Good to see everybody joining. Thanks for tuning in. For those of you guys who don't know me I'm Charlie Canyon I'm currently the chief fellow over Emory sports medicine, be graduating in August, the last two years I've been chair of the APM our current and future fellows member community. We've had a couple new gatherings. Last fall before the annual assembly we had a similar panel but given that the member may this year falls in the spring and lot of guys are getting ready to put together your fellowship applications are starting to get ready to transition to fellowship but that'd be good. I'm excited to get everybody together. I was able to feel free and turn on your video join discussion either by the chat or, you know, feel free to just raise your hand chime in we'll keep it super informal but we've done these different panels like I said a couple times throughout the last couple of years and I've always really just enjoyed more. The further they get along into this path you realize how tight knit this community is not only in sports medicine but then sports medicine, because I address you as a kind of a subject. So group so I had a lot of great friends and glad a lot of people have been able to log in. I think it's a great opportunity for us to be an opportunity to network and talk to each other and give people are applying a chance to answer questions, get questions answered. People are starting fellowship opportunity questions answered and then asked Donald and Rosa to join too so they can give some of their perspectives having recently transitioned into their attending roles too so just want to cover that spectrum from resident to fellow and early career but we'll start with introductions from the panelists. If you guys can just say your name, your where you are now and and if you're in somewhere else. This summer. Let us know as well. And really just kind of keep it casual rubber join and like I said feel free to drop questions in chat or pop on your video and we'll go from there, but we'll start screen left for me so that's Donald. Cool. Yeah. Hey everyone so I'm Donald because it and on, you know, I've known Charlie for a long long time I would say, I think almost like a decade now last time we thought about it. And so I'm based out in Dallas, I'm at UT Southwestern currently as payment our sports faculty, and I'm currently also one of the red and see a PDS. I did pretty much all my training in Dallas and then I did a fellowship at Stanford and then came back to Dallas to be faculty. Awesome. I don't think it's quite been 10 years Donald but my graduate will find be 10 years of training with the second year fellowship so maybe like eight or nine, eight or nine close. We'll take it. And Rosa. Hi everyone. I'm Rosa Pasquale. I don't know Charlie quite as long but a few years going on now. Um, I did residency at NYU and I went to Emory for my sports medicine fellowship, and then graduated last year and I stayed in Atlanta, transition to one of the clinics downtown, and have been now through Department of Orthopedics but also I'm working in PM&R as well. And we just bought our house today in Atlanta so we're staying there for a while. About Lindsay. Hey everyone I'm Lindsay. I'm currently at the University of Utah for sports medicine fellowship but I did my residency at University of Washington in Seattle and I'll be heading back there this fall for PM&R sports faculty position. He was Charlie was my co resident so. Sarah. Hi everyone, I'm Sarah Dikowski, I'm a PGY for at the University of Michigan, and going to be going to Stanford for sports medicine fellowship this coming year. Derek. Everybody my name is Derek. I'm a current resident the University of Colorado, and I'll be following in Lindsay's footsteps to be the PM&R fellow at Utah next year. Awesome. Thanks guys for spending your Monday night, I know everyone's still probably getting caught up from AMS or Donald you know he was in Japan so he's, he has no idea what time it is. But I think we got a really nice balance panel. You know I thought I did a really good job of, you know, creating a nice diverse panel and then I realized that you only really have three different fellowships represented but, you know, I think everybody applied a lot of different programs and give it give their perspectives as well. Definitely like I said we'll welcome any questions through the chat. But we'll start with, you know, the current first year fellow with Lindsay what's been a highlight of your fellowship here. There's been a lot of highlights. It's been an awesome year I think just being in sports medicine and sort of transitioning from residency and just having a focus and moving toward that aspect of my career has been really fun. I think I was excited about having co fellows but I didn't realize how excited I would be like once I've been here, here you tell we have this for fellows and so I have one family medicine emergency medicine and pediatrics and it's been an awesome group we learn a lot from each other and they've just been a joy to work with and I think that just goes for the fellowship as well just having a lot of different perspectives within sports medicine here has been something that really enjoyed. And then just being close to the mountains is awesome. I'm curious about Donald and Rosa's transition into your attending hoods. Is there what's been the biggest surprise in terms of transitioning from fellowship into that, you know, more independent stage. I think the biggest surprise for me is how much we know is so it was a good surprise. I think it's a really difficult transition in terms of you know you're just, you always have backup and you always have someone to ask and now you know the buck sort of stops with you and it's really exciting. But I think that was sort of how I knew that fellowship really was great and really set me up because I, you know, I have a moment probably once a week where I'm like, Oh my god what is this what do I do with this and I end up texting and calling, you know, Charlie's on care and it's just going to be really fun and like Lindsay said just getting to this stage in your career where you are doing what you love and doing every day it's super rewarding and it's been really, really great. I agree with Rosa I think I have one positive and one negative surprise, I would say. Rosa with how much we actually know after the training. I would say, coming out of fellowship was the first time that there is no backstop. And like you realize like if you don't know it. The majority of other people also don't know it. You can always