The decision to pursue a subspecialty fellowship is one some resident physicians set out for from day one. For others, it is a gradual process as the resident experiences different subspecialties during training.

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For residents set on pursuing fellowship or those pondering the possibility, there are ways you can bolster your credentials early and throughout your residency training.

John Roberts, MD, is vice dean for graduate medical education at the University of Louisville School of Medicine. A neonatologist and AMA member, Dr. Roberts has worked with pediatric residents and neonatology fellows for more than 40 years. He offered this advice on how physicians can strengthen their fellowship candidacy during residency.

Dr. Roberts said the process of pursuing a fellowship should begin with the end in mind. That means knowing what subspecialty you hope to pursue, or at least narrowing your options. From there,  residents should  decide what type of career they prefer, academic or clinical He broke down fellowships into three classifications: research-driven programs, programs that are more clinically focused, and programs that try to balance the two. He said it’s important to pick one lane; the different fellowship directors are looking for different characteristics in the program applicants and the resident can develop those characteristics during residency.

“After deciding  which direction they want to go,  residents should seek out programs that can foster their career choice,” Dr. Roberts said. “After identifying those programs the residents should ask themselves: If I was  the program director what would I be looking? Residents should then try to develop or acquire skills and characteristics that would make them more competitive candidates. And, they should emphasize those attributes in the application process.”

The July fellowship application window opened earlier this month, so resident physicians interested in applying to fellowship programs should consult FREIDA™, the AMA Residency and Fellowship Database®, which offers users the opportunity to explore more than 7,300 fellowship programs accredited by the Accreditation Council for Graduate Medical Education. Users can narrow their search by location (list or map view), application information, benefits and special tracks.

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Fellowship directors don’t expect you to be an expert in your preferred subspecialty before you enter training. They do expect you to demonstrate mastery of the specialty in which you are training as a resident.

“Before you become a neonatologist, first you need to be a good pediatrician,” Dr. Roberts said. “Do the things you need to do to excel in your program, so that your program director is saying you are one of the best residents to come through the program—you have great character, you’re a leader. Do the hard work in your program to stand out in a positive way among all your peers.”

Learn about the top five factors fellowship program directors look for in applicants.

When it comes to speaking in front of groups, Dr. Roberts encourages residents to go above and beyond to build that skill set.

“Be proactive in seeking opportunities to be a speaker,” Dr. Roberts said. “As a fellow, you are going to be asked to speak at meetings, to give lectures, to speak to patients and go to national meetings. If you can say on your application that you have that skill set that is going to put you ahead of many other people.”

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Dr. Roberts said this is mainly a necessary activity for residents who are pursuing a research-intensive fellowship.

“If you are looking at a research-heavy fellowship, get involved in some area that shows you have the interest and ability to pursue that track,” Dr. Roberts said. “Many of our residents will get involved in quality and safety research.”

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