Thank you all for attending the AAP MNR Member May Session led by FICT. I just, my name is Monar Tani. I'm gonna be the staff manning this session and I'm gonna quickly go over some of the housekeeping notes before we get started. So, the views expressed during the session are those of the individuals present and don't necessarily reflect the positions of AAP MNR. We are committed to maintaining respectful, inclusive and safe environment in accordance to our code of conduct and anti-harassment policy available on our website. All participants are expected and encouraged to engage in professional and constructive manner. This session will be recorded. We're gonna make it available on the online learning portal. A link to the activity will be sent to the participants after. For your best attendee experience, we usually ask you to mute yourself while the speaker is speaking and then use the raise your hand feature if you have a question. And that's about it. Any questions for me before you guys get started? Okay, I will stop sharing and you guys can go ahead and take over. Hello and welcome everyone. Thank you so much for joining us tonight and taking time out of your busy schedule. I do have a PowerPoint, but feel free to ask anything. Hopefully you can see me sharing the PowerPoint. Okay, good. You know, all these years and we still have to make sure. So yeah, so this session will be focused on kind of finding your fellowship fit. So none of us have anything to disclose, maybe someday, but not today. But I'll start off with myself. My name is Rosie Connick. I'm a PGY-4 at the University of Florida. I'm going into pain at the Mayo Clinic in Jacksonville and I'll pass it off to Caroline. Hi everybody, I'm Caroline Pupke. I am also a PGY-4. I'm at Emory University right now, finishing up residency and I'm doing a TBI fellowship at Spalding in Boston. So moving up there at the end of June. I guess I can hear Kirsten. Yeah, I was about to say, I was like, should I pick the next person? Hey all, my name's Kirsten Schlosser. I am currently a PGY-3 at the University of Washington. I am submitting my rank list today for neuromuscular medicine and I'm happy to speak to you all. I guess I'll pass it off to Tim. Hey guys, congratulations, Kirsten. That's awesome. Thanks everybody for tuning in. Thanks Kirsten, that's awesome. Thanks everybody for joining. Tim Curtis from the University of Utah. I'm a PGY-4. I'm staying here to do the NAS Interventional Spine Fellowship. Excited to talk to everybody. And then Jeremy, I'm not sure if you can speak. I can hear you. Yeah, yeah. Hi, I'm Jeremy Roberts. I did a PEJ rehab fellowship at University of Colorado and I'm currently doing a sports medicine fellowship at Atlantic Sports Health slash Morristown Medical Center. I did my residency training at New York Presbyterian Hospital. So I can speak to the PEJ rehab application process and the sports medicine application process. Great. So what we're hoping to accomplish with the objectives today is kind of discuss some of the different fellowships and how the application process is a bit different than residency. Kind of navigating these virtual in-person interviews in addition to having your regular clinic needs and then identifying any approaches to like ranking programs and dealing with any surprises at the end. So just to kind of go where AAPMNR has a great fellowship directory, there's a bunch of different fellowships. The ones that are bolded are the ones that we'll talk about today. The ones that are starred, we either have people who know about them and can like comfortably talk about most of the things in relationship. So yeah, if any questions come up during, feel free to put it in the chat and we will answer as we go or towards the end. So for pain medicine, it's an ACGME fellowship. These are some of the societies that are relevant for pain. So the American Academy of Pain Medicine, ACIP, ASRA, IPSIS and NANDS, they're kind of the main societies that have decent opportunities for trainees to get involved. Some of them have overlap, like I know Tim is also involved in IPSIS for example, between the pain and the NAND fellowship version. So definitely look into that. So timeline wise though, so starting in June 22nd, you can obtain your fellowship heiress token even though you're not really applying until December, but it gives you almost six months to take your time and put in all your information in the heiress. Heiress does maintain your information from year to year. So you can reuse all the stuff that you had during your residency application as well. So December through February is typically the times that people are applying. Officially they say, you know, January 15th, but really like you're safe up until mid-March is really at the last, if you're doing this last minute that you can apply. This year is the first year that they have launched signaling and you have five signals. The interviews are mostly March through August. My personally, my last interview was August 15th, but I believe, so it's a long application and interview season. And then September 17th was when rank lists were due on NRMP for this cycle. And then October 1st is match day this year, but obviously this changes year to year, but this should give you an idea. And then, you know, statistics wise. So this is from my cycle for 2024. Most people matched and there were, as you can see at the bottom, so 94% of people matched. There were 6% of people who didn't match, but there were still 69 positions left unfilled at the end of the match. And that if you fail to match, then you enter essentially a scramble process where you're contacting the programs directly to try to obtain a position. So there were 115 programs. NRMP match statistics are great, so use that. But I'll pass it off to Tim. Yeah, so happy to talk about the Interventional Spine Match. It is, goes through NAS, the North American Spine Society. That's the kind of governing body that it's accredited through. So it's non-ACGME. It is a somewhat similar, but not as extended of a timeline as the pain cycle. In that is, it's quite early. You end up applying during your PGY-3 year, kind of during the winter of your PGY-3 year. I think that the applications