ask for resources but you have enough understanding where you can just make sense in your mind, like, what would be the logical thing to do rather than having to find a specific textbook answer that this is the right thing to do. A lot of times that doesn't exist in sports. And then I would say on the negative surprises. It's the first time that I think you're not as protected. I think going through medical school residency and fellowship, you always kind of had like a like someone there that was like, that's not a good opportunity for you or this is a great opportunity for you. But once you become an attending, when you have the skill set, everybody wants to get a little piece of that skill set. So, at a certain point you have to decide what you want to kind of narrow down your choices into and learn how to say no. I would say when you're first in attending go ahead and say yes to everything. But then as you start to get busier and busier you need to start saying no. But Sarah and Derek what are you guys looking forward to the most for fellowship. I'm looking forward to the kind of focus that Lindsay was talking about finally getting into kind of the aspect that that we are most interested in as a psychiatrist going into sports medicine and getting to kind of learn and practice what we enjoy every single day and now. So that being done and just, you know, finally this kind of homestretch of the last hurrah getting to do what you want to do and it's exciting being almost almost there. Yeah. Yeah. Oh shit. You know, like you said you've worked like to this point, pretty much just doing the things that you're interested in so oftentimes, you know, I feel like I don't realize how busy and full my schedule has gotten. And you just kind of turn around and realize all the cool things you've done all opportunities you've had. So we got a question from James. He'd like to hear. Would be great to hear thoughts on pitfalls and best practices on the transition to fellowship and job search with the PMR spots in particular. So, I guess we can kind of break that down first in terms of like the transition to fellowship. You know, Lindsay, what was your strategy. Yeah, I guess. During like fourth year for for residency I feel like I just tried to soak in as many opportunities as possible like on rotations that was a lot of the bulk of what I tried to do to prepare ahead. Some of my like MSK rotations toward the end of fourth year like sort of spattered throughout residency and so it was nice to sort of end with a sports rotation and really talk. I was just like picking the brains of like every attending during those rotations just to get their ideas and thoughts about, you know, things to, you know, prepare for in a career and like just the pearls that you don't really think about when we're in the process of trying to match into fellowship. And then just trying to be as efficient as possible something that I was trying to work on in preparation for fellowship as well so you know trying to get everything set up for injections and you know seeing as many patients as possible. Just to get as much breath that I could just so I could be prepared. I didn't think that there was anything in particular that I was studying a size for studying for boards because my fellowship didn't start until August. And that's when, or that's when written boards were for me so there's a lot of MSK on the boards as well and so I tried to use that as like preparing for some aspects of musculoskeletal medicine but in terms of other resources that I like have users a couple of different like sports medicine textbooks and ultrasound textbooks which I'm happy to write in the chat that I found helpful this year as well. So like just working hard and your residency definitely will put you in a good position to to transition to that fellowship role. It's often challenging when you're trying to, you know, wrap up everything from residency and, you know, especially most people are moving for fellowship and then navigating like board studying but I think my advice, you know, or wise is kind of trust your training and trust your preparation. I spent four years working towards the test cramming it all in a month you know you want to be diligent but I think the most part you can only create extra stress at that point so everybody's got a great programs everybody's prepared. Yeah. And then, how about like probably fall on the Lindsay again. Rosa. Rosa, you know she was very lucky and Donald and Rosa both had their next steps figured out pretty early. I'll give you guys a chance to expand on that and then we can go back to Lindsay, in terms of job search. So, um, I think I would say the advice I can give you is just to be very persistent, sort of, up to the point of being almost annoying I wouldn't. Like, oh, I know this department that I really want to work in doesn't have a job. Just take it upon yourself to email the chair, email the, you know, someone in HR if you can, you know, go physically drop off your CV I did that in Atlanta, you know, because I was told at first that there were no jobs here. And I was like, well, okay, I'm gonna find one, and sort of just like had my, you know, you know, my PD was like okay I don't know we don't have one here but let's see, you know, he works with someone at a private practice and he's like, let me give them a call and, you know, really don't be afraid to get people to advocate for you don't be afraid to advocate for yourself. And just really go for it like the worst that people can do is say no, I will also take that a step further and say when you get to contract negotiation to do that as well because really you should, you know, people have been telling us for years that we, you know, we, we don't really matter you know like whatever like now you you are holding the cards a little bit and you have to recognize your value and really get people to give you what you deserve in that sense and, like I said, the worst that people can do You know, I've never seen anybody get an offer yanked for asking for, you know, a relocation bonus or something like that so really I think just trust your gut like everything I'm gonna say trust your gut trust your instinct and just really like start, don't be afraid to put yourself out there. I think for me like as Charlie kind of alluded to, I, I was relatively sure I was going to go back to UT Southwestern where I did residency after my fellowship. My wife was an MD PhD so I was just waiting for her to match to make my final decision, but I still did some job searching just in case and from what