When to get started thinking about fellowships?

[Guest]

Hey all, current PGY-2 interested in endovascular/maybe open cerebrovascular fellowship here. I'm at an academic center and have talked with some of our faculty about fellowship but not sure when the formal application process begins for post-graduate fellowships in that area - do you apply around PGY4/5 for a postgraduate fellowship elsewhere? Just wondering so I can tailor/work on focused research and prepping for applications.

[Guest]

It’s a good question, the problem is that every fellowship is different in terms of timeline, I.e., whether they book people 2 vs 3 vs 4 years out. The other problem is that if you apply to multiple fellowships, you may have to choose between accepting an offer (which is usually exploding) and waiting to hear from another program that may not be looking at your app until the next year. Regardless, if you apply as a pgy5 you are unlikely to be too late for any of the open fellowships (with the exception of Lawton maybe), just keep in mind that if you don’t hear back you may be too early.

[Guest]

Vascular was ahead of the curve in terms of having people apply early in residency. Most people I knew were done by around Feb-March of their PGY5 year. The Lawton slots tend to fill up a little early. Many of the endo spots are going to enfolded fellows.

For people in other sub-specialities: tumor tends to interview and fill in PGY6. Spine seems to have a longer window as there are more spots, but I know that some of the more desirable places accept people in PGY5. Functional is also PGY5. Peds goes through the match - so PGY7. I do not know if there is any behind the scenes action with peds.

I think that there will be a trend towards this settling on January of PGY5 to January of PGY6 being the window in which most fellowships are handed out. That matches well with the idea that PGY1-4 is the "core" of training. Not sure if anyone accepting a PGY4 for a PGY8 position is a good idea - but what do I know.

Source: friends who have landed the top fellowship in each sub-speciality (except vascular).

[Guest]

What's the argument against a match during PGY6 or PGY7?  Just feels like a rat race to apply as early as possible

[Guest]

The argument for a match is that you avoid exploding offers and getting caught up in the horse trading that we all know goes on. The reality is that if you stay in academics you can only delay that so much - what do people think a faculty job search looks like? Fellowship is just a low-stakes faculty search with the same shenanigans.

I honestly do not have a great argument against a PGY6/7 fellowship match for everything. The programs like it because it allows them to say that they're booked up a while out. The fellowship directors like to look at their schedule and know who's going to be there (I'm not even kidding about this). For many of these, I think that booking whenever is fine. I do not understand why skull base/vascular book before you've done a chief year.

I will say that going into chief year with a respectable fellowship lined up makes that whole year much more enjoyable. I lined mine up during PGY5 - certainly made the attendings see me differently. Would do it again, 5/5 rating.

[Guest]

I lined my spine fellowship up as a PGY4. Made my later years much more enjoyable, also let me start my attending position search early and lock in a position before I even graduated residency (one that also started paying me while I was still a resident as well, which made my residency and fellowship time
Vastly easier and more enjoyable)

[Guest]

(03-23-2022, 10:01 PM)Guest Wrote: I lined my spine fellowship up as a PGY4. Made my later years much more enjoyable, also let me start my attending position search early and lock in a position before I even graduated residency (one that also started paying me while I was still a resident as well, which made my residency and fellowship time
Vastly easier and more enjoyable)

How common is it to get pay during your residency and fellowship like this? A PP practice gig I'm assuming?

[Guest]

It’s pretty uncommon, but it happens. Sometimes depends on what ur able to negotiate, sometimes it may be because a place has a hard time recruiting, sometimes it may be because they badly need a certain skill set. I’ve seen it both with academics and with PP/hospital employment

[Guest]

What year in residency did you line up your attending job? Current PGY-6 who also lined up a spine fellowship as a PGY-4 and starting to think of applying for attending jobs.

[Focus]

Never hurts to put feelers out. Getting several job offers before you sign is ideal usually. I would say starting to look as a PGY6 makes sense, especially for those not doing a post-grad fellowship. For those doing a fellowship it often makes sense to delay a bit so as to take advantage of the connections of your fellowship group as well as your residency. In that case start sending out feelers as a PGY7 and lock something down by mid-fellowship.