research, Education,
Administration, Advocacy, Policy would you like to have?
• Variety of Practice Opportunities (that is, are you able to tailor what you would like to do?)
• Subspecialty vs. primary care
• Predominantly inpatient vs. outpatient
• Chronic vs. acute
• Continuity of care vs. short-term
• Procedures
• Deaths and bad news
• Academic vs. community setting
• Hours of work
– Daytime vs. nighttime
– On-service time vs. shifts
• Ability to work part-time
• Costs: Time on-service, geography, lifestyle, salary
How to Gain Exposure to Subspecialties
• Electives and Selectives
• Away rotations
• Doing research
• Division meetings
• Attend subspecialty clinics during quieter months
• Subspecialty conferences
• Informational interviews
How to Identify Mentors
• Associate Program Directors, Advising and Career Development
– Laura Bachrach, MD and Becky Blankenburg, MD, MPH
• Assigned Advisor
• Fellowship Director at LPCH
• Faculty in your division of interest
– At LPCH and elsewhere
• Fellows in your division of interest
– At LPCH and elsewhere
– LPCH Residency Graduates
• Current LPCH Residents
Created by Becky Blankenburg, MD, MPH
Associate Program Director, Advising and Career Development
LPCH/Stanford Career Development Series
6/9/2010
LPCH Fellowship Directors
Adolescent Medicine
Neville Golden
Allergy and Immunology
Kari Nadeau
Cardiology
Jeff Feinstein
Critical Care
David Cornfield, Cristina Alvira
Developmental and Behavioral Peds
Heidi Feldman
Endocrinology
Darrel Wilson, Tandy Aye
Gastroenterology
John Kerner
General Pediatrics
Fernando Mendoza
Genetics (Residency Program)
Greg Enns, Jon Bernstein
Heme/Onc
Arun Rangaswami
ID
Hayley Gans
Neonatology
Lou Halamek
Nephrology
Paul Grimm
Pulmonology
John Mark
Rheumatology
Tzeilan Lee
Finding Out About Fellowship Programs
• How to get information on programs
– Look on the web
• ACGME Website: www.acgme.org
• NRMP Website: http://www.nrmp.org/fellow
• Subspecialty websites (American Thoracic Society for pulmonary as example)
• Individual program websites
– Email/call programs for more information
– Talk with advisor, fellowship director, other attendings and fellows in the division
– Consider arranging an away rotation at the institution you are interested in
• Figuring out where to apply
– Think carefully about what you want to get out of fellowship
• What type of clinical training
• What kind of research/scholarly product you want to complete
• What you want to do long-term
• Possibilities for advanced training (MPH?, MSEd?, etc)
• Where the mentors are who fit what you are looking for
– Meet with advisor, fellowship director, other attendings and fellows in the division to see
what programs they recommend to you
Special Note About When To Do Fellowship
• It’s ok to take a year off (or even two or three) before fellowship…
– Think about what is best for your personal situation
– Good to take time if you don’t yet know what to go into…better to be sure of your
decision
– Fellowship directors understand this
Created by Becky Blankenburg, MD, MPH
Associate Program Director, Advising and Career Development
LPCH/Stanford Career Development Series
6/9/2010
Timeline for Applying to Fellowship
• Varies greatly from subspecialty to subspecialty
• Talk with the LPCH Fellowship Director in your subspecialty to double-check application dates
• Some fellowships are part of a national match:
Fellowship Program
Match
Begins
Rank List
Due
Match Day Fellowship
Start Date
Allergy/Immunology
1/6/10
5/5/10
5/19/10
July 2011
Peds Specialities Spring Match 1/20/10
Peds Cardiology
Peds GI
Peds Nephrology
Peds Pulmonology
5/19/10
6/2/10
July 2011
Neonatology
5/12/10
9/15/10
9/29/10
July 2011
Genetics
7/28/10
11/17/10
12/1/10
July 2011
Peds Specialities Fall Match
8/11/10
Dev/Behav Pediatrics
Peds Critical Care
Peds ED
Peds Rheum
Primary Care Sports Medicine 9/1/10
11/17/10
12/1/10
July 2011
12/15/10
1/5/11
July 2011
Peds Heme/Onc
4/21/10
5/5/10
July 2011
11/18/09
For more details, please see the NRMP Website: http://www.nrmp.org/fellow
•
Be aware that some of the above subspecialties have some programs that are not participating in
the match (so they might have some match and non-match programs, which will affect their
application processes and timelines).
