What to look for in fellowship?

[Vigileo]

Long time lurker, now 2nd year (soon to be third) getting app together for PCCM. Broad questions below.

What should we be looking for in fellowship programs both clinically and, if appropriate, research wise?

In terms of clinical experience, what's an intelligent way to ask about procedural exposure? My home program does the gamut - lots of intubations, tube thoracostomy and surgical chest tubes, perc trachs, EBUS, etc. Is this the norm? How did you guys assess this on interviews and how important is it?

Are things like transplant or pulmonary hypertension important for clinical practice? How about academics?

Research - Do you need to be an ARDSNet site or have a big name to be able to work your way into academics, at least in terms of either clinician educator or clinical researcher if you train at an otherwise academic university program?

If it's helpful, I'm a US grad at a solidly mid-tier academic IM program in the SE. Think I'm interested in academics, either clinician educator or academic with hands in clinical research. If not, then PP. Definitely no bench research but like the idea of academics.

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[Vigileo]

Any thoughts? Too broad of a question?

 

[UofM527]

Some of these questions are largely dependent on what you want out of a program as far as I'm aware

Regarding the procedure aspect, definitely just straight up ask at interviews - they will tell you what sort of procedures they do frequently and numbers for different bronchs etc. this is definitely not uniform area - if I had to make generalizations, i would say a handful of the heavy hitter research places do far fewer procedures in many cases bc that just isn't the focus of the people going to train there. Also, some programs essentially don't even do intubations, many don't do trachs, some do very little EBUS or Nav etc...definitely ask on this one, especially if it might matter for your future goals

Regarding pHTN and transplant, it seems like a good thing to gain exposure in, but if you do not end up wanting to focus in these areas, other people will be doing them and they will not need to be any large part of your future practice

Research can happen anywhere for the sort of things you are considering - you should ask at interviews what fellows typically do at that institution and after graduation. Ask about clinician educator tracks as several programs have them and support this route now - also to be aware some big name more basic science programs really do not support or encourage this route , but obviously those type places likely will not be where you visit given what you want from a program right now

 

[jdh71]

Any thoughts? Too broad of a question?

It is broad I suppose, but really boils down to what do YOU want to do? You need to find a program that will fit your career goals. I know when I was looking I was interested in basic science research and I let them know that in my personal statement and made sure they had basic science opportunities available during my interview time as well as the possibility for training grants to pay for my time to do research. I was also interested in the number of fellows successfully getting K awards coming out of fellowship or very soon after. That's just an example from my days of looking.

If you want lots of bronch procedures and maybe some more "interventional" stuff, look for those programs. You want PHTN find a place where pulm do it the most, does a lot their own RHCs.

You really need to ask yourself what you want first.

 

[Vigileo]

Thanks all. When I think about goals, I want to be comfortable managing patients that are sick as ****, including necessary resuscitative procedures (intubations, chest tubes, whatever) as well as have some clinic and enjoy the intricacies of pulmonary medicine. I see myself doing that in an academic environment with the ability to do or build some clinical research and do a little teaching. Little interest in bench work for a research career. Attainable even if I can't/don't want to go to MGH, Penn, etc?