went in sometime around January. Then there are several months where you don't hear anything. Oh, excellent. Rosie, you're the best. Yeah, there's several months where you don't hear much. And then around March, April, kind of May timeframe are when the majority of the interviews happen. I think a few of them trickle out into June and July. Then after the interviews are completed, you submit your rank list. That's done through NAS. And then you match at the kind of end of July or I don't remember if it was early August. The application itself, we can get into this later. I contemplated both pain and spine. The application itself is sort of less cumbersome than the ERS application. It's just your letters of recommendation, your CV and a personal statement and that's it. And yeah, happy to chat about kind of what my experience was on NAS versus pain in that I contemplated both. They can lead to sort of similar end points in the ultimate job that you end up pursuing. I think Rosie could also speak to some of the key differences. So NAS will focus mostly on bread and butter kind of spine procedures. And it's a lot more narrow in its focus on sort of the overall all-encompassing pain, gets you pain from all sorts of angles and can have a lot more advanced procedural training. The other kind of main differentiator between the two is the ACGME accreditation. That is sort of a, can be sort of a point of trepidation for some folks, whether or not that that is gonna matter for eventual credentialing or limit your job prospects. I personally just made the decision that it, I didn't care as much. I quite enjoy being a physiatrist. I don't think I've ever came to that point where I couldn't get credentialed at a particular institution that I wanted to work at. I was happy to do a general physiatry job. And I quite enjoy the sort of the depth and breadth of the procedures that are available through NAS fellowships. And I enjoy treating pain of kind of musculoskeletal etiology. And then through NAS, I could continue doing EMGs and ultrasound guided joint injections and kind of treat those things. And I felt like it was a more natural extension for me for our APM and our residency. But happy to open it up to Rosie on kind of how she thought about it and why she ultimately ended up choosing the pain route. And I'll keep this brief. For me, the main concern was also ACGME training. I would prefer to, I decided that I would wanna do the ACGME route for sure. For me, it was really the question more of do I wanna do sports or do I wanna do pain? And ultimately for me, it came down to well in pain. I can do all the procedures that sports does. And the only thing is I can't really do sports coverage which I wasn't that passionate about in those sports that I would have had access through my residency training. So that's kind of how I take pain. I will say this, there are, ACGME does have restrictions and depending on where you train, if you train in a private practice for NAS, you may not have as much of a work hour restrictions or are you doing any of this cut work or any of those kinds of things. So ACGME training does give you more protections as well in addition to just having that thing on your wall that says you're ACGME accredited. So that was kind of my pathway there but happy to answer any thoughts or comments from questions also, but feel free to leave any comments and in the meantime, I will pass it to Carol. All right, so like I said in the beginning, I'm doing a brain injury fellowship. Brain injury fellowship is not quite as popular as some of like the other fellowships like spine or pain but there are quite a few programs to choose from. So there's 29 programs kind of all throughout the country. The link that Rosie provided does have all of the fellowships listed on it, which is nice. That's what I actually used when I was looking at different fellowships and some of the programs except one and then some except two, I think that's the max is two brain injury fellows per program. Next slide, Rosie. So the timeline for application is during your PGY-4 year. So at the end of June, you can get a token to apply via E-RAS which opens on July 2nd and then you can get all of your application stuff together which Rosie said was nice that some of it was carried over from when you were in residency. So you didn't have to get a lot of the things done again but you do have to have like a personal statement, your CV essentially and then some letters of recommendation. Trying to get those things in before July 16th is ideal because that's when the programs can view the applications and then they start sending out interviews. Typically interviews are from September to December for brain injury fellowship. All of the interviews are virtual and they're typically about half a day, which is nice. And then in December, your rank list is due on December 3rd and then match day is December 17th. Next slide. Thank you. And so, like I said, there are 29 enrolled programs and 20 of the programs filled, there were 25 positions filled, that being that there are some programs that have two positions offered with 10 positions being unfilled and nine programs being unfilled. So you really get to choose where you wanna go for brain injury fellowship. I think most of my colleagues that applied into brain injury medicine got one of their top two choices, which is nice because you can really decide where you wanna be for the next level of your training, if there's a specific location or a specific place that you wanna train at, it really gives you that opportunity, which I think is really nice. Next slide. And then I'll talk a little bit about spinal cord medicine as well. I actually really like spinal cord injury medicine and was debating between brain injury and spinal cord injury for a while, but there are 26 programs for spinal cord injury currently. They actually have a different type of an application. They have a common SCIM application. And so the link that Rosie provided gives you all of that information. I actually looked at it earlier because I had not seen it, but it really is the way that you apply for the spinal cord injury fellowships. And so they just do a different path as far as the application