Need honest advise on Rheumatology Fellowship

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Residentdoc86

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Question: What can I do to improve my CV for the 2021 Rheum match?

My Bio - IMG from Canada on J1 -> H1b visa -> GC from US citizen spouse after waiver. Over 225 in Step 1-3 on the first attempt. Graduated from a community IM Residency. Worked on a few non-rhuem related case reports and presented at both ACP regional and National. I've always liked rheum but did not have major exposure to the field in residency. Due to family reasons, I decided to pursue a waiver job. I currently work in an Academic Primary care clinic with a strong medical school/residency/fellowship presence. I share primary care patients with the Rheum PD and the PD also sees patients in my building but we've never formally met. I would love to introduce myself and try to collaborate with our Rheum program but I am a bit hesitant because the program here is really small and everyone knows each other. I am not sure if this would get back to the boss about my plans to leave the practice after my waiver is over.

I passed ABIM, I'm currently working on ACP guided fellowship program and I volunteer at a free clinic.

My plan is to find rheum related cases reports to write up, take a course in MSK ultrasound, do an away elective for 2 weeks and possibly get a LOR from that (I heard this is possible even as an attending).

Is there anything else I could be doing to improve my CV?

Any advice will be greatly appreciated.

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I don't think the MSK US course or away rotation are likely to strengthen your candidacy. Case reports would be more helpful.

I highly recommend emailing the rheum PD to ask for a meeting to discuss your candidacy. It's okay to introduce yourself via email, and providing advice to prospective rheum fellows is part of their job. They could have research opportunities, connections to various programs, ideas for getting more exposure to rheum (possibly volunteering in their clinic?) and just good advice for you. Unless there's some political aspect that I'm missing, I wouldn't worry about it getting back to your boss--in fact, you are probably going to want your boss to write a letter for you!
 
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I appreciate your response. I like your idea of going for it and getting in touch with the Rheum PD.

I'm just more concerned about my boss being upset and disappointed at my decision to leave the group to pursue a fellowship. We just lost 2 doctors, one retired and the other one resigned.
 
Question: What can I do to improve my CV for the 2021 Rheum match?

My Bio - IMG from Canada on J1 -> H1b visa -> GC from US citizen spouse after waiver. Over 225 in Step 1-3 on the first attempt. Graduated from a community IM Residency. Worked on a few non-rhuem related case reports and presented at both ACP regional and National. I've always liked rheum but did not have major exposure to the field in residency. Due to family reasons, I decided to pursue a waiver job. I currently work in an Academic Primary care clinic with a strong medical school/residency/fellowship presence. I share primary care patients with the Rheum PD and the PD also sees patients in my building but we've never formally met. I would love to introduce myself and try to collaborate with our Rheum program but I am a bit hesitant because the program here is really small and everyone knows each other. I am not sure if this would get back to the boss about my plans to leave the practice after my waiver is over.

I passed ABIM, I'm currently working on ACP guided fellowship program and I volunteer at a free clinic.

My plan is to find rheum related cases reports to write up, take a course in MSK ultrasound, do an away elective for 2 weeks and possibly get a LOR from that (I heard this is possible even as an attending).

Is there anything else I could be doing to improve my CV?

Any advice will be greatly appreciated.

You should definitely reach out to your local rheum PD. You need something that shows your interest in rheum on your CV. Case report would be a minimum goal. Ideally, you start a small research project with a focus on rheumatology. This could be QI, maybe with a primary care link. This does not need to be world-changing, but needs to give you some rheum street credit. This makes a huge difference when you apply. Connections are important. Network locally, consider going to the ACR annual meeting. See if you can submit a poster.
 
Thanks for all the advice. Please keep them coming.

I have a potential case that I will be referring to the PD. 21 yo with vague symptoms and a very impressive ANA. I have other labs pending. I'm hoping this will be an interesting case. I will contact the PD to see if I can write it up with his help.

I think this is a good way to show my interest in rheum and hopefully get some one on one help.
 
Agree with all above. You need to get rheum specific research under your belt -- in the forms of case reports/posters, retrospective research, literature reviews, or whatever you can get your hands on. You need to get LORs from rheum physicians and should meet/work closely with the Rheum PD. Rheum is a small world so everyone (especially in the academic world) knows each other. You should also be honest with your boss that you're applying-- what are you going to do when you need to take time off for the interview trail? He/she needs to know especially if you will be requesting a LOR. Being transparent goes a long way.
 
Sorry for the late response. I also agree with the above.

Getting in touch with the Rheum PD and/or other Rheumatologist at your program will be very helpful. They can give you advice on what to do to strengthen your application. Maybe they need help with a case report. Or maybe they need help with research or a literature review. Or even a rheum related QI project. All that can dramatically help you and may even result in a letter of rec. So you need to let them know your interests.

Yes, if your boss finds out about that, it would be awkward. So you must be transparent. Its a difficult conversation, and they will maybe try convince you to stay, but ultimately they will respect your goals. They will appreciate the early heads up . And you may be needing a letter of rec from them as well. If you tell them now its not like you are leaving tomorrow. You will be giving them ample time until it comes time to replace you ( so they can start the process early instead of last minute which would suck for them).

Do the away rotation ( or perhaps rotation at your hospital?) but you need a Rheum letter of rec. So definitely do some kind of elective.

Maybe you could even do a talk at a noon conference whether its to the rheum dept or the IM dept or family med dept. I think that would actually be something you could list as a formal presentation. and you can also get advice from the Rheumatologist at your program regarding this.

I hope this helps and good luck!
 
Thanks for the advice. I will look into an away elective.
 
Just closing the loop on this thread. Thank you everyone for the suggestions.

I ended up matching at my #1 choice.

IMG from Canada on J1 -> H1b visa -> GC from US citizen spouse after waiver.
Over 225 in Step 1-3 on the first attempt.
Graduated from a community IM Residency.
I'm board-certified and currently work in an Academic Primary care clinic with a strong medical school/residency/fellowship presence.
Started working with the Rheum department in the summer of 2020, and co-authored a book chapter, and case report.
Working on 1 systematic review, was unable to finish before the match
3 Rheum LOR and 1 LOR from residency PD.
Applied to 60 programs, mostly H1-B visa programs
Got 11 invitations, attended 10 interviews

Matched at my #1.
 
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Thank you for the update. It certainly helps for others that are I. Your same position see what can make a difference.
Congratulations!
 
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