I've seen from a lot of people in my class and all is like word of mouth matters a lot. I think it's important to start to narrow when you're PM&R it's a small group, when you're PM&R sports it's an even smaller group, and kind of like as Rosa alluded to like even though there's not a position, usually if a lot of people like you, they might find a position And one other thing that I think can't be downplayed is not only do people want to know that you have a good skill set, but also that you're proactive, and if you have any specific interest that a lot of times brings a lot of value for a new faculty member to say like, this is a specialty I want to go into I want to do research in this. If you really have that self drive to show that a lot of places would just make a position for you. Kind of double down in terms of just encouraging you to use your networks and, you know, do that early on like Donald I'm sure that you had those conversations, you know with Southwestern, you know before starting fellowship. And then, you know, especially people have been involved in leadership positions, you know, reach out to your mentors and lean on your program director and their networks to like Rosa said you generally don't know unless you ask, and then, you know, the worst case somebody says no we don't have a job and it's not personal and it was just timing, a lot of times, but you know, put yourself out there and lean on those networks. I don't want to put you on the spot unless you have something to add there. No, no. Next one tees up nicely for Sarah and Derek. How did you guys approach letter applications and letters of recommendation. Do you guys remember Andy asked me the same question last week and I had to really dig deep in my memory to try and remember what I did but how do you guys approach letters recommendations for fellowship applications. I think it all came from our faculty at our university that had at least some interest in sports medicine or some practice within sports medicine. One always comes from your PD, and then you can choose where the others come from. I used three to answer that second part of the question. I did get scared at one point because somebody said you absolutely had to have for that was not true. And there are some rumors throughout this process that will kind of get you a little nervous at times but yes you only have to use three, and I really just tried to pick out faculty that I connected with the most that had at least some interest in sports medicine. Yeah, I debated the three verse for thing for a while, and was going to go with three and then didn't know way and one ended up coming from that so I went with for ultimately but everyone had some kind of MSK sports or adaptive sports kind of SCI affiliation for me, and I know people who did three and four. So I don't know if there is a general that I think the biggest thing is just making sure that you know that the person's going to write you a really solid strong letter and can speak to who you are as a person and provider. Yeah, I think I also did three. I had one sports letter, and then once my program director and then the others like department chair and also work with me and our leadership. So, yeah, one thing I would add is, especially if you're applying to programs that aren't founded in PMR and even the PMR based programs. I think it's important to have somebody who can speak to your medical skills and medical knowledge so there's inpatient attending or, you know, sports attending this has a different primary board. I think especially just since that's something that seems like it's being challenged now too, and I know that you're all great physicians first, so, you know, just make sure that that is reflected in your applications. And then, so next question, general, once you start working outside of other sports medicine colleagues, the specialties seem to understand your skill set, I didn't even mean to tee it up like that, or is it often hard, you had to do some explaining. So Lindsay, that one I'll toss back to you just because you're, like I said, in a multidisciplinary fellowship, I guess like from the context of your other fellows, did you feel like you guys were, you know, had different foundations or how that, how that worked in terms of having you know, four different fellows from four different backgrounds? Yeah, I think the system works well together. We all have been educating each other on what we do. I think emergency medicine is maybe a little bit more straightforward in terms of what they do. And it's honestly been awesome having someone from that background, just with the nature of our fellowship, we do see like a lot of acute trauma, both in like our MSK urgent care sort of clinic, and then up on the mountain, there's a lot of stuff that comes through, it's set up as an urgent care. And so we do see like lacerations, and we'll see people that are really sick and need to be sent down. And so having a co-fellow to ask my silly questions to has been awesome. I think that there's education on my part as well, just letting people know about what like our training has been in PMNR, like between the inpatient and outpatient aspects, I think they understand that we have a strong foundation and anatomy and like a basic understanding of working with musculoskeletal system, neurologic conditions. But like, what are the types of patients that we do see and what we can offer them has been something that I've been talking with my co-resident or sorry, my co-fellows about as well as other faculty as well. And then Rose McDonald is kind of non-operative sports medicine folks in, you know, different practice settings. How's that been? Yeah, so that, I mean, this is a great question. I am, so I'm in orthopedics primarily. And so I work with a lot of surgeons and I did sit down with most of them when I first started one, just so that they knew who I was, because I think a lot of them saw me and they were like, Oh, are you a new resident? No. But really just to, again, this all comes back to advocating for yourself. So, you know, what is your skillset? Like how comfortable with you are with, are you with procedures? So like, for me, you know, our foot and ankle guy, I told him, I was like, yeah, like I, I can do sub-tailor joint injections. I can do, you know, nerve hydra sections. And, you know, again, this goes back to what you're comfortable with, but I kind of told him right off the bat, like, Hey, if you want to do this and he was like, Oh, great. And now he sends me like, you know, whatever, seven a week or something. And