Rheumatology Interest and Fellowship Applications

[kdismyhomeboy]

I am a current PGY-2 in a community-based IM program and have developed a fairly recent interest in rheumatology. There are certain things about the field that interested me to begin with (long-term relationships with patients, flexibility in schedule, cerebral aspects...), but I am currently on an outpatient-based elective with a private practice rheumatologist and have been enjoying myself and the work. I could see myself finding a satisfying sustainable career in the field, as opposed to hospital medicine where I would likely burn out quickly.

I have been reading through the previous threads in this forum, but would appreciate any advice as far as practical approaches in building on this interest and the desire to pursue fellowship training.

I haven't had any rheumatology-related research (or miscellaneous for that matter during residency/medical school) but did have a previous publication in a small journal from my time doing benchwork prior to medical school. I am hoping to publish at least a case report and attend the ACR meeting later in the year to get my feet wet. I'm not particularly interested in academic research, but was hoping to also do an away rheumatology elective at an academic center (depending on scheduling difficulties). Being that rheumatology has not always been considered a very competitive fellowship, my impression based on previous threads is that getting a good LoR, publishing a case report, and expressing interest would have sufficed in fellowship applications. My concern is that my previous board scores have been somewhat underwhelming and I have been struggling with performance on ITEs (which reflect more of my test-taking ability than clinical skills) and that the field may becoming more popular and competitive now. In this context, I think I would be at a disadvantage in applying during the upcoming cycle in roughly 4 months without a clear direction in place. I wouldn't mind finding ways to strengthen my application and applying next year with the prospect of working for a year or two before doing fellowship. These are the thoughts that have been weighing on my mind, but I would certainly appreciate any insights/advice from others.

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[rokshana]

get some case reports and see if they can be accepted to ACR for this year, get to know the Rheum dept at your hospital (and let them get to know you), see if there are any short term (like 3-4 month projects that you can get to work on and at least get an abstract out of) and apply this cycle...if you match great, if not then spend the next year improving your application and apply again...

 

[akviv47]

I'm a PGY-3 going into Rheumatology in July so I guess I can help.
Publishing case reports is a great way to start. ACR does not accept case reports but there are other (albeit less prestigious conferences like CCR which does accept them)
Get at least 1 Rheumatology letter. Getting a letter from a big academic center will definitely help. Apply far and wide.
Good Luck!

 

[rokshana]

I'm a PGY-3 going into Rheumatology in July so I guess I can help.
Publishing case reports is a great way to start. ACR does not accept case reports but there are other (albeit less prestigious conferences like CCR which does accept them)
Get at least 1 Rheumatology letter. Getting a letter from a big academic center will definitely help. Apply far and wide.
Good Luck!

oops! did not know that!

 

[kdismyhomeboy]

I'm a PGY-3 going into Rheumatology in July so I guess I can help.
Publishing case reports is a great way to start. ACR does not accept case reports but there are other (albeit less prestigious conferences like CCR which does accept them)
Get at least 1 Rheumatology letter. Getting a letter from a big academic center will definitely help. Apply far and wide.
Good Luck!

get some case reports and see if they can be accepted to ACR for this year, get to know the Rheum dept at your hospital (and let them get to know you), see if there are any short term (like 3-4 month projects that you can get to work on and at least get an abstract out of) and apply this cycle...if you match great, if not then spend the next year improving your application and apply again...

Thanks! I appreciate the advice. We don't really have a rheumatology division - there's a single rheumatologist who occasionally sees inpatient consults. If I am unable to arrange an away elective, then I'll try to work with the local VA.

 

[drfunktacular]

Compared with many other IM subspecialties rheumatology is just not that competitive, even if it is moreso than it used to be; particularly if you are not highly selective in terms of geography

I started fellowship in 2012 and I had no published research whatsoever. That said, I am very good at taking tests so all my numbers were pretty good. I also had multiple rheumatology LoRs, but my residency program had a rheumatology division. If you're worried about your scores, some research would certainly help to offset that. Really I think the most important thing is to demonstrate a more than passing interest in the field and familiarity with what rheumatologists do. Good performance on rheumatology rotations, rheumatology LoRs, and rheumatology research all help to support that impression. If you are conversant in what rheumatology encompasses and express interest in being a rheumatologist, learning more about rheumatology, and being willing to help your faculty complete research projects, I think you can find a spot without too much difficulty (again, particularly assuming that you are willing to live outside of the same NYC/SF/LA areas to which many applicants seem insistent on limiting themselves).