process, but then you do still rank through NRMP. Next slide, please. So again, the timeline is PGY-4-year. It's a little bit earlier in PGY-4-year as far as like when you get to interview and rank and match, which is nice, you'll find out earlier in October, but typically applications are due around August. Like I said, ERAS is not used. They use their own common app, but then you do register on NRMP for the match. There is an annual conference, the ASCIP annual conference around Labor Day every year where interviews can occur. They also do virtual interviews, but I know a lot of the interviews do occur there knowing one of my mentors who's a spinal cord injury attending. He does a lot of interviews at that conference. And then in October, the rank list is due on NRMP. And then at the end of October, typically is when their match day is. I think this year was like October 26th. So a pretty quick turnaround, which is nice. You know where you're going pretty early. Next slide, please. And then, so there are 24 enrolled programs. I think 26 total with some active programs. And then they had only six programs fill this year. So it's not quite as popular as some of the other fellowships. And I know they're looking for people who are interested in spinal cord injury medicine, even at my own program here at Emory. But people, if you are really interested in spinal cord injury, you really get to kind of choose where you want to go and choose where you want to spend the next level of your training, which is nice. And so hopefully we'll see that trend kind of increase in spinal cord injury medicine, because thankfully all 13 applicants that applied did match, but definitely want to see that number increase hopefully. Before I switch, what made you choose between the two? What was the deciding factor? Yeah, so I like both brain injury and spinal cord injury medicine. I like the inpatient aspect of it. I really think brain injury medicine to me is more fascinating as far as like getting to see them recover from disorders of consciousness and really getting to see them recover acutely. I was always more interested in brain injury medicine and then kind of started taking a liking to spinal cord injury medicine. But I think really getting to see that short-term recovery in brain injury medicine, seeing people wake up from comas and stuff was really fascinating to me. And some of the research that they're doing in brain injury medicine is also really intriguing. So that's where I definitely kind of made that decision was just the future of brain injury medicine looked really fascinating, something I wanted to be a part of. That's so cool. Thank you for sharing. I'll leave it to Kirsten. Alrighty. So I'm going to talk about neuromuscular medicine, which is what I am currently working on right now. So what's interesting is these are entirely neurology programs, except for I think there's one in California that's PMNR based. So most of the people that you're competing with for spots are actually neurology trained residents. I can go into this later, but there is a key difference in your exposure to EMGs compared to neurology residents who usually don't get an exposure to EMGs. And that's a big component of fellowship. So you are kind of at an advantage in that way, but then there's a learning curve on the other side with just kind of learning neurology. And so during your interviews, that's going to be something that comes up for sure. In total, there's 58 programs with 114 positions. The most important website you'll use during this whole application is actually the AANEM website. It's going to be your best friend. Next slide. So the timeline is actually feels quite truncated compared to some of my other colleagues applying. You do start in your PGY-3 year in the second half of your PGY-3 year. So January 1st, I had to make a decision that I was going into this. And then you do interviews. So March 1st, you have to submit and you start hearing back pretty quickly because the programs have to interview you and you have to get in your rank list by the end of May. And so, like I said, my rank list is due today. It's kind of in, but maybe we'll tweak it, we'll see. And then I'll find out next week. So the turnaround is quite quick. Next slide. And so the match rate, it's interesting for neuromuscular medicine, it's 89.7%, about 76% of programs fill. However, there are very few PUMA residents that actually applied to neuromuscular. So I believe I've heard a number of like four per year. So you're really a unicorn if you end up applying to neuromuscular medicine and would highly encourage it because I think our skills really lend itself well to this population. So if you'd like to talk to me about neuromuscular, I'd be happy to talk to you about it. But I think the success probably is 100% is my guess. Next slide. And then while I'm not applying into cancer rehab, just gonna talk a little bit about it. This is actually a non-ACGME fellowship. There's 14 programs, 12 in the United States. And this also has a relatively short turnaround, so about a six months. So this, unlike neuromuscular, most other, I'm sorry, unlike neuromuscular only really, you're applying in your PGY-4 year. And so you'll start that application process June 22nd, you obtain your token, the applications open in July via EROS, and then you kind of start the interview process in September to December. And then in December, you'll start your rank list and then hear back soon after that. And because it's, so cancer rehab is expanding. I know, for example, University of Washington just opened up a program like this past round, so it's still pretty new. For this data that's available, basically there were 10 certified programs, six of them filled, and then basically 100% matched into the specialty. So I'm gonna pass it on. Hi. So I'll be talking about sports, which is, this is the ACGME one. Even though ACSM and AMSSM are the primary sports medicine societies, AMSSM is sort of the one that fellowships are kind of running through, but ultimately the application is through EROS. Sports medicine is similar to neuromuscular, kind of a unicorn coming from PM&R. There are 28 PM&R accredited programs, and I think that's growing