so really just like, I think that is super important to do wherever you go, even if you think they know, even if they send out an email blast of how to, you just want them to, you know, see you face to face, meet you, meet your personality. And I think it just goes a long way. And like, you know, if you have special skills that you offer, like let them know that and let them know who is appropriate for them to refer, like take it a step further. Like, so for me, I do acupuncture, so that's been fun sort of, you know, teaching everybody about that and like who are good patients for that. But yes, I think in general, you should, even if you think you don't need to explain it and you definitely should just because I think a lot of people can benefit from it. Then you said, cause we did that ultrasound teaching with the internal medicine residents. You said they've been hanging out with you and sending you some referrals as well. Yeah. So yeah. So Charlie and I actually did like ultrasound teaching with the primary care track of the internal medicine residents. And it's been great. They now will just like directly message me on Epic and be like, Hey, I have this patient with a trigger finger. Can I send them to you for an injection? Yes. Great. And then they now come work with me like much more regularly, I think than they did. So again, it's just, you know, you're learning this, everything is about networking, putting in face time and just really like putting yourself out there and becoming a resource for your colleagues so that when they say, Oh, you know, like I, maybe I'll send this to, you know, Dr. Kenyon. He mentioned that he does this and, you know, and the patients will do well and it will just sort of like reinforce that, you know, you're doing a great job and you have a valuable skill set that they should be referring to you for. Donald, do you have anything you want to add? Don't feel. No, I actually do. I mean, cause I think the UT Southwestern like non-operative sports isn't super established yet. So I think getting, letting people figure out, and I would say one of the great things about PM&R also is one of the hardest things about PM&R in terms of the diversity of what PM&R practitioners actually do. So one of the most effective tools is I've had like my orthopedic surgeon I work with most, I have him come with me to see like ultrasound guided injections when he first started and he initially was going to do ultrasound guided injections, but then after watching me do them, he's like, Oh, it's different. So then he started just referring all of them to me instead of doing them himself. So I think on top of that, there are some kind of usually more old school orthopedics surgeons who think, you know, a non-operative sports provider is equivalent to one of their PAs or NPs. So I think it's important to show like, you know, our knowledge base and all that. And I think that gets around. The difficulty I've run into is, you know, not every PM&R provider does all the same like nerve hydro dissections and all that. So I think that I can definitely see how that gets confusing to some other providers. You say you'll do, you know, you'll do this like, you know, superior colonial nerve block, but then no other PM&R provider would do it. Like, so then that kind of confuses them. So I think just getting out the name, I think the fact that more fellowships are becoming more standardized is really helping that. And I think on the other front from like the sports coverage front, I know Charlie kind of alluded to it. There's like the whole NBA thing going on about whether PM&R doctors have enough medical knowledge to be primary care doctors. And I know in our community, I've been seeing it where a lot of the ATs around the area, when they think of sports medicine doctors, they think of orthopedic surgeons and family medicine doctors. They leave out the PM&R doctors. So kind of, you know, showing your face at all the coverage, letting the athletic trainers in the community know what we do, I think is very helpful. So I think it's still kind of a battle going uphill, especially in less established PM&R sports areas, but definitely one that we're making ground on. Just because you kind of touched on it, Donald, as somebody who went to a fellowship, you know, where I'm sure you were doing coverage every day, if not twice a day, or they said opportunities to, I know they keep you guys busy. And you're now being in a place where you're trying to advertise your skill set and continue to build those kind of coverage and team physician skills. What are some of the things that you've been doing to kind of expand those opportunities for yourself? Yeah. So it's really just getting your name out there. I think one of the, so one of the unique situations I have is I'm in a orthopedic clinic where I share a pool of patients with the orthopedic surgeons one day a week at our county hospital. And I think that's been really helpful because I do all the ultrasound. I do some diagnostic ultrasound. I do a lot of the procedures and I think it's, you know, they find a lot of that valuable. And then also I go to a lot of training rooms and I, I bought like a Lumify and I bring it with me to training room and it's hard to break in with the trainer sometimes, but then all the trainers started texting me because they found out I was bringing the Lumify around and they're like, can this save my athlete from going to get an MRI? And I was like, for a lot of things, yes. So I think that's been helpful as well. So I think just showing your face at a lot of things and showing your skillset, sometimes even if they don't ask you directly, if there's something you can show them, it's never a bad idea to just kind of speak up. Even with the surgeons, they're talking about like, what can we do for this person? You know, I think they actually enjoy it when you chime in, like, Hey, I can actually do this rather than you having to go take them into surgery. And I think they really, they really appreciate that. Awesome. I've got a great question from Jamel. So his question is something that I think we all went through the same thing, just in terms of trying to figure out what fellowships to apply to. And it's not an easy thing to get a lot of information, especially coming out of these couple of years where, you know, there weren't as many like in-person conferences and networking. So we'll start with the, you know, Sarah, do you have any, any thoughts on how you kind of compiled your list and what types of things you were looking for in different programs? Yeah. So