Program Director's Note - Where Should I Apply to Fellowship?
Hi Everyone,
Most Yale residents apply to fellowships, either now or in the next year or two. The most popular destinations in our program are cardiology, GI, and heme-onc, but we have residents entering every field, including hospital medicine and primary care.
Applying to fellowship is a lot like applying to residency: update your CV, write a personal statement, ask for letters, post your application, and wait for interview invitations. But applying to fellowship differs in key ways:
Programs: Most residencies offer similar experiences—continuity clinics, floor and ICU rotations, and exposure to subspecialties—but they differ in location and vibe. While location and vibe vary at the fellowship level too, you’re going to notice large differences in clinical and research opportunities. A few years ago, one of our residents wanted to study tuberculosis, so he chose an ID fellowship that served a large population of immigrants with TB. A few years later, another resident wanted to run a microbiology lab, so he chose an ID fellowship that offered advanced laboratory training. I can point to analogous examples in other fields. When applying to fellowship, look for programs that offer experiences that match your specific professional goals.
Personal Statements: I’ve written about personal statements in previous Program Director’s Notes, which I encourage you to read before drafting your essays. Fellowship directors want to know why you chose the field (besides liking it), what skills you hope to acquire, how you plan to contribute to the program and subspecialty, and what you see yourself doing after graduation. Your personal statements will tell fellowship directors if your mission aligns with theirs. Equally important, writing a thoughtful, memorable personal statement will allow you to stand out from a crowd of talented applicants.
Signals: Most but not all fellowships will use program signals if offered in their subspecialty. The ERAS website lists the number and type of signals available in each field. Programs use signals to identify candidates who are genuinely interested in their fellowships. You are much less likely to be offered interviews from programs you don’t signal since they will assume you are unlikely to rank them high enough to match. This is particularly true in the most competitive fields, which have plenty of talented applicants to choose from. For subspecialties that offer “gold” and “silver” signals, you can assume you will get a closer look from programs you signal as “gold,” but since there are fewer gold signals available, most programs will consider silver signals too. You should use your signals wisely: you want to convey interest in the programs you’re most excited about but also target fellowships where you have a reasonable chance of being considered, which we’ll discuss below (see “Introspection”).
Geographic Preferences: Our residency pays less attention to Geographic Preferences than we do to Program Signals, and I suspect most fellowships do the same. Programs can see if you prefer their region (e.g., New England), choose not to use a Geographic Signal, or signal regions of the country other than their own. Selection committees will be pleased if you’re interested in their region but will also consider applicants who choose “no preference,” because doing so conveys the message that you’re more focused on specific programs than geography. If you choose to submit geographic preferences, be aware that programs can see if you’ve chosen other regions but not theirs, which may lead them to conclude you’re less interested. Also, programs will look closely at what you write to explain your geographic preferences. For example, I often see applicants who say they’re interested in New England because they have family in Boston, which I take to mean they’re less interested in New Haven. On the other hand, if they say they have family in Connecticut, I take this as a sign of interest in Yale.
Introspection: You will all be excellent fellowship candidates, but this doesn’t mean all programs will invite you to interview. Programs that emphasize investigation will seek candidates with major research potential, but programs seeking master clinicians and educators will focus on candidates who want to lead clinical programs and teach. Be honest with yourselves as you choose where to apply and signal. Neither overestimate nor underestimate your chances. If you need some objective advice, reach out to program leadership.
Special Considerations: Consider factors specific to your application. Are you on a visa? If so, you need to know which programs offer visas and which kind. Are you in a couple’s match, particularly with a partner entering a different field, perhaps with a different number of signals? If so, consider letting the fellowships know so they can coordinate with other programs at their institutions. Is there a blip in your application? If so, let’s discuss how to address it.
Personal Preferences: For those of you with non-medical partners, consider their needs, particularly if you’re contemplating a big move. For those of you with family and close friends, consider how easy (or hard) it may be to visit. And for those of you ready to explore a new place, this may be your chance. Fortunately, there are excellent programs to choose from all over the country.
Local Resources: Our faculty will be recruiting and advising you at the same time, but they all see themselves first and foremost as mentors dedicated to helping you match in the best place for you, even if that means leaving Yale (weep, weep). You should also tap into our huge network of alumni who are faculty and trainees throughout the U.S. They are a great resource.
Our residents match into fantastic fellowships every year. In a future Program Director’s Note, we’ll consider interviews, rank lists, and the fraught issue of post-interview communications. For now, start thinking about where you want to apply, and send me drafts of your CVs and personal statements for feedback and suggested edits.
Enjoy your Sunday, everyone. This week, I’ll be at the ATS International Conference in Orlando, returning home Wednesday.
Mark
P.S. What I’m reading and listening to:
Performance of a large language model on the reasoning tasks of a physician By Peter G. Brodeur et al.
How South Korea Cut Stroke Deaths by More Than 80% By Tom Frieden
The Human Body’s Hidden Pathways By Avraham Z. Cooper with Illustrations by Jerome Berthier
5 Tips to Get Useful Health Answers from AI Chatbots By our very own Sudheesha Perera and Murali Doraiswamy
Here’s What Psychiatrists Mean When They Say You Have A.D.H.D. By Awais Aftab
When Your Terminal Cancer Becomes a Chronic Illness By Daniela J. Lamas
Lee Schwamm: Onboarding AI at the Hospital On Health & Veritas with Harlan Krumholz and Howie Forman
The Hotel Rosen Plaza, Orlando, FL