each year, but it is really hard to get in and match through PM&R. I'm gonna be pretty blunt about it. There's only 40 spots. It's growing in popularity. And then there are non-PM&R sports medicine programs, such as the one I'm in, that are, for the most part, family medicine based, but there are some either pediatric based. I don't know if ER programs take PM&R applicants. Some pediatric programs might. IM programs, family medicine programs. So this is something, especially on the AMSSM website, that you'll have to do some digging in order to see which programs do and don't accept PM&R applicants. Match rate overall is 70 to 80% for all applicants, but I think it's a lot lower for the PM&R exclusive specific spots. Next slide. Oh, I can't read this well. I'm not driving right now, but if I were to be driving, can someone else read it for me? Oh, good. So it's looking at the top five valued characteristics. By certification. So prior leadership experience is one. Research experience pertaining to musculoskeletal or sports medicine. Those are kind of the main ones for, sorry. Main one for PM&R is the research experience and prior leadership experience that people have valued. For family medicine, they still value board scores. And this is true for like pain and some of these other fellowships. Like your board scores don't go away. And if you failed any of the boards, that also doesn't go away. So I would make sure you address that during the, you know, in your blurbs, in the application. Any sort of prior leadership experiences still matter. The interview matters as well. Having any sort of sports coverage as well. Jeremy can probably talk more like off the cuff about this. Like what are all the things that his sports fellowship is looking forward to? Yeah, related to this, there's a great, sorry, am I chopping out? There's a great PM&R sports medicine document. I think it's on the AAPM&R website or AMSSM. And it goes through the eight factors that the family medicine and PM&R programs are looking for. And it's a real, like I looked at it every couple of months to make sure I was hitting all the key things. Beyond this document, it talks about sports coverage experiences, leadership experiences, doing physical exam experiences, some research as well, developing an early interest in sports medicine, and like in a priority and some teaching experiences. And it really goes like one through eight, really prioritizing the things that they'll be looking for in order to provide an interview or invite to interview. And then ultimately when they're looking to match. Next slide. Yeah, they also just said a member may session about this. So I can recommend referring to that too. I can't see this one. You can go over it as well. Yeah, sure. These are just some match statistics. So as you can see here, most of the programs failed. Like there were 234 certified programs and only four went unfilled and only four positions were unfilled at the end. So 79.5% of applicants matched and 20.5% did not. This is like a breakdown that one of my attendings gave me for what are the match rates depending on the different subspecialty for sports. So as you can see here for FM, for family medicine, it's like 78.6 ultimately for PMNR 85, EM 84 and MP 79. And he says the applicants are generally much stronger from the PMNR side because they know they need to get involved in the sports coverage and some of the residency programs provide that earlier on as well. And typically people tend to know also going in very early. Now moving to PEAVS. Yeah, so I can cover this one as well. Oh, and in terms of the interview cycle, sports starts in, if you're applying as a PGY-4, it'll start in July between your PGY-3, PGY-4 year. And then interviews are mostly in late September but the bulk in October, November. And then you submit ranks in December and then matches second or third Wednesday, January. And then pediatrics is a similar timeline. If you want to match as a, or enter as a PGY-5 between PGY-3 and PGY-4, July you apply. And then interviews will be in, they were September through December for me. Basically they're spread out over four months. Those are all virtual, whereas the sports, there was a huge mix of in-person and virtual. The pediatrics for now, it's all virtual. And this is also in pediatrics, a buyer's market. There's a lot less applicants than there are spots. So they're looking for a lot of people who are just really vibing or matching with the personalities, with the programs. Some programs, the slide before it are about 24 different programs. Some have one fellow every other year. Some have two fellows per year. Some have one fellow each year. Some normally have a couple of fellows each year but then didn't match a spot one year. So then it gets altered. So the different programs have different flavors in terms of the number of fellows they have. But in terms of association with residencies, almost all the fellowships do have a large association with a lot of the residencies as well. So there's a nice overlap in terms of knowing people from each program or getting insights even into geography and location. What else did I miss about the slide? You covered it. Okay, next slide. So after that, I just kind of had this because some of us will not want to do, maybe not wanna do fellowship. So kind of what can you get certified in without a fellowship? So nowadays it's still lifestyle medicine. You can get electrodiagnostic medicine but you'd have to refer to the ABEM website for details about that. And then occupational medicine, you could either do a fellowship that's one to two years or you can also go through the practice pathway where you can get certified if you spend 25% of your time for three to five years doing like occupational medicine and workers comp. Just kind of some like general planning points for fellowship. It's kind of be a good resident in all rotations. So PMNR is small, people know each other. Your PD, your future potential PD could have trained with somebody who's on your faculty. So even if you don't like whatever rotation, maybe it's SCI, still pretend to be enthusiastic enough. Even if you're gonna try to go into painter sports. It's also okay to change your mind