Fellowship and Research

[drboris]

Hey Guys,

Three small questions:

1) Is research a requirement to get a fellowship (cards, GI, heme/onc, A/I)?

2) Is research a requirement during fellowship?

3) How are fellowships structured, what the breakdown of rotations/clinics?


I don't like to do research (have no patients for it), but I do like the potential advancements that can be achieived. I just want to know if should expect to do research if I decide to do a fellowship, or if I should try to pick something I like where I do not have to be involved in research.

Thanks

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[ntmed]

1) Is research a requirement to get a fellowship (cards, GI, heme/onc, A/I)?

Definitely yes for Cards and GI. I suspect the answer is yes for all competitive fellowships, including Heme/Onc and A/I.

2) Is research a requirement during fellowship?

Part of the training for subspecialists is to be able to advance the state of knowledge in that area. So reseach is definitely a requirement. But there may be some latitude about how much research you need to do.

3) How are fellowships structured, what the breakdown of rotations/clinics?

This information should be on your medical school's web site.

 

[AJM]

1. As ntmed said, research is required for the competitive fellowships. However, you don't necessarily have to have research experience in that subspecialty to be competitive for a position.

2. At the academic programs, research is definitely a requirement and a large focus. At the less academic programs fellows will spend more time in clinical rotations and less time doing research, and will probably finish fellowship having completed only a small project. There are a growing number of programs out there that are starting to develop tracks for clinical research or even physician educator tracks for people not interested in basic science research. At my program, for example, we have several different ways of pursuing clinical research, and I will probably get an MPH or M.epi during my research years as a path to do clinical research.

3. How fellowships are structured varies based on the subspecialty and the program in question. I'll give you an example of the subspecialty I know best: academic pulmonary/critical care programs are 3 years in length with 1.5 years of clinical training during the 3 years (1 year of pulmonary rotations and 6 months of ICU). During the 3 years fellows have pulmonary clinic once a week in addition to their rotations and research. Typical year breakdown is as follows:
1st year - 12 months of clinical rotations (consults, ICU, PFT's, transplant, etc)
2nd year - 6 months of clinical rotations, 6 months of research
3rd year - 12 months of research
4th year - I add this on because at academic programs most fellows do an extra year of research so that they can be more productive.


But how fellowships are structured are highly variable. At the non-academic pulmonary programs, for example, fellows might do clinical rotations for almost the entire 3 years, and only spend 3-4 months on research. You should check out various program's websites in the specialties you might be interested in to get a sense of their schedules.

 

[PTCA]

I was wondering, what sort of research impresses academic programs most?
Is clinical research just as good as basic for competitive academic programs?
My concern is that lab work is pretty specific. So is it only attractive for programs that have similar lab research interests?
If you have a lab research background do these programs require from you a significant commitment to their labs during residency and fellowship?
And if they do, does this have a toll on your clinical training?
Are you at liberty to decide to concentrate on clinical training (and perhaps clinical research) despite the fact that they have taken you in perhaps counting on your basic research skills?
Can you have a successful career in academic medicine pursuing solely clinical research (is it easier to have that focusing on basic or translational work)?

I hope I am not highjacking too much

 

[ntmed]

I was wondering, what sort of research impresses academic programs most?

The most important thing is that you've done scholarly research, and you are the primary author on peer-reviewed publications. Your actual field of research, or the type of research, is secondary. Although to get into competitive fellowships, it would help if you did research in that particular area during residency.

 

[AJM]

My concern is that lab work is pretty specific. So is it only attractive for programs that have similar lab research interests?
Are you at liberty to decide to concentrate on clinical training (and perhaps clinical research) despite the fact that they have taken you in perhaps counting on your basic research skills?

Programs don't care what specific type of research you've done in the past, only that you've been productive at it. What they are interested in is your future research interests -- they want someone who has interests in areas that are compatible with that specific program. That said, once you get a position at a program, you are not locked in to any specific research project or type of research -- they leave it up to you to decide what you want to do.

If you have a lab research background do these programs require from you a significant commitment to their labs during residency and fellowship?
And if they do, does this have a toll on your clinical training?

Residency and fellowships are primarily clinical training programs -- you have to do a minimum number of clinical rotations in order to successfully complete any particular program. Also, whether or not you have a research background makes no difference in how much research you are expected to do. At most programs, everyone in the same program is required to spend the same amount of time doing research reardless of their prior experience. If you would like to spend extra time on research, you can choose to extend the length of your fellowship, which is what many fellows at academic programs do. You cannot shorten your clinical time, because you have to satisfy ACGME requirements.

Can you have a successful career in academic medicine pursuing solely clinical research (is it easier to have that focusing on basic or translational work)?

Definitely. Clinical research is becoming more and more valued, especially if you do good clinical research. Lots of people do clinical research, but most of the work out there is not well done. If you focus your training on being an excellent clinical researcher, you will likely be highly sought after by many academic institutions.