before I even researched any programs, I got a piece of paper and I wrote down like what I valued most, like if I'm going to do an extra year of training, like what do I want to get out of training? And so what I, once I made that list, a lot of my research, yeah, just with the post COVID era is online. You kind of have to do your diligence with websites. I talked to as many people as I could to, did go to the fellowship fair in person at AMSSM and tried to just kind of have a few quality conversations with people there. But a lot of it was trying to kind of narrow that list to what I thought would be a good fit for me with my future career goals and then applying and kind of feeling it out and having those conversations at the interview too. Derek, how about, how about you, what was your process like? Yeah. So I think expanding off the career goals was kind of where I started things off with. So I, and I break that down between community and kind of a private practice setting in academics. And for me, I had to focus on wanting to be in academics in the future. So that's where I kind of, where I started with was looking at which programs were the big universities, big academic centers. And I think a lot of that was primarily because I don't know as much about the community centers nearly as much as the academic centers, but also looking at, you know, which providers are on faculty at these places and are we seeing them at various national conferences where it's AMSSM, APMR or whatever else that kind of geared a lot of, maybe a little bit of bias towards some of these programs just for me personally, as I kind of went through that process. But it started with PMNR and then expanded out to kind of the other categories like family and PEDS and things like that, and tried to try to figure out who I had seen and what I had heard of from these programs as I went through this process. Because like Sarah said, some of the, some of the websites, you might not get quite as much information out of those as you'd want. For sure. You know, I would also encourage everybody, you know, whether it's somebody on this panel or again, just like reach out to your network or people who've come across, like I said, the further you get into it, you realize how, you know, small and tight knit the community is and everyone, you know, really goes out of their way to support each other. So, you know, don't hesitate to follow up, you know, with an email, ask any questions and, you know, most everyone is interviewed or knows people or other programs. So it's a good way to, you know, don't be shy and asking questions and, you know, the way that I can get really excellent responses is like Sarah said, the, you know, really start the process by reflecting on what your goals are. I would say like, just so you don't overwhelm yourself, like pick the top three things, write those down early, you can come back to it, you can evolve, but if you have those things written down, then it gives you kind of a solid foundation to start that process with. Yeah, so what Charlie's alluding to is I'm from New York, I never left my whole life and then I was in New York during COVID. So my husband and I were basically like, we want to go anywhere outside of New York for fellowship. And so that was hard for me because I didn't really know too many people outside of the city. So I kind of done what everyone has talked about already. I really just tried to get in touch with people through like mutual friends who had gone to programs that I thought I was interested in. So for me, you know, Emory was high for me because I had family here. So I was trying to reach out to like, you know, mutual friends through my brother in law who like knew one of the former fellows and just like got in touch with people. And then, you know, once you start, like everyone alluded to, you'll start sort of being like, oh, well, I know someone at this program. And I found that to be the most helpful things. Like I agree with what's been said, the websites aren't particularly helpful. Even the fellowship fair. It's very overwhelming. I remember going and it just, it can be a lot and you can kind of leave feeling more confused than you want to do it. And I thought like just having quality conversations with people off the cuff, like not in a forced space was more helpful to me. And that was sort of what led me kind of down coming down to Atlanta and still like even when I was thinking maybe about going back to New York after I was starting to have those conversations again. And I think that's sort of the best way to do it if you can. And again, remember everyone in sports is so nice and welcoming and everyone wants to hear from you guys. Don't ever feel like you're being a bother to people. Like if two people are too busy, they just will say that they're too busy. But usually people are really happy to tell you about their experiences and just help you get to the program. That's the best fit for you. Yeah. I think, you know, boiling it down kind of more like the nuts and bolts approach to welcome anyone else's opinions, but I feel like the, what I always tell people kind of branching points are like, okay, first you've decided you want to do musculoskeletal medicine, right? I think you're, you know, laid that out, then different things that are important to consider one, like, do you want to do a lot of spine or not spine does, if you're doing spine, does that mean you want to be doing fluoro interventional stuff? And then, you know, how much coverage do you want to do? Like, you know, all these panelists, like I said, we come from probably the three heaviest sports coverage fellowship. So, you know, it was probably a big part of everyone's decision or less for Sarah and Derek. I hope it was because otherwise you're going to be standing on the sideline, very cold. So yeah, I mean, procedural skills you're looking for, whether that means, you know, more ocean diagnostics or, you know, interventions, you know, biologics or something you're interested in. Certainly that kind of leads to a subgroup of programs too. And then like Rosa said, you know, for me, it was a priority to be somewhere with co-fellows. So that's been awesome because now Rosa, Stacy, Bill, and I share like a hive mind. So if any of our patients see us, you're actually seeing, getting four doctors for the price of one. And they're all close and connected. But yeah, I think those are some of the big things as people start to kind of pull together as kind of decision points that again, are hard to get the sense off the website. But