regarding fellowship, whether it's to do one or not or which fellowship you would end up doing. So I had some like general questions that do come up after this, but does anyone have any specific questions that they wanna put in the chat? I don't see any for now, but okay, here we go. So Emery is asking, are there specific things that PDs are looking for in letters of rec? So does anyone wanna start off with this one? I mean, I can start. I think so specifically for me going into brain injury, I focused on getting a couple of brain injury letters of recommendation. And then I also got, like Rosie was just saying, always try to do your best in every rotation that you're on. I also got, and I thought it was important to get letters of recommendation from other people that I'd worked with so that they could see that I was a well-rounded resident and a well-rounded physician. So I think you definitely should get a letter of recommendation from your program director. I think that's in some instances required, but I got a specific letter of recommendation from him. And then I also, like I said, got I think three brain injury letters of recommendation. And then I got two outside of brain injury medicine, somebody that I worked on consults with, and then somebody that I just did general inpatient with. You can only upload four letters of recommendation. And so I kind of use those in different ways just depending on the places that I was applying. And so like Rosie was saying, if I knew that one of my letter writers was at a specific program for brain injury fellowship, I sent that letter of recommendation. But I think getting letters specifically to the fellowship you're applying to are important at least one or two, getting your program director to write a letter. And then I do think it's helpful just to have a general letter, just if you wanna have kind of more of a well-rounded application. If anyone's doing neuromuscular, I think the best thing to do is have a neuromuscular physiatrist write your letter. Particularly actually a neurologist who's trained in neuromuscular, just because they really question what your exposure to neurology is. So having that type of letter would really help strengthen your application. That being said, I didn't meet our neuromuscular neurologist until too late to get a letter. So mine were just neuromuscular physiatrists, just. And I felt absolutely fine during my interviews and everything. So I think that's the best thing to do. I think that's the most important thing to do. I think that's the most important thing to do. Jeremy, anything for sports or PEDS? Yeah, I think from a PEDS standpoint, the big thing both for letters and even on an interview to be honest, is they wanna know that you know if you're doing psychiatric sports, it's very neuro-heavy or taking care of kids with disabilities. It's certainly very rewarding. But I think the biggest example is there are people who apply to like combined PEDS PM&R programs before they even go into PM&R. And then a lot of them, like they don't get interviews because their own personal statements were like not reflective of what the field actually is. So making sure that you've rotated, if your program doesn't have any PEDS rehab rotations, finding a way to make sure that happens as an away rotation. And if your program does have heavy PEDS, making sure you have one if not two letters to demonstrate that you both understand what you're getting into and what you love about pediatric rehab and that you're someone who can take care of kids and their families as being their medical home. And then sports, they do wanna see, like in sports, everybody knows each other similar to these other fields. So I think finding, especially with the programs you're applying to where people might be a little buddy-buddy and then ultimately within your program with the rotations you do, again, showing that you didn't just do like, oh, I did a bunch of injections on these rotations, but that you worked with Dr. X, you did ultrasound with them, you did some coverage with them, you volunteered to go to their PPEs, you volunteered to do some community service with them, even after your mandatory sports coverage, you still went to a couple other coverages. And then on top of that, you engage with whatever project they might be in. That's probably the maximum amount of things for a letter, but that over, let's say three years to get a letter like that from a sports med attending, I think other people in the field would find that to be very valuable. Yeah, and I will say for pain, kind of similar to what Carolyn said, I also looked to have, I had two people who were more PMNR and then two people who were pain, right, my letters. So whenever they can say anything about you, like top 5%, top 1%, anything like that is always like a great thing to write that you're outstanding at whatever you may be outstanding at, whether it's your bedside manner, always going the extra mile or always like prepared and reading about patients, good with feedback, et cetera, things like that. Things that you wanna make sure that they can, it is a one-year fellowship, but you wanna make sure that they can handle you for a year. So that's what they're trying to get out of that letter too. So on the topic of away rotations, has anyone, Jeremy, have you done an away rotation or has anyone else done an away rotation? Yeah, I did away rotations. Actually, no, not during residency, but I had done away rotations during medical school. So I happened to know some of the people that I then later met along the trail, but I think this is gonna be very residency dependent. I did an away rotation in pain. It is very difficult to get your program to agree. Typically you have to have, you have to be missing something. So in my case, I went to pain, I went to UCSD. And the thing that was my clutch point was that we don't do much regenerative medicine or advanced regenerative medicine, like bone marrow aspiration at UF, and that we don't do any marijuana prescribing, which they do over there. And this is a state institution here, so we don't prescribe. So that's kind of how you can get away with it. Same thing, like for TBI, you can get away with it by saying like, oh, you