Applying for Fellowship
Andrew Lane, MD – Eastern Virginia Medical School, Norfolk, VA
Stephanie Ros, MD – University of South Florida, Tampa, FL
Suneet Chauhan, MD – University of Texas – Houston, Houston, TX
Alfred Abuhamad, MD – Eastern Virginia Medical School, Norfolk, VA
Society for Maternal-Fetal Medicine Fellowship Affairs Committee
So you want to be an MFM fellow? Well then, let us be the first to welcome you!
While you have already completed a similar match process for residency, there are several key differences you need to know about to successfully navigate the process. Applying for fellowship is expensive, stressful, and time consuming. According to a 2016 article most applicants spend more than ten days away on interviews and spend an average of $5,286 during the interview season. The objectives of this series are to orient you to the resources you will need to succeed, offer advice on approaches to complete a competitive application, and mentor you on how to shine in your interviews.
Frishman GN, Bell CL, Botros S, et al. Applying to subspecialty fellowship: clarifying the confusion and the conflicts! AJOG. 2016 Feb;214(2)243-246.
TABLE OF CONTENTS
SECTION 1: Identify your resources
SECTION 2: A typical application
SECTION 3: A typical interview
SECTION 4: Interviewing on a budget
SECTION 5: Advice for those at smaller/community programs
SECTION 6: Top things to consider before the interview
Download the full document
SECTION 1: Identify your resources
Your first step is to orient yourself to the resources you will be using during the process.
While this varies somewhat from year to year, the following timeline, starting in PGY-3, is typical.
- June: applicants can register for ERAS and begin working on the application
- November: applicants can begin to submit ERAS applications to programs
- December: programs start to receive submitted ERAS applications
- May: deadline to submit ERAS applications
- May - September: interview invitations sent out, most will be sent out in May - June
- May - September: interviews, most will be in July - August
- August: NRMP rank list opens
- September: NRMP rank list deadline
- October: Match day
You are familiar with ERAS from residency and in much the same manner you will be using ERAS to apply for fellowship. ERAS is part of the AAMC and has a page specific to applying for fellowship. This includes the MyERAS Fellowship User Guide. The user guide is a yearly run down of the application process and includes instructions on how to register and apply, lists important dates in that year’s cycle, and explains associated fees.
You are also familiar with NRMP from submitting your residency rank list. NRMP performs a similar function for fellowship rank lists. They also have a lot of helpful information regarding the last several years of fellowship matches so you will have realistic expectations of what you are up against. This includes important dates, a list of participating programs, and several data reports.
Starting on the introduction to fellowship match page will give you the basic background information on the matching process and link you to list of programs.
Moving to the OB/GYN match results statistics page will give you a list of the important dates you will need to know for your application year.
Each year NRMP publishes a report called NRMP Results and Data Specialties Matching Service. This report summarizes the fellowship matches for the preceding 5 years broken down by specialty. This includes information such as the number of programs (filled and unfilled), the number of positions (filled and unfilled), and the number of applicants (matched and unmatched).
They also publish a yearly report called Specialty Match Program Results. This includes a state-by-state breakdown of the fellowship matches for the preceding 5 years. This includes statistics for each institution individually.
Additionally, they publish a report called Charting outcomes in the Match: Specialties Matching Service. This report breaks down the characteristics of those who matched into their chosen specialty. It focuses on characteristics such as USMLE scores and number of programs ranked.
Finally, they have published the results of the 2016 NRMP Specialties Matching Service Program Director Survey. This survey explores the factors that fellowship directors use to select applicants to interview and rank. The survey is specific for each specialty. This included feedback from 15 MFM fellowship directors. Some of the most important factors identified were: interactions with faculty during interview and visit, interpersonal skills, letters of recommendation, interactions with house staff during interview and visit, feedback from current residents and fellows, and involvement and perceived interest in research. Some of those of moderate importance identified were: USMLE scores and medical school grades. Those identified as least important were: second interview/looks, residency class ranking, in-training examinations, and electives.
The Foundation for SMFM – Resident Scholars
The Foundation for SMFM is the charitable arm of SMFM. The Resident Scholars is a program set up for the identification of individuals in their third year of OB/GYN residency education who exhibit leadership, commitment, and interest in teaching, research, or public policy. Although application to this program is not required, the individuals selected are highly regarded when applying for fellowship.