•
For non-match fellowships:
– Peds ID:
• Fall 1¾ years before starting (i.e., Fall of second year for starting right after
residency)
– Other non-match specialties:
• Fall 1¾ years before starting to Fall ¾ year before starting (i.e., Fall of second
year to Fall of third year for starting right after residency)
Sooner the better
Definitely check with the fellowship directors as these timelines are moving targets
•
•
Created by Becky Blankenburg, MD, MPH
Associate Program Director, Advising and Career Development
LPCH/Stanford Career Development Series
6/9/2010
How to Apply to Programs?
• For Match Specialties:
– Look at the NRMP Website: http://www.nrmp.org/fellow
– Some use the ERAS applications
– Some still have their own applications
•
For Non-match Specialties:
– Look at the program websites
– Email/call programs for information and applications
– Brief cover letter
– Puts you on the radar screen
– Sooner the better
What is in an application?
– ERAS Demographic/Informational Section
• Or if a non-match specialty, then a cover letter +/- application
– CV
– Personal Statement
– Letters of Recommendation (3-4 letters total)
• 1 from Residency Program Leadership (Program Director or Associate Program
Director)
• 1-2 from Subspecialty/Area that you are applying in
• 0-1 from another subspecialty or general pediatrics attending
• 1 from your research advisor (if you have done research)
– Dean’s Letter/MPSE (from medical school)
– Transcripts
– USMLE Scores (need to be released by NMBE)
How to Ask People to Write Your Letters
• Think carefully about who you want to write your letters (good to have people who know you
well)
• Ask them if they can “write a strong letter of recommendation on your behalf”
• Meet with them in person and discuss your fellowship and career goals, and at that meeting,
provide them with:
– CV
– Personal Statement
– Addressed, stamped envelopes
• Give your letter writers at least 1 month to complete the letters, and leave an extra month to
follow-up on letter writers who have not made the deadline
Created by Becky Blankenburg, MD, MPH
Associate Program Director, Advising and Career Development
LPCH/Stanford Career Development Series
6/9/2010
Scheduling Interviews
• Most interviews are offered, not requested
– But if you haven’t heard from a program or will be in the area anyway, it is ok to contact
the program and ask
• Be persistent (but nice and appreciative) in scheduling an interview
• Try to cluster interviews
– Because the timing of interviews at some programs may overlap with offers from other
programs
• Sooner the better
Preparing for Interviews
• Learn about the programs you are going to visit
• Why do you want to attend that program?
• Why would you be a good fit?
• What type of research and with whom would you want to work?
• Read up on the particular research or clinical interest of faculty you may be meeting
Comparing Programs
• Priorities of the Program, Fellowship Director, and Division Chief
– Career advancement of fellows
– Clinical needs of division- are there adequate faculty and support staff?
– Research needs of division- are there adequate faculty and support staff?
– Other needs of division (eg., teaching)
– Recent or impending changes (retirements, sabbaticals, leaves of absence etc)
• Quality of Mentorship
– Quality of clinical training
– Quality of research training, opportunities, and facilities
• May include being able to earn Masters Degree
– Success with getting fellowship grants
– Duties and ancillary services (advice nurses, clinical NPs)
– Satisfaction of current and prior fellows
– Post-fellowship placement of fellows
• Funding
– Are they NIH training grant supported or not?
– Who provides the funding for your fellowship?
– Do you have to apply for grants during fellowship?
– Is there a safety net in case you apply for a grant but are unsuccessful?
• Accreditation
– Look at the program’s last RRC site visit on the www.acgme.org website
• 5 years is the maximum amount of time a program can be accredited
• If the program has only been re-accredited for 1-2 years, that is a red flag
• If the program has been placed on probation, do not go to that program
Created by Becky Blankenburg, MD, MPH
Associate Program Director, Advising and Career Development
LPCH/Stanford Career Development Series
6/9/2010
Actual interview day
• You are the consumer – make sure the fellowship will be a good fit
• Ask the right questions of the right people, but make sure your questions are answered
– Fellows and administrative staff may be most appropriate to ask re: logistics, salary, call,
etc.