don't have a closed unit. For PEDS, like Jeremy said, if you don't have a PEDS, you know, inpatient rehab, and that's important to see as well. I'm sure, like I wonder, you know, I'm sure that they want you to have experienced inpatient rehab, just like for residency, they want you to experience inpatient rehab before applying PM&R, right? So, yeah. And this is like, if you want to do an away, it's a six to eight month process minimum, because also count on the fact that you have to get a state medical license, especially like if you're going out of the state that you are at. I'm sorry, Carolyn, you wanted to say something? Yeah, I was just gonna pretty much echo what you said. Our program only allows us to do away rotations if we don't offer that specific fellowship or certain aspects of fellowship, like you were stating. Because I think our rule is that you have to spend 80% of like your elective under Emory's umbrella, just based on payroll and like accreditation and stuff. But yeah, I think if you are at a program that doesn't offer those fellowships or you're looking for something specific like regenerative medicine, then you can get it approved usually through your residency program. But it is a long process. I know a few people who do that. It's worth it, though. We kind of touched on ACGME versus non ACGME so I'll skip over this. Now, this is new from the geographic preferences from when we were applying. This did not exist when I was applying for residency. So I'm curious to hear, Carolyn, how did you end up handling this? Did you put any or did you leave it blank? Yeah, I did put the southeast because that's where I am and where I'm from. And then I did put the northeast as well. So most of the programs and my goal was to ideally stay on the east coast. And so most of the programs that I applied to were on the east coast. I did have a few like I did apply to UW and in the Midwest a few places. But, yeah, I use the signaling more to say I wanted to stay on the east coast. And then when I said why, because you can explain why you want to signal geographically. I said, you know, I'm from this area. I want to stay in this area. Or if I have ties to like the northeast, I have family in the northeast. And so it could just show them that, A, you're likely to match their program or rank their program and also potentially stay in that area after fellowship, which will make you a more desirable applicant, I think. Kirsten, I don't think you had any of these options. No, I did not at all, because it's totally through AAM. But I did basically exclusively apply to the east coast, except for out here, the one program out here. So it was easy. Yeah, for me, it was very difficult to pick where, because in each of these, there's like a state that I wouldn't really be interested in potentially. And then, you know, I wanted to be in a bigger location for me as well. So, for example, you know, in the east-south central area, I'd be fine with Tennessee and going to Nashville. But the rest of them probably would not be, are not as good of a fit for me personally. So it was kind of like, which ones do you pick? So I guess in that case, you just kind of pick whichever two or three geographic preferences are most. And then I explained, like for me, the preference is urban area. And then I did put, because you also have the option of putting urban, suburban and rural. So like I use that more so than the actual geographic preferences, although some programs do look at it. Like my residency program looked at it like, oh, they didn't geographic preference us. Like, well, they also could have put no preference. So it's kind of tricky. And there's just not enough data right now to say, like, how is this going to work out? How are our program directors really looking at it? So. Since no questions in the chat, I'm going to ask, like, what was the biggest difference comparing residency to fellowship interview? I think they were maybe a little less stressful, kind of. I think it's a little bit more challenging as a resident personally just to do fellowship interviews because you're trying to coordinate them around your residency schedule. So we get at my program five interview days, which was nice. I could break them up. Like I said, most of my interviews were half days. But even then, like trying to coordinate with your attendings was always fun and somewhat of a challenge. But I think they know that you have like a true interest in that fellowship. And so for me, for brain injury, they always ask the question, of course, like why brain injury? But then they just really want to get to know you more as like a person, how you're like your career so far through PM&R had been and what led you to brain injury. They want to know, like your research interests, like they really are already, I think, somewhat picturing you as a fellow. So they're trying to see if you fit best with them and that's where you want to be. So I think they were like a little bit less stressful, in my opinion. A few of them did ask like a clinical question, which was unique. And I thought it was enjoyable just because it broke up the monotony of the questions. You know, where are you from? Why do you want to do brain injury? What are your research interests like? It just made it a little bit more challenging, but also to me, just a little more fun to think more clinically. But I definitely feel like they weren't as stressful. I going into brain injury knew that I would match somewhere. And so it was just more so where I would end up. I'm not sure if Jeremy, Jeremy's unmuted, but OK, I can go. Yeah, I would say, especially from a sports medicine standpoint, interviews were very much. They felt very a lot more friendly and just one on one. Like is this a person that I want to associate with for a year? Like in sports medicine, you're going to be doing a lot of sideline coverage with the athletic trainers for a while. Depending on the size of the sports medicine department or program, there may only be a couple of poor faculty. So you'll be seeing that same faculty over and over and over, as opposed to some places where you do a rotation of one thing and then you don't see that faculty again. So I think they just want someone