Scholars are provided with two years of mentoring, support, and educational opportunities for career development. This includes being recognized as a named scholar at the annual meeting, mentoring from leaders in MFM, funded attendance to the SMFM annual meeting, funded attendance at a biostatistics course, and the opportunity to participate on SMFM committees.
The application deadline is typically in October of PGY-3 and the application can be accessed through the Foundation’s website. The application requires many of the same documents as your fellowship application so submitting this application will give you a head start on your fellowship application.
SECTION 2: A typical application
The requirements for a completed fellowship application will vary slightly from year to year and from institution to institution, but have similar components no matter where you apply.
Most of the ERAS application is filling out an online CV. Unfortunately, you cannot just upload your own, but must instead use their on-line format. The application is very limited in its editing capabilities. The best way to prepare is to make a standard CV that you can use in the future and then copy and paste from this into the application.
Start by finding a faculty member who is academically active so you have someone to mentor you through creating a CV. Ask for his/her permission to use the format if you like it. Then all you have to do is keep the headings and formatting, delete the individual listings, and replace them with your own accomplishments. Once you have a working draft, have that same mentor review it and ask for feedback.
Letters of Recommendation
Typically programs will ask for 3-4 letters of recommendation. Many request letters from specific authors such as the residency director or department chair. You will have your bases covered if you get letters from your residency director, department chair, another MFM faculty member, and a fourth faculty member (MFM or otherwise) who know you well. You can always have more letters on hand than you need. It is typical to wave your right to read them. In a relatively small field such as MFM, a letter from a nationally known author can go a long way.
Make sure you give your letter writers as much time as possible and give them a deadline that is not the last day applications are due to be safe. Consider making a formal appointment to meet with the authors one on one. Give them a folder that contains: your CV, a list of the programs you are applying to, and your personal statement. When you meet with them be sure to emphasize anything you want to make sure is in the letters and show them your list of programs to see where they may know people. If the writer knows someone at one of the programs, have her call ahead to let the contact know there is good candidate coming their way. Give the authors a clear deadline and follow up on a regular basis to remind them of the deadline. Oh, and don’t forget the thank you card!
We will address this in another section below. Important keys: have others proofread it, check grammar/spelling, avoid clichés, and be yourself. If English is not your first language make sure you have native speakers review your statement.
This is the fun part. Start by looking at the list of programs mentioned earlier and then go to each program’s website to learn more. Some have not been updated since ultrasound was invented, but others are exceptional. Also make sure to check out SMFM’s Fellowship at a Glance resource on its website. This resource lists all fellowship programs with basic information about the programs such as number of fellows per year, academic output, availability of bench research, critical care training, salary, number of call nights per month, and more. This resource may help you narrow your program list.
Meet with your spouse, family, faculty, other residents and get feedback on good places to apply and who knows who where. If there are recent resident graduates from your program who have applied to MFM, they are also useful resources. Always remember that a big name isn’t everything. The place that is right for you might be the one you least expect and you will never know unless you go. So explore!
SECTION 3: A typical interview
Your interview begins the moment you board the plane. Typically, the night before the interview there will be a dinner with current fellows and sometimes faculty. This can be at a restaurant, bar, or home. Always try to attend these dinners. This may be the only informal time you will have with the fellows away from the faculty. You can ask all the questions you are afraid to ask the fellowship director during your formal interview the next day. Also, you can learn a lot by just listening. Everyone on both sides is on their best behavior at interviews, but if the fellows aren’t happy, they won’t be able to suppress showing it indefinitely. Be cognizant that this informal event is part of your interview.
The interview day typically starts around 8:00 with the fellowship director giving an overview of the program. Most programs will give you either a paper or electronic copy of the presentation to reference later. The remainder of the day typically consists of interviews and a facility tour.
The interviews typically consist of a series of 15 – 30 minute sessions with anywhere from four to eight interviewers. The facility tour generally includes the clinic, ultrasound suite, and labor and delivery. The day goes by very quickly. See our notes below for more tips on the interviews themselves.