– Talk with faculty and fellows about research opportunities, opportunities for pursuing
advanced degrees during fellowship, etc.
• Make sure to ask the obvious questions in a nice way, but don’t make it the focus of your visit:
– Office space, admin support, meals when on call, computers, courses, meetings, book
allowance, home vs. in house call- can vary greatly
• Look at the list under the previous section (“Comparing Programs”) for key information to learn
about each program
Post Interview
• Thank you notes/emails
– There was a lot of discussion on the panel about how necessary this is
– Recommend: thank you note/email to the fellowship director, fellowship coordinator,
division chief
– Some say that you only need to send thank you notes/emails to others if you had
particularly strong connection with the other members of the division
Offers
• Match Fellowships — operate like residency match
• Non-Match Fellowships – operate like medical school offers
– Don’t be pressured into making a hasty decision
– Don’t leave programs hanging too long
– Remember: you’re the consumer
• Combination of Match and Non-Match Fellowships
– If you are considering both match and non-match programs, be careful… if you are
strongly considering a non-match program, then it’s ideal if program can make their offer
before the match. (But it doesn’t always happen this way.)
– Sometimes people have had to enter the match not knowing if they are going to be
offered a position at their dream, non-match program. In this case, just be careful to not
rank any programs where you wouldn’t be happy with your training (because if you rank
it, then you might end-up matched there).
NRMP Match Do’s and Don’ts
• See Appendix A for more details
Created by Becky Blankenburg, MD, MPH
Associate Program Director, Advising and Career Development
LPCH/Stanford Career Development Series
6/9/2010
Success as a Fellow
• Most important two things:
• GOOD MENTORSHIP!
• GOOD FELLOWSHIP DIRECTOR!
• Scholarship Oversight Committee
– Made up of training directors and faculty development committee.
– Local body that determines whether a fellow’s “work product” meets the requirements of
the ABP. (The fellowship director determines if the clinical activities meet the
requirement.)
– Divided into subcommittees who evaluate the IDP of every first year fellow at the end of
the first year of fellowship. Feedback is given and if the fellow does not “pass” the IDP
evaluation then a reassessment is done after a new plan is put into place.
• Individual Development Plan (IDP)
– Distribution of Areas of Effort:
• Research/Other Scholarly Activity: traditionally, has been basic/clinical research,
but now can include educational research, policy, etc; includes
presentations/publications/grant support/peer review of articles
• Patient Care: gaining new clinical experiences
• Professional Self-Development: coursework taken, advanced degrees, sub-board
pretests taken, academic associations
• Education (Teaching Activities): student or resident teaching/curriculum
development/teaching tools
• Administration: participation on committees, governance of unit, department, etc
• Other Professional Accomplishments: community/volunteer work- whatever not
covered above
Created by Becky Blankenburg, MD, MPH
Associate Program Director, Advising and Career Development
LPCH/Stanford Career Development Series
6/9/2010
Hints for Medical Students
• Start to identify career goals
• Take electives during your clinical years
• Start to identify mentors
• Choose a residency that exposes you to a variety of subspecialties
Hints for Interns
• Start to identify career goals
• Start to think about subspecialties
• Start to identify mentors
• Meet with mentors
• Request particular electives/rotations for junior year
• Arrange away electives for junior year
• Consider attending academic pediatric and subspecialty conferences
– Pediatric Academic Societies Meeting (May 2011, Denver, CO)
– Other subspecialty conferences
Hints for Juniors/Seniors
• Solidify commitment to fellowship and subspecialty
• Start to think about training goals
• Research programs
• Write for applications
• Arrange interviews
• Interview
• Weigh options
• Choose a program
• If possible and necessary, arrange your senior schedule so you have time to move to fellowship
Last Words of Advice
The best pieces of advice given at this presentation were:
• Find good mentors in the areas that you are considering – it is good to meet with them, even if
you are undecided.
• Determine what your priorities are and then find the area of medicine and fellowship that best fits
those priorities and best fits you.
• Be transparent with the fellowship directors regarding what type of research you would like to do,
so they can best match you with a mentor.