as you, especially Jamel, I know you're, you know, early on in the process now. So as you kind of formulate those goals and priorities, it really helps, you know, kind of chunk programs together. I don't know if anybody has any thoughts or things to add, or you can tell me I'm crazy too. I'll say one perk of NorCal is the weather is always nice for coverage or usually nice for coverage. So Crystal has a nice segue question. Any specific questions you've got often during Sports Invo interviews versus typical interview questions for PM&R residency interviews? So Crystal, you're saying just like in like the Sports Invo interviews themselves that we're getting that, how that differed from residency? Yeah. So I think, you know, for me, the biggest thing was residency interviews were in person. So interviews were virtual. So it was a different dynamic that might be different for, we've got people spend a few different years. I don't know how many interviews I had where I was actually asked like real questions. Yeah. Very casual. You know, if I'm being honest, I don't know if anybody else had, and if they did ask me some weird questions, I was like, this is kind of awkward. Like, I'm not sure this is the same vibe I was in everyone else. But yeah. I don't know, Lindsay, you were saying something? No, I was just laughing. It definitely seemed like it was more of a conversation for a lot of the interviews. There were some that had like structured questions that they asked, but I wouldn't say that that was the typical. And if they did, if they were asking questions, they were like, you know, asking about where you see yourself in your career in the next few years, what your interests are in sports medicine specifically. Like if you had search specific, like research interests, just wanting to get to know who you are a little bit more from that perspective. But it never seemed like it was like, oh, like this is a rigid, you know, interview question or anything like that. But some did have like a structure and they, they said it at the beginning of the interview. They're like, you know, we're all in different rooms. We're going to ask these specific questions and then we can talk about things. Otherwise, it was pretty straightforward. It's all been very welcoming and I'll tell everybody to like, you've already done all the hard work in the process, right? Like if you're getting the point of an interview, you've already impressed some people. So it's really just about getting to know you and people want to know if you're a good teammate and you're going to work hard, I think are kind of the two, you know, they want somebody they're going to have, enjoy being around for the year and then, you know, be part of that fellowship family afterwards too. I think in general, a lot of the interest questions are, you know, they are genuinely not thinking like someone's the best applicant, but like who's the best fit for each fellowship because each fellowship does have a little bit, something different to offer. So, you know, just finding the right fit is what matters more than what's like the top program or the top applicant. Donald, now that you're, I know it's, you know, for the residency, but now that you've kind of entered this ACGME leadership track, how has that changed? How you, you know, give advice? Yeah, I would say, I think, I usually say like, you know, kind of what you just said, when you get to that spot, you know, obviously people already want you. And then they really just want to get to know you, whether it's a good fit. I do think what shocked me the most, being really part of the process, is how different everyone's opinion is for the same applicant, right? Like everyone on faculty or everyone putting their input, one person might think that's the best person, and then the other person might think that they're like not the best person, right? And it's very rarely unanimous. So I think from the applicant standpoint, the way I look at it is, you should just really be yourself and you can't really control what the other, what the, I guess the people interviewing you truly think of you, because everyone's just looking for something different. I guess kind of transitioning that kind of same line of questioning, Lindsay, when you were going around, you know, job interviews, how was that vibe like? Was it still kind of conversations or are there more formal processes or, you know, how was that stage of interviewing like? I would say that was like the least formal part of everything that I did. Like it was just, I mean, one place that I interviewed, I interviewed with every single person in the group, but it was just like half hour conversations about like life, really. Like it wasn't really, we talked about the job and, you know, I got to answer or ask my questions, but that was another situation where they're just trying to figure out, cause they all work really closely together and wanted to make sure that I would be, you know, a good fit for that group. Yeah, all the places that I interviewed, they're all a little bit different, but I would say they all had a more casual approach to the interview process. Cause I think at that point, it's like they've interviewed you usually virtually first, and then they've seen your resume, they probably already talked to your references. And so it's really just about being yourself and making sure that, you know, this is something that you'd be really interested in. So I actually enjoyed that. I think it was nice to be on this side of things, you know, looking for jobs and not trying to match into something. It was like really your choice. You know, in terms of where you were going to go and you didn't have to wait and pray on the match guides to get to the place that you wanted. There you go. Sarah and Derek, do you have any, you know, pros for surviving the interview season? I know it gets really exhausting, but it's also very exciting, very fun. I think just it's been a few years. If you're applying this cycle, remember ERAS is slow with the documents. So don't worry if they're not processing things. Cause I remember my stuff got delayed and I was freaking out and it wasn't just me. For the interview season, again, I think just going back, like you're feeling if they're a good fit for you the same way they're feeling if you're a good fit for them. And so I kind of like to keep track of everything, I kind of walked away from interviews just feeling like each program had a flavor. So that kind of helped me keep it straight. And one of my good friends from med school also applied sports. So