A Resident's Perspective...

Remigio A. Roque, MD

Residency - Oregon Health and Science University, PGY-4/CA-3, 2014 -2018
Fellowship - University of Washington/Seattle Children’s Hospital, Seattle, WA 2018-2019

Why choose a fellowship for your career path vs general practice? Why did you choose your specific fellowship?

I think this is a very personal decision and both  can  be  the  “right decision”. Choosing to pursue a fellowship allows the opportunity to gain more knowledge, expertise, and skills in a particular area. It’s a good option if you know that you want to specialize in a particular area or if you feel like you need more experience in a particular area prior to going into a generalist practice. This may be more important if your residency program has areas which are lower in case volumes or are difficult to obtain case minimums. Fellowships are also becoming more important if you want to pursue a career in academics. On the other hand, if you know you want to be a generalist, it might be better to jump into a private practice or academic generalist job. This has the advantage of being able to get started in your practice, start making a “real” salary, and working toward tenure/ promotion/partnership. For some, it is hard to pursue a fellowship later in their career once they are making that “real” salary and have settled into a practice.

I started residency interested in pursuing a fellowship, knowing that I likely wanted a career in academic medicine. I chose a pediatric fellowship based on my experiences on my resident rotations. I enjoyed working with children and families, the even-more-preciseness of everything with smaller patients, and I found it incredibly rewarding to be involved in surgeries that could make big, lifelong impacts  (like  repairing   cleft palates). While I had enjoyed other rotations, on Peds I more often left at the end of the day feeling excited about the next day (even after a long, tedious day in the peds ENT room). The hard days on my peds rotations were still something I looked forward to.

Were you able to contact previous fellows or recent graduates on the interview trail? If so, what advice did they share?

At pretty much every interview, there is opportunity to interact and talk with current fellows about their programs. This is invaluable in helping to know what the culture and day-to-day workings of the program are like. I would also advocate for contacting past residents from your home program who are current fellows or past fellows at places that you are considering. Advice I received was to make sure to ask if there were any case minimums that were hard to meet, how helpful the program was in the job search process, and how much protected time fellows got outside of their clinical duties.

What advice would you share concerning the interview process? Is there anything that you would do differently or think was really beneficial?

My advice would be to apply as early as you can. It doesn’t have to be the day the system opens, but I wouldn’t wait until the deadline. Some programs will offer interviews on a rolling basis; others will wait until after the   deadline   for    applications ends. Either way, having your application in earlier increases the likelihood of being offered an interview and having more flexibility in scheduling a preferred date. Make sure you know who in your residency program administration will be the one approving your time off for interviews and helping to get the coverage you need - communicate with them early and often. They will be your best friend during interview season. Be prepared to use some vacation days to interview - it may not be the case for everyone, but most people I encountered on the interview trail sacrificed some vacation for interviews. I found it helpful to be really organized by keeping a google document of all the programs I applied to, interview dates I had scheduled, and the email/phone numbers of the program coordinators so if I needed more information or wanted to reschedule I didn’t have to dig through my inbox. Another piece of advice (which sounds obvious) is to be honest in your interviews and don’t lie - the world of anesthesiology is small, but the world of pediatric anesthesiology is even smaller. It’s a close-knit community of people. Even if you don’t end up at a particular program for fellowship, there is a high chance you will interact with your interviewers again at meetings or when looking for employment. Treat the interview process as an excellent way to network. For example, I went to the SPA meeting after the Match had concluded and saw people I interviewed with from most of the programs - many of whom said hello or had conversations with me.

What did you consider important things to know or ask representatives/programs during your interviews?

Of course, it is important to ask all the usual things about the call schedule, rotations, opportunities for additional fellowship training or jobs, etc. to figure out if the program will meet your A Resident’s Perspective education goals. I also think it is just as important to ask current fellows about their happiness and satisfaction with the program - Are they happy? Do they feel overworked? Do they have  appropriate  work-life  balance? Do they feel supported by their program leadership? The answers to those questions may seriously impact your opinions on a particular program. Also - remember to ask if the program is going to offer spots outside of the Match - this is becoming less and less common, but is important. Usually these spots go to internal candidates or candidates committing to a 2-year fellowship. If there are 8 spots, but 4 are outside of the match, there are essentially only 4 spots that you are competing for!

Important deadlines? Letter writer recommendations or advice? Rotations that are beneficial in your CA-3 year prior to starting your fellowship?

Remember that the whole process comes really early - midway through your CA-2 year! ERAS opens sometime in November and you can start working on your application  and personal statement. Starting in early December, you can submit your application to programs. ERAS closes in May. Programs, however, will review and make interview offers at various times from about February- June. Interviews occur from March - August. *Remember that if you are interviewing after June, the fellows may be brand new and may not be as helpful as outgoing fellows. For the programs I interviewed at later in the season, after their fellows had graduated, I felt like I didn’t get as good of an idea of the program and if it would be a good fit for me.

Registering for the Match occurs separately through the NRMP - registration opens in June and rank lists can be submitted in late August - mid September. Match Day is in early October.

In terms of letters of recommendation, one letter has to come from your program director. Most people have a pediatric anesthesiologist write one of the other two. My biggest advice here? Ask early! Pick people to write your letters that know you best and will be able to put a personal spin on it. I was surprised by how many people commented on my letters of recommendation during interviews.

Date of Publication: Spring 2018