My first hands-on experience with a fellowship track was during my second year of residency when I spent two months at the Sinai Hospital of Baltimore. Upon hearing that podiatry offered a “fellowship” during school, it was always something in the back of my mind.
One of the main reasons I chose my residency was because of this opportunity to experience a mini-fellowship. At the time, this program had four fellows, one of whom was a podiatrist. As residents, we were fully integrated into the fellowship experience — complicated patient cases (clinical and surgical), high volume caseload, critical thinking, long hours and great demands. Working side by side with present and past fellows, hearing and seeing their experiences, I knew this was something I wanted to pursue.
The fellowship application process was a bit challenging. My recommendation for applicants is to assemble your application packet in the spring of your third year of residency and start reaching out to programs to visit during that summer. I did not start until September of my third year of residency and in doing so, I felt that I was behind the rest of the pack. I also recommend networking. Talk to current and past fellows. Talk to other residents you know are applying to get their take. The applicant pool is a small community and everyone I encountered was more than candid in their assessment of a fellowship.
Now that I have finished the process and was fortunate enough to be offered a fellowship position, I often have people ask: “Why do you want to do another year? Aren’t you wasting a year? Do you think you’re not ready to start on your own? Did you not get enough training during your residency?” I feel the training I received at my residency was amazing. It was comprehensive (clinic, hospital and operative management of patients), highly hands-on and academic (I can go on). I learned with attendings who are not only great teachers but great people, many of whom I consider role models in podiatry and life.
My desire to do fellowships is multifaceted. However, the main goal is to have a “total patient experience,” sequential patient-doctor interaction from start to finish. Often in residency, you get the surgical schedule and see what procedures you will be performing, which the attending chooses preoperatively in the office. These same attendings will be following the patients for the postoperative period. The “total patient experience” is difficult to obtain in residency.
Looking back on my experience, I recommend to current residents to be more interactive in the care of your patients, especially those having elective procedures. Go spend time in the office when surgical decisions are happening. Call to see when a patient you operated on is coming for a follow-up visit and make it to the appointment (or at least text or call the doctor later on to see how it went). Be involved in the patient care of the patient you operated on. Your ability to handle this part of patient care is what separates the good doctor from the great doctor.
By working in a fellowship side by side with the attending, I will have the ability to get that experience and bridge my residency to the workforce. Once residency graduation happens, we will spend the majority of our time working up and taking care of patients with little actual operative time. In the office, I don’t want to question my surgical decision making or wonder postoperatively “Does that look right? Is that normal?” I want to know the answer through the experience that fellowship offers me.
I look forward to the upcoming year. I do not know what is completely in store for me but that is the exciting part. Am I wasting a year? I see that question as shortsighted. I will likely gain more surgical procedures and patient encounters in my one year fellowship than most residents get in the three years of residency under the guidance of a skilled surgeon. From that surgeon overseeing my fellowship, I will learn new techniques. Equally as important, I will learn from him how to be a teacher and teach my residents. I will do research and publish. I will present posters at conferences. I will never stop learning something new every day.
I can hardly see how any of that is a waste. I can only come out ahead from this experience. I see fellowship as a way to progress our profession and I encourage anyone even thinking of fellowship to explore the option.
Dr. Hood is a Chief Resident at Crozer Keystone Health System in Upland, Pa. He is an incoming Fellow with the Pennsylvania Intensive Lower Extremity Fellowship in Malvern, Pa.