we just kind of chatted and kept each other sane, which I think helps to have a buddy or a friend you're talking through it with. For sure. Yeah, I 100% agree on kind of connecting with peers throughout this process, whether you knew them before or not. It's a good time opportunity to get to know your colleagues for the future. But man, it helped in so many situations to kind of calm nerves and make sure everybody was on the same page. Make sure we heard the same things or to clarify various things from interviews just to kind of have that support system was super impactful for me throughout that process. As you guys go through, you'll probably see a lot of familiar faces and whether it's live or virtual, but again, you kind of, as you go through, you realize it's just kind of, again, say it over and over again, just a small kind of tight-knit group and you'll build some friendships through that application process. And especially that's virtual. Well, then like last year or last week at APM or AMS, there was probably four or five people that I felt like I'd met a million times before, but had only known them virtually. So it was kind of cool to kind of catch up and see how their fellowship and early careers were going. So Amy has another great question in terms of like red flags for programs and what should you be aware of? And just kind of as you're going through the fellowship application process, we'll go back to Sarah and Derek there. Do you guys have any red flags that you guys came across or had an eye out for? I think for me, it wasn't necessarily red flags, but it was back to kind of what your preferences were. So we'll like use sports coverage, for example. I think that some programs list, these pro teams, collegiate teams and high school teams. And I think you have to clarify how involved you're actually gonna be with those teams, whether they just have somebody within the group that covers this MBA team, or whether you truly have that involvement. And if that's not part of your interest, then it doesn't really matter. So it's no longer a red flag, but if it is and they list it, then that's where I would say that might become a red flag. So again, it wasn't so much like, these are my defined red flags. It was just kind of asking clarifying questions to make sure that the programs had what I wanted in that fellowship year. Yeah, I agree. I think I didn't come across anything that was like a red flag that you would keep on your radar in the way that you would as a med student going to residency. But I think for me, I'm someone who doesn't wanna do spine. So if I saw a place where all their grads are doing pretty much fluoro all the time, to me, that's not a good fit. And so kind of having that internal system of, yeah, that's probably not a good place for me, or hey, yeah, I think that would be good is something to keep in mind. And that just goes back to knowing yourself and what you value. Yeah, I think you alluded to a great point there, Sarah. Like we talked about evaluating programs, but a nice way to do that is to kind of do that alumni scan and see what kind of settings people have ended up in, knowing what their skill sets are. So I think that's another great way to get a feel for the program, because ultimately that's goal, right? Is to not only have a great year, but hopefully have a great job afterwards. So if year after year, people go into the practice setting that you're not necessarily seeing yourself in, then that might be something to take account for too. Yeah, Charlie. I'll say one thing I wanted to add to Derek's statement was just the fact that, using alumni from your residency program or just people you know that have gone through, that's probably the one true way to figure out how involved you would be with the team or how involved you would be with certain procedures, because only the people that go through the fellowship, I think truly know, and that might add some value and help you rank different programs differently. I was gonna agree with that. I think for me, like after the whole initial interview process, I like reached out to a bunch of fellows and they were gracious enough to like either answer my emails or talk to me over the phone. And I think that that was really helpful too, because you go through all these interviews and you're like, wait a minute, did they say this or did they say that? And then you're like, wait a minute, I gotta go figure this out before I start thinking the wrong thing. So I think going back is always helpful. And a lot of the fellows were really open to doing that because again, it's about you trying to find the best fit and vice versa. So, and I would say I didn't really have any red flags. It was just mostly things that didn't fit my mode, like Derek and Sarah were talking about. I would say that is all such great advice. I think the only piece I'll add too is just coming back to like really trusting your instinct. I think, you know, we were the first year it was virtual interviews. And I think a lot of us were really scared about if you were gonna get a good sense of the program and the people from doing it on a computer. And I will say that I could tell within like six minutes into an interview if I was like super into a program or not. And so just like trust your gut, like I've been saying kind of the whole night and you won't go wrong with it because, you know, for me, like I had programs I interviewed with that people told me were really great or the reputation is really great. And I was sitting there being like, oh my God, like is, you know, is there something wrong? Like, I'm not feeling it, I'm not getting the vibe. And you start questioning it and don't, like that's just your, that's your mind and your heart being like, okay, maybe we look somewhere else and you will get the right feeling at certain programs. And you're gonna be like, okay, I'm jiving with these people, like we're a really good fit. And, you know, the lists are great. I'm a list person, that's my love language. And I, you know, made it a hundred different ways and went back to it. And at the end of the day, I kind of just went with like, okay, actually this is the program, like I remember, I remember talking to these people. I remember really like enjoying it. And then I had good experiences when I followed up with like the fellows afterwards. So I would just trust that process and listen to yourself and listen, you know, it's easy to go back to the lists and I think that's why we're all like, you know, type A very successful people. But definitely just at the end of