that will be both very interested, interest and is interesting. And it's just like an easy personality to get along with. Not that our interviews aren't like that. But I feel like with our interviews, they're just looking for an overall like some programs have multiple people within each class. And if you have at least 20 total residents, it's easy to have like a mixed array. Well, whereas sports, it's one, two, three, four max fellows a year. So it's going to be a lot more one on one time. And then with the P3 have similar to the letters of rec. They felt the interviews are mostly like, do you know what we have is? Are you like, why are you good for the field and what are you going to do with the field? It's very friendly. They're just looking to get to know you again. We have is more of a buyer's market. So similar to brain injury, you know, you're going to match. The question is, you know, what do you want to go to? One of the larger program, a smaller program, a program that's more inpatient, a program with more call program with more outpatient program with more procedures program with more consults. A little bit more variety where you're kind of choosing. So I agree with everyone else so far. Fellowship interviews were a little easier than residency interviews is a little more personality based. And the one thing that I think, like, because I'm experiencing it right now that's different is when I was approaching residency, my priorities were different. My priorities were more academic related and like where where is going to get me from point A to point B in the best possible way, most efficiently and etc. And now my priorities are where do I want to end up where I will likely need to make connections and stay there for X number of years afterwards or in the area afterwards and where can my husband get a job and things like that. So I think that's a big difference in the consideration of like where I actually want to go. And that kind of has struck me more than it did strike me during residency applications. I feel like it's a little different for me just because I think so I did another residency before PM&R and preventive medicine, which is why I know like occupational medicine stuff. And then I only applied to programs that were advanced so I actually applied to less PM&R program than I did for pain medicine. So it was like a different experience and I was really trying to be like okay do I want to live here or not and I probably still applied to a couple programs I was like well this is a good program so let me see. So I think from that perspective, the conversational style. I still feel like it was similar to what I experienced with residency interviews, there was one program, my CV is very academic heavy that essentially as like why. And it was a community program so they're like why us like why do you even want to come here but they said in a very like brash manner and it just makes you think like you at the end of the day you invited me here so like, and I'm interested. It's not, I do believe in getting like a variety of training through different circumstances so yeah that was kind of, and then I interviewed a lot more programs for, I think I interviewed for more programs than combined I interviewed for prelims and the other specialty I interviewed for. So I interviewed at like 27 programs. So coordinating that when you're actually working and trying to figure out where it can fit in your schedule was challenging. Luckily for pain, it's still primarily virtual so there is some leeway and some interviews are on the weekend so it's not as big of a deal. Some people definitely did not like the weekend interviews, say this. So, and again, if anyone has any questions feel free to pop them in the chat because I was just thinking, you know, these are made up by me. So anything that you didn't expect during the match. Carolyn start off first. Not really I think. Personally, I had a top three and I was going to be happy either. If any of those top three chose me. I think I was surprised I was very excited to end up at Spalding, I have a home program here and so I love my home program but I just wasn't sure how it was going to lay out but and I knew that was kind of my backup, but nothing really unexpected. I think, overall, you know, interviews were pretty seamless scheduling was fairly easy. I will say that thalamus was a little bit of a challenge to you sometimes I don't know if anybody else had to use thalamus. Sometimes trying to like sign up for interviews was a little bit confusing. I will say that, and this might have just happened for brain injury or it might happen in other fellowship interview processes as well but I had a couple times where like I would sign up for an interview day and then they would ask me if I could switch my interview day. Thankfully I was pretty flexible on the rotations I was on because I was on outpatient rotations, but I think that might have been a little surprising to me, just more so because I would like sign up for a day that worked best for me and then they're like hey actually can you do this Monday and I'm like, hold on, let me ask that attending if that's okay. Like I said, everybody was really accommodating thankfully but maybe that was one thing that surprised me whereas like when you were going through residency interviews like you sign up for your day as fast as possible and you've got that day. I think just because it's a smaller application pool. They were just trying to make it easier on themselves and so if they had more people sign up for you know October 17 first, for example, and I had signed up for October 14 they're like hey can you just move to the 17th, which worked out fine but maybe a little bit surprising. I would actually also say that scheduling was probably one of the most infuriating parts because at least for me what would happen was I'd be offered a number of dates, and then they'd say pick your top two or three and then you'd email them and say these are the two or three that I can do and then you would hear crickets for like two weeks. And so, I would have dates on my calendars with question marks surrounding them and then I'd get other offers with similar overlapping dates but I couldn't