SECTION 4: Interviewing on a budget
The interview process can be very expensive. Unless you are lucky enough to have a spot set aside for you or you live in a major city with several programs within driving distance, you will be spending a lot of money. Here are a few ideas to help ease the financial burden.
This is the time to break out that airline rewards card if you have it. Look for a free flight and make sure you are getting rewards points for any flights you are booking. Do not book a flight that leaves 1 hour after your interview ends. You will spend your last few interviews stressed about getting out of there instead of focusing on the task at hand. Try to use various travel sites to get the best deals. Consider using airlines/options where you can make changes without penalty in case you need to make a last minute change.
A rental car is always a good stand by, but compare prices with ride share options. Most cities that are large enough to support a fellowship are large enough to support a robust ride share economy or public transportation. Unless you are traveling large distances to/from the airport or the interview, it will often be less expensive to use one of these options. If you know someone else will be traveling at the same time consider splitting the service with them to lower the cost even further. This is typically easiest when leaving the interview to go back go the airport. Some programs will provide you with the contact information for others interviewing on your date so you can contact them ahead of time.
Traditional hotels are still the most common way to go for interviews. Again consider if you have any unused rewards points that you may be able to use to book your stay. Contact that uncle you haven’t seen since your fifth birthday, friends from college, and other residents both in and out of OB/GYN in the area. If you know another interviewer will be in town and feel comfortable, consider sharing a room. Alternatively rooming services may be more economical depending on the destination. Make sure to ask the fellowship coordinator if they have special rates set up with any of the local hotels.
SECTION 5: Advice for those at smaller/community programs
The application process can be especially daunting if you are coming from residency without an established fellowship, well-connected attendings, abundant research opportunities, or mentors familiar with the process. The key is to realize and exploit the uniqueness of your situation.
Make sure MFM is the right field for you
In programs without access to MFMs or fellows as part of your training, you need to spend some time confirming that MFM really is for you. Strongly consider completing an external elective at a program you would be interested in applying. This will get you first hand experience of what fellowship is like and expose you to a more academic setting that is typical for fellowship. While there, make sure to get a letter of recommendation and meet with the fellowship director for advice and to express your interest personally.
Find a mentor(s)
This is the most important thing that you can do to prepare. You need to find someone to keep you on track, identify opportunities that will build your application, and tell you when to decline others. This may require several mentors with various strengths, rather than a one size fits all approach. These are also the people who will make calls for you to open doors that you otherwise might find closed.
Realize your unique situation
When writing your personal statement or sitting at an interview, you need to be able to exploit your unique situation and describe why they should invest three years in you over the ten other applicants that day from larger institutions. First, take a deep breath, because once you make it to the interview everyone is on equal footing. It is how you interview that will make the difference now. To interview well, you need to identify the strengths of your residency program. Maybe your program leads the nation in forceps delivery volume, the residents do all the cesarean hysterectomies because there are no fellows, or you do double the national average of hysterectomies. If your hospital does 6,000 deliveries each year and residents are involved with all of them, tell someone!
Identify your unique research opportunities
One of the most difficult obstacles will likely be a lack of traditional research opportunities. You don’t need to do a huge prospective project or ten small ones to match. Instead, you need to do a few things well from beginning to end. The key here is completion of quality projects since all fellowships involve a research thesis. At your interview, remind the interviewer there were not any projects that you could sign onto at your program, put in a few hours as part of a big team, and print a poster. No, you went the library to do a literature search, you learned how to do an IRB application, you built a database, and you taught yourself statistics because there was no statistician. You need to remind people that you did something from start to finish with very little resources and mentorship and if you can do that at a community program, imagine what you could do with the mentoring and support that fellowship provides. Another idea is to try to complete smaller projects and volunteer for leadership opportunities that may come your way. Think about quality improvement projects and departmental clinical management guidelines. Consider giving lectures to medical students, mentoring students interested in OB/GYN residency, serving on your residency’s education committee, or be the representative for your program at your hospital’s residency affairs committee. Better yet, get involved with ACOG as a junior fellow representative. Make sure you keep track of any volunteer activities as well.
