The University of Maryland's Department of Emergency
Medicine has strong track record of educating physicians at all levels of
training. Our postgraduate fellowship training programs offer a variety
of opportunities for continuing training and specialization within the field
of Emergency Medicine. Emergency Medical Services, International Emergency
Medicine, Ultrasound, and Research are our established fellowship disciplines,
and our educational offerings are regularly reviewed in order to best address
the training and specialization needs of the EM community.
Economic and lifestyle benefits notwithstanding,
the decision to pursue a fellowship should be based, ideally, on personal
interest and career satisfaction, says Marvin Dunn, M.D., director of residency
review activities for the Accreditation Council for Graduate Medical Education
(ACGME) and a former medical school dean. “I give residents the same
advice I gave to medical students — carefully
select the field or area you think you will enjoy working in most, and you
will be rewarded, regardless of the reimbursement,” Dr. Dunn says.
Many physician-fellows choose their program for experiences that were different
from the ones during residency.
Checklist for Choosing a Fellowship
Look beyond basic program descriptions and statistics before applying to or
making a final decision about a fellowship. The following tips will help you
avoid potential pitfalls:
Talk to current and past fellows
Most fellowship programs
will arrange for prospective fellows to meet with current fellows (without
faculty present) during a visit to the institution, and this meeting can
provide valuable insight into the pluses — and minuses — of
the program. During this time, ask specific questions about the fellow's
scope of responsibility, work hours, and case or procedure volume. Find
out if fellows have clearly delineated responsibilities and whether teaching
requirements, are clear. In addition, talk to fellowship graduates who
are a few years out of the program to find out how the fellowship affected
their professional life.
Assess the program’s stability and viability
Identifying
the top fellowship programs is mostly accomplished by word-of-mouth, but
you should consider factors other than the program’s reputation. For example,
determine whether the program’s slots are consistently filled year
after year and whether there has been frequent turnover in the directorship.
A low fill rate or frequent changing of the guard may portend problems. Also,
research the hosting institution to identify any financial difficulties that
could affect the fellowship.
Accreditation isn’t a make-or-break consideration,
but it counts
ACGME’s
accreditation system assures that programs meet standards of teaching quality,
fellow oversight, and working environment, among others. Still, not all subspecialties
require or are eligible for accreditation, and an unaccredited fellowship
may be very high quality. Some programs remain unaccredited because doing
so permits them to bill Medicare for direct care of patients. Others
establish the fellow in a part time faculty position, which accommodates
their course of study and also addresses billing issues.
NOTE: The author, Bonnie Darves, is an independent health
care writer based in Lake Oswego, Oregon.