• If you are looking for help getting started, please meet with your class Associate Program
Director/Program Director:
o 2010-2011 Interns: Becky Blankenburg, MD, MPH
o 2010-2011 Juniors: Laura Bachrach, MD
o 2010-2011 Seniors: Lynn Kahana, MD
Created by Becky Blankenburg, MD, MPH
Associate Program Director, Advising and Career Development
LPCH/Stanford Career Development Series
6/9/2010
APPENDIX A: NRMP MATCH DO’S and DON’TS
(Note: This is only a guide. Please always refer to the NRMP website
(http://www.nrmp.org/fellow) for official details.)
What is the Match?
• The NRMP Match was created to allow program directors and applicants to consider all their
options before making final commitments, and to establish a uniform date and time for the
announcement of residency position appointments.
• After completing their respective evaluations, programs and applicants each prepare a final listing
of their choices in preference order, which are then used by the Match to place applicants into
residency positions.
• The success of the Match depends on a high level of trust among all participants in the Matching
Program.
NRMP Statement on Professionalism
• The NRMP maintains the highest professional standards in the conduct of the Match and in its
interactions with all Match participants: applicants, program directors, institutional officials, and
student affairs deans. The NRMP expects all Match participants to conduct their affairs related to
the Match in an ethical and professionally responsible manner.
• Applicants are expected to adhere to the terms of the “Specialties Matching Service Match
Participation Agreement” in their search for a residency position.
• Program directors and institutional officials must honor the conditions of their Agreement with
the NRMP and also respect the right of applicants to freely investigate program options prior to
submission of a final rank order list.
Match Violations
• What is a “Match Violation?”
• The NRMP has established principles and policies to guide participants (programs and
applicants) through the Match application and rank order process.
• Match Violations negatively affect all participants in the Match. Consequences can result in:
• An applicant being pressured by a program director to reveal the program’s place on the
applicant’s rank order list.
• A program director being notified that a matched applicant will be a “no show” and
finding that no other suitable candidates are available.
• An applicant being pressured by (or pressuring) a program director to sign a contract
before Match Day.
• A matched applicant who could have matched to a more preferred program because that
program now has an open position because another applicant was a "no show".
Created by Becky Blankenburg, MD, MPH
Associate Program Director, Advising and Career Development
LPCH/Stanford Career Development Series
6/9/2010
Examples of Match Violations
• Agreements Made by Match Participants Before the Match
• An applicant:
• Requests a contract before the announcement of Match results
• Commits to a concurrent year training position outside the NRMP Match and
does not withdraw from the NRMP Match.
• “Guarantees" a program director that he/she will rank the program first on their
rank order list, but only if the program director will rank the applicant within the
program's quota.
• A program:
• Accepts and signs an agreement with an applicant before Match Day.
• “Guarantees" an applicant that he/she will rank the applicant within the program's
quota, but only if the applicant will rank the program first on his/her rank order
list.
• Not Honoring Results of Match
• An applicant:
• Decides not to honor the commitment to matched program and does not seek a
waiver.
• Accepts a position in another program.
• A program/institution:
• Adds new appointment requirements that were not communicated to applicants
prior to the rank order list deadline.
• Interviews an applicant who matched to a concurrent year position in another
program and who has not obtained a waiver by the NRMP.
• Approaches an applicant who is matched elsewhere to explore the possibility of
having the matched applicant switch programs.
• Decides not to honor its commitment to a matched applicant who satisfies all the
appointment requirements.
• Involved in a waiver investigation fills the position prior to the NRMP approving
a waiver request.
• Seeks a waiver from a commitment to a matched applicant in order to offer the
position to another applicant.
• Offers a position to an applicant whose waiver request was denied, and training
commences during the applicant's one-year prohibition from accepting a position
in any NRMP match-participating program.
Match Communications
Applicants and program directors may express their interest in each other; however, they must not make
statements implying a commitment. It is a breach of the applicable Match Participation Agreement for
either party to suggest or inform the other that placement on a rank order list is contingent upon
submission of a verbal or written statement indicating ranking intentions. Program directors and
applicants frequently engage in the practice of sending letters following the applicant's interview with the
program. Those letters often contain statements that can be misinterpreted by either party. Match
participants must understand that such letters are not binding and have no standing when final rank order
lists are submitted.
Created by Becky Blankenburg, MD, MPH
Associate Program Director, Advising and Career Development
LPCH/Stanford Career Development Series
6/9/2010