know if I could commit to one because this one was being held for another one, and then you're trying to work with your attendings. So, yeah, that was probably, I know we didn't say frustrating but it was a surprising frustration throughout the process for me. Jeremy, anything for you? Yeah, I think if you go to, if you talk to enough people and go to see enough panels and get advice from your mentors there's really not much that's unexpected I guess like each year. There are minor tweaks in the ERAS like I had gone from applying where you could put as many things as you wanted on the ERAS to only like 10 of your top experiences, etc. But if you talk to enough people and have really good mentorship, you kind of have a good pathway as you go through the whole process which is obviously stressful unto itself, but I think there's a nice amount of guidance along the way. Yeah, and I want to say if you do run into the problem of well I can only have 10 experience which, which I don't think anyone in here would have been applying when you could put in as many as you wanted. I did collapse a bunch of them into one. So say like, oh, this is my University of Florida leadership thing so I wrote like wellness chair for house staff council etc and I just combined like three or four roles into one. So if you have more than you know the 10 and you can also, you know, figure out a way to combine them so that it makes sense for the, for the application, because now that now that you can now that you're limited to 10, but also don't try to fluff up your CV too much either. That doesn't help. I did have a program that asked me like what dates would I like to interview, and then I sent them a list of dates, and then I never heard back from them again, but it was a peds pain program so and they did feel so I think that they had found somebody outside. And just filled in still and so that was unexpected. But yeah, I don't think I want to turn it over to the audience. Any questions. I have a couple more minutes. I can answer every I can read it because I know we wanted them to be read so Emory said if there was a program that you're interested in online during your initial program research but not much is published online. How was your experience getting more information. I chuckled a little bit because I would reach out to the programs just to get more information. Specifically, why I was laughing is because a couple times I would see them listed on the website that I shared, but they weren't published on eras and I was like what is going on why is this program not published is something wrong. And so I would reach out to them for more information and be like, by the way, is there a reason that you're not published on eras are you, you know, matching outside of the NRMP match. And usually they'd be like oh shoot we didn't remember to publish and so they would publish after I sent that. But they were pretty nice about you just reach out to like their program coordinators or even like the fellowship directors. And they are pretty easy about getting back to you and answering any questions you might have, but it is helpful to make sure that if you see them listed on like the fellowship program. directory and they aren't published on eras just reach out to them and say hey is something going on because like Rosie said sometimes they'll match outside of the NRMP match or they'll do their own match process so it's good to just reach out to get that information. Yeah, I also had experiences where because neuromuscular so tiny like brain injury like there's almost no information and sometimes on the fellowship like page. And so some things that I would do is like look up old YouTube like videos sometimes I'd find those of old like videos they've done. Also looking up the program directors name sometimes they get interviewed just in general or or like attendings names who are highly involved in the program and you can at least get a feel for them and what they do and what kind of work is important to them. And then also, sometimes there are these collabs between different programs and so even though you're looking at X program Y program is actually also featured in those videos so there's a lot of ways of doing some like deep internet digging. That I usually would do before, but most just to reassure you at least for neuromuscular most of the info that you're getting is actually during the interview, and I think that's probably across the board because fellowships are just generally smaller. And so the the impetus to especially probably maybe not so much for pain or sports, but at least for these smaller fellowship programs impetus for them to provide you with a ton of information and spend that time and energy on that isn't there quite as much as when you're applying to residency. Student doctor network still also has some information I'm sure how outdated it is I don't know, on the pain side there's a Google spreadsheet that people pass around and NASA has one as well though it's been crickets this last cycle, and then discord is a big one for the pain cycle as well. So, I used all of those but you kind of have an idea I feel like, and I may be wrong but like you're a little more location focused when you're applying for fellowship, you may not be really looking as in depth like oh I want to make sure I want to get this procedure, you know you're like okay I know I can get that you can always get trained in an additional procedure. You can always get trained in an additional procedure. Later on, most of the pain attending today, they did not train in mild, they did not train and some of these kyphoplasty they not train SI joint fusion. Those all came later so you can still learn, regardless of what that thing that you want to learn is. And I'm going to drop my email in the chat as well. So that brings us to time. It is 7 30. I don't know if there's any more questions or I see that you guys have shared your email. Maybe folks will email you guys with questions. Thank you again everyone for taking the time to join us today.

AAP MNR

fellowship application

FICT

Monar Tani

inclusive environment

Rosie Connick

fellowship opportunities

ERAS applications

interview process

professional commitments