Just when you thought you were safe it’s that time again; where we start to think about

How am I going to pay those loans back?
What fellowship do I want to apply to?
How can I get that fellowship when I am competing against so many people in my class?

Well, I am here to help you with just that.

Applying for a fellowship is competitive–duh.  We all know that right? It depends on a multitude of factors; the program you are doing residency in;  whether they have fellowships in house; if your program has an affiliation with another program that “guarantees” you a spot or most importantly where recent graduates have matched and how.

Before I get in to the bits and details of how to go about making yourself a competitive applicant for fellowship I want to address on how to pick a fellowship.  Some people entering will know right off the bat what they enjoy and what they want to apply for.  In my opinion that’s excellent because by now you have gone through rotations and have been exposed to fields of your liking.  If you are still a bit iffy on what may interest you then you have to ask yourself either “do I really want to do a fellowship?” and “what am I good at?”

Many people get stuck on “what will I enjoy the most?”  and I think thats not the best question to ask yourself because you may enjoy a specialty for the wrong reasons– lifestyle and money being the top two.  If you are good at something it is likely that you enjoy it because your brain is able to pick up the subject really well. Some of you may be asking “what if I am good at everything?” Well thats just the doctor coming out of you so we’ll ignore those people.

Ok now getting into how to go about securing a fellowship. If you have the luxury of an in-house fellowship that is great news because you can ask your colleagues how they acquired such a position. Research, going to conferences, requesting extra clinic hours or elective time in that specialty, doing a chief resident year, or doing nothing and just having good letter of recommendations are all possible answers. If you do not have in house fellowships then the first thing to do is not be shy.  This is the time to act.

If you’re interested in something immediately let your chief residents know (since they usually make your schedule) and when things start to settle let your mentor know too.  Ask whether first year is the right time to have a meeting with the attending in that department to express your interest.  Always look for interesting cases that you may have and don’t be shy to ask if it will be something worth writing up.  If you are unsure of what an “interesting” case is, ask the fellow (if your hospital has them) or ask the attending directly.  Conferences are usually going on through out the year in different states and most programs reimburse you for going.  It is always a great idea to go, especially if the department is going, and/or you have a presentation (which is a big thumbs up).  This will allow for you to get closer with your department and make connections with others.

First year of residency can be very tiring and take a hit on your personal life, but you have to remind yourself it gets better and there truly is light at the end of the tunnel.  Some of your colleagues may throw you under the bus or their competitive nature may get the best of them, especially if they know you are aiming for the same fellowship. Remember to always be professional, courteous, and respectful.  Physicians have asked nursing staff, colleagues, and even family member of my patient’s about the above-mentioned.  So remember even if we think our “good deeds” go unnoticed, sorry to break it to you, but they do not.  Best of luck.

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sdkOsman Bhatty, MDMohammed Faisal Loya (@DrFLoya) Recent comment authors
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Osman Bhatty, MD

Any idea which IM fellowships are competitive vs. more obtainable in today’s age? I know these things rise and fall with the times.


Dear Osman
Would you know any IMGs who’ve done their orthopaedic residency outside the US and have obtained Orthopaedic Fellowships in the US? They could be a big help to me and guide me. Please share any info u may have at docsdk at yahoo dot com docsdk@yahoo.com

Mohammed Faisal Loya (@DrFLoya)

Hey. For medicine the most competitive are cardiology , gastroenterology, pulmonology/critical care followed by allergy and heme/onc, lastly nephrology, rheumatology, palliative, geriatrics, sports medicine