Go to the Society for Maternal-Fetal Medicine Annual Meeting™
Consider going to the annual meeting in residency in either your second or third year. This will allow you to see how vibrant the national MFM community is that you will be a part of one day. This will also allow you to network and meet others in the same position as you. Ask a faculty member or another resident to come with you as it can be intimidating to go as a resident alone. Make sure to look at the program and find the session specifically for residents called the Resident Forum. This forum offers great advice on how to get into and succeed in fellowship.
Apply for Quilligan Scholars
See our comments in the above section for information on the program. The competition is stiff, but if you can win this award you will have a huge leg up as this program will plug you into mentorship with national leaders and will identify you as a future leader in the field.
Apply early and broadly
While you don’t need to have your application completed on the first day ERAS opens, you are going to want to submit it early. Some programs send interviews invitations before the deadline and there will be less applications to compete with if you submit early. You also want to apply broadly. This means apply to a diversity of programs, both academically and geographically. If you are coming from a community program, you may need to apply to more programs than if you were at a large academic institution. Don’t be the person who doesn’t match because you did not apply outside of your city or state.
SECTION 6: Top things to consider before the first interview
Before your very first interview, please pause and consider the following:
Know why. Why do you want to be an MFM?
Articulate the reasons and be able to convince people why it matters. However, please consider avoiding the common colloquialisms such as: “nothing is more satisfying than …,” “I enjoy taking care of…,” “I want to cure preeclampsia…,” or “an MFM is who I am.”
Explain why you are applying to that program
You need to be able to explain why you picked that specific program. Applying to East Coast fellowship programs just because you or your partner’s family is from that region is insufficient. Be adventurous. Go to programs that will forge your career. It can also be unsatisfying for the interviewer if they feel you only want to be there because of social ties.
Tell a story in your personal statement
We are but a summation of stories and experiences. Nonetheless, there is a specific event that propels you to pursue fellowship. If there are multiple compelling experiences that led you to specialize, triage them. Share that singular transformational event (being cognizant of HIPAA rules). Differentiate yourself from others. Describe who you are; do not tell who you are. Avoid vague words like “hard working,” “conscientious,” “highly-motivated,” “passionate,” or “driven.” Such descriptors do not differentiate you from 100 other applicants. “We’re all stories in the end; just make it a good one.”
Be kind to the administrative staff
When you apply and correspond with the administrative staff at the various institutions, please (PLEASE) be attentive to their instructions and be kind to them. The administrative staff have the ear of the faculty and their opinions matter.
Be knowledgeable of the faculty
Google is a good way to learn about the faculty you will meet, but PubMed is better! Know enough about the faculty you will interview with; not necessarily to flatter them, but to understand how congruent your interests are with theirs.
Arrive early and be prepared
A simple motto: if you are on time, you are late. Know where the interview will take place. Google Maps can help or consider a dry run of the route. Factor in some time to get lost as some campuses are a concrete jungle. Coming with written questions is not a bad idea. However, these inquiries should be more insightful than simply: “What are you looking for in a fellow?” “What are your programs strengths?” “What is there to do after work?” “How often are fellows on call?” “Can fellows moonlight?” and “Is there something you would change to make the program better?” Be original in your inquiry; be pithy with your questions!
Be confident; be comfortable
Exude confidence and it will be contagious. Know that an invitation is a confirmation that the Fellowship Director considers you a potential fit in the Division. There is a fine, thin line between charming confidence and annoying arrogance. Confidence is in the handshake, the way you walk into the room, the way you sit, how you engage the interviewer, the minuscule pause before your response, and it is in conversation in the simple, succinct statements you give. To be confident, you have to be comfortable with who you are. If you cannot accept who you are, why should the Director? Most Directors have an instinct for when you are trying to impress them or be likable rather than just being yourself.
Why invest in you?
Every person invited to an interview is as capable and accomplished as you are. Therefore, the key questions are: “Why should the program invest their next 3 years in you?” and “What non-tangible dividends does the program get from investing countless hours with you?” Having quality answers to these questions will get you far.
Be honest; be yourself
Someone I admire once said: “If any candidate admitted that they want to do a fellowship so they can go into private practice and make money, I would take them on the spot!” I hope such sentiment does not resonate with everyone, though it does exemplify the value of honesty. The simple, single purpose of interviewing is to know the quintessential you. So, be honest about yourself and your goals; be the pleasant, confident, assured, unique person that you are!