5 Tips to Get the Most Out of Your Fellowship Year

  1. Introduce yourself early and often
After five years of residency, you knew everyone in your hospital and everyone knew you—now you start from scratch! Most times you will be working at more than one facility, having to meet tons of new people. People that are there to help you, teach you, and make your life easier this year. So be proactive, be personable, and be the one to introduce yourself to all those new people. Learn everyone’s name and greet them the next time you see them in the hallway. A nod is not enough, greet them by name. They will appreciate it and that small gesture will make a lot of future interactions for you that much easier. Learn and embrace the culture of the program. Different programs have much different cultures and it’s important to assimilate earlier rather than later. Same with your co-fellows (if you have any) or the residents you will work with. Be the one to proactively engage the group, schedule get togethers and establish a culture of collegiality and teamwork early on. Your co-fellows are a great resource of information, support, and knowledge this year, but also for years to come.
 
  1. Write down everything and keep notes of everything
Clinic note templates, operative notes, surgical tips, OR setup, attending preference cards, list of trays and instruments, postop plans, rehab protocols, clinic handouts…. EVERYTHING! It's implied that you will take all that information with you. It’s encouraged! Don’t be afraid to ask the nurses in clinic to give you printouts of the clinic handouts. In the OR, ask for printouts of your attendings’ preference cards (and supplement that with your own notes on positioning, prepping, and draping) and their trays. You will be surprised how in the busiest of fellowships there are still complex cases that you might do only once or twice; keep detailed notes after each case, you will need them. Even for simple cases that you do weekly now, it might take a few months before you book one as an attending. It doesn’t matter how comfortable you feel doing this case now, you will appreciate a quick refresher and some reminder notes the night before your first case as an attending. Medicine is lifelong learning but this is your last opportunity to formally be a “student”, so be honest with yourself and your learning style.
 
 
  1. Learn the soft skills
Communication, resilience, wellness, emotional intelligence. This is important! And this is one of the hardest transitions to becoming an attending. I am confident you will learn how your attendings indicate patients, how they position, drape, and do a surgery. But this year I urge you to be mindful and to pay attention on how attendings run their clinics, interact with the ancillary and support staff, how they deal with challenging patients in clinic and how they deal with complications. Truly listen to that preop spiel in clinic, observe them during the first few minutes dealing with an intraoperative complication and going to plan B, appreciate that quick 10-second comment from them at the end of a complex case or after coming out of a difficult discussion in clinic; it will stick with you and guide you for years to come. Soft skills will be more important the first few years in practice than your surgical skills. Do not neglect this one!
 
  1. Be your own advocate
Part of the fellowship year is landing a great attending job. Your fellowship faculty know their role in this and facilitate it year after year. Start those discussions with faculty in your program early! A month or two into the fellowship talk to them about programs in your ideal location. Make it known what you want, what location, what practice setting, etc. Their networks might identify jobs that are not publicly posted. And stay in touch with them throughout the process, from applying, to interviewing, to providing their support on your number one choice. Ask their opinion about a potential job and if it’s a good fit for you; it’s a small field, they know you and they will be honest with you. Your “job” is to be honest with yourself and know what you want. Their “job” is to help you land that position. And they will. Advocate for your goals and the years of hard work you have put in so far. And this brings me to my next, and last, point.
 
  1. Be a great mentee
During fellowship you will gain lifelong mentors in your specific field. This is the year to cultivate those relationships early and work on them. Don’t be afraid to ask your attendings about personal coping strategies, finding balance at home, navigating leadership politics and hospital conflicts, compensation, and billing. Be the one to reach out to their administrative assistant and schedule that meeting, come prepared with an agenda, be open to change and feedback. It takes time, effort, and practice to be a great mentee. Jack Flynn wrote “the most important thing that makes a great mentee is their ability to sprint through any door that is opened.” Be a great communicator, be proactive, schedule short but frequent meetings and be clear with your mentor about your needs and goals. Help them to help you. Follow up with them. This is your year!
 
I am excited for all of you to embark in this special year. I am confident it will be a memorable and productive one! Feel free to reach out any time.
 
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