I would advise against delaying your application just with the purpose of buffing up your CV. That might be necessary if you want to get into a top oncology fellowship for instance but in rheumatology I think you're better off just trying to move on with your career as quickly as possible.

 

[Successor12]

Compared with many other IM subspecialties rheumatology is just not that competitive, even if it is moreso than it used to be; particularly if you are not highly selective in terms of geography

I started fellowship in 2012 and I had no published research whatsoever. That said, I am very good at taking tests so all my numbers were pretty good. I also had multiple rheumatology LoRs, but my residency program had a rheumatology division. If you're worried about your scores, some research would certainly help to offset that. Really I think the most important thing is to demonstrate a more than passing interest in the field and familiarity with what rheumatologists do. Good performance on rheumatology rotations, rheumatology LoRs, and rheumatology research all help to support that impression. If you are conversant in what rheumatology encompasses and express interest in being a rheumatologist, learning more about rheumatology, and being willing to help your faculty complete research projects, I think you can find a spot without too much difficulty (again, particularly assuming that you are willing to live outside of the same NYC/SF/LA areas to which many applicants seem insistent on limiting themselves).

I would advise against delaying your application just with the purpose of buffing up your CV. That might be necessary if you want to get into a top oncology fellowship for instance but in rheumatology I think you're better off just trying to move on with your career as quickly as possible.

Since you are the best one when it comes to career guidance in the Rheumatology field. I have a few questions about private practice. Am starting fellowship in Rheum this July and very much excited and I know that I want to go into private practice however with very little experience and knowledge about private practice/models/partnership tracks/ hassles of running a private practice/what you should consider when you look into private practice right out of fellowship/ expectations for pay as you move down the line of private practice

Now am just throwing questions but am not even sure how relevant or important they are in making a decision? I met an attending today and we had this interesting talk about how finances matter in terms of job satisfaction. He mentioned that money is something one needs to start planing for how to manage a year ahead of going into practice. Any insight into how a fellow who definitely knows they going into private rheumatology practice should plan efficiently for this would be helpful!

 

[kdismyhomeboy]

Compared with many other IM subspecialties rheumatology is just not that competitive, even if it is moreso than it used to be; particularly if you are not highly selective in terms of geography

I started fellowship in 2012 and I had no published research whatsoever. That said, I am very good at taking tests so all my numbers were pretty good. I also had multiple rheumatology LoRs, but my residency program had a rheumatology division. If you're worried about your scores, some research would certainly help to offset that. Really I think the most important thing is to demonstrate a more than passing interest in the field and familiarity with what rheumatologists do. Good performance on rheumatology rotations, rheumatology LoRs, and rheumatology research all help to support that impression. If you are conversant in what rheumatology encompasses and express interest in being a rheumatologist, learning more about rheumatology, and being willing to help your faculty complete research projects, I think you can find a spot without too much difficulty (again, particularly assuming that you are willing to live outside of the same NYC/SF/LA areas to which many applicants seem insistent on limiting themselves).

I would advise against delaying your application just with the purpose of buffing up your CV. That might be necessary if you want to get into a top oncology fellowship for instance but in rheumatology I think you're better off just trying to move on with your career as quickly as possible.

I appreciate the helpful input. I am not very selective geographically and plan to apply pretty broadly. While my program may not have a rheumatology division, I'm hoping to be able to incorporate many of the items you suggested and reaching out to the contacts I do have to help.

 

[Rheum01]

Hi everyone, I am a PGY2 currently and planning to apply for Rheumatology coming application cycle. I would like to know regarding the safe numberof programs to apply for someone who has decent scores,good LORs but no researches. Also, if anyone could provide me with the name of the top ranking programs in USA in Rheumatology, I would be really grateful. Thanks in advance.