the day, just go with your instinct on it. First I'll piggyback on, you know, Derek's statement about coverage. I think, you know, a lot of programs, like I said, will flaunt like certain levels of coverage, which I think there's, you know, value, you know, from our own experience. Yeah, we'll go and cover the, or, you know, go to a game with the Atlanta Hawks, but it's very passive experience. I think there's value in seeing that environment and being around and just understanding how it works. But, you know, my best learning moments have been with my division two, you know, collegiate team downtown, the only person there and stuff happens, it's on me and you gotta figure that out on the fly. So, you know, the real learning experience are your high school or colleges a lot of the time. So just, like I said, really understand what that kind of balance of autonomy and exposure looks like and make sure it's a good fit in line with your goals. The second thing I would say, whether it's job or fellowship, that don't be, I think, an important question to ask, because no job, one thing we haven't touched on, I think everyone would agree on is like no job, particularly like fellowships get pretty good, it's a great year, but neither job or fellowship, there's not gonna be that one like perfect program, right? There's always gonna be that one thing that you were hoping to get in, but couldn't, you know, for me, that was adaptive sports. So, you know, I wanted somewhere I could do some research and do some coverage, but Emory didn't have any built in depth sports. So, you know, it kind of said like, if I find opportunities to have the freedom to, you know, go and pursue those things, and they're like, absolutely, like, you know, it's gonna be a busy year, but if it works out and it's not conflicting, of course you can go and do that thing. So I think that's a true program the size of Stanford and Utah as well, where, you know, I just kind of called up the local adaptive sports group, found out, you know, where their basketball tournament was, they don't have anybody covering it, and, you know, next thing I know, like we're plugged in there, we're bringing medical students and residents out. So, you know, I think it's an important question to ask during a fellowship is, you know, for Rosa, you know, she was interested in doing some dance stuff, so was able to get plugged in with the ballet. You know, there's gonna be a lot of opportunities that might be in the area that might not be part of the core fellowship curriculum, but, you know, ask and see what the freedom is there. And then like Donald, Lindsay, or Rosa, I don't know if you have any comments on, you know, concessions you might make through the kind of job search process too. Yeah, I guess just going through the process for PM&R specifically, I feel like the jobs varied quite widely just from our base residency. Some of them wanted to do a lot of spine, some of them had sort of like a 50-50 mix, some had no spine or like flexibility. And so that was one of the things that I was trying to sort of figure out on my journey looking for jobs, as well as like the opportunities for like diagnostic ultrasound, using ultrasound in clinic, and other ultrasound guided procedures. And then like the coverage aspect was another thing that was important to me as well. So those were like sort of the main sort of buckets that I was trying to assess out through the interview process, just because some might've swung more towards the spine heavier types of positions, and others were more like general primary care sports medicine base. And so that was important for me because I feel like you can switch jobs. It's not like you're locked in like a residency or fellowship, but I wanted to look for something that aligned best with what I wanted to do in my career. And so that was important for me to start off that way rather than to just find something that's like, okay, yeah, it's a job, but it's still important to try to find what you like, even in this process when it matters most and you're the one that's on the end of choosing and trying to find what's right for you. I think there'll always be like concessions and you try to choose like the three or four things that are most important to you. Like for me, it was location, the ability to teach, also just kind of ability to grow in my career like in leadership positions. And I thought Southwestern had all of that. In return, I'm one of like the, currently I'm probably the most senior PM&R sports faculty and this is my second year in. So the good thing is having that network of other fellows and it's hard to tell when you first come out into practice what should be hard and what shouldn't be hard. Like, should it be that hard to get certain machines? Should it be that hard to ask for some time to cover rather than doubling up your clinic and then going to provide coverage? So I think it's been helpful to have a network in the nation where it's like, hey, at your institution, what do they allow you to do? And then if you're able to bring that back to your chair, most of the chairs are pretty open as long as you're a hardworking employee. I would just add and say that definitely kind of what both Don and Lindsay said, you gotta pick what's sort of the most important to you and start with that. But then really don't be afraid to use your voice to like ask for more things because once you get started and you will show your value, so you should like, I kind of have been tracking my RVU since I started and I like keep that in the back so that when I meet with my chair and I could say, okay, look, I'm on track to like smash my RVU target for this year. What are you gonna give me for me doing this basically? And so it all comes back to just, I have my MBA, so I just feel this all day, all day, like know your value and serve that to people because you have a skillset and you will have a skillset coming out of fellowship that not a lot of people have, especially like what Donald said, he's doing with the surgeons, what I do with the surgeons, like their minds are blown when they're like, oh, you can do this procedure and you can do this and you can see the whole thing and you can get like an immediate response. Like there's not a lot of people who can do what we do. And so, if there are things that you want, I would just make sure that maybe the chair is open to some things and make sure that, you can't get everything in writing and you can't get everything up front, but try to feel out if they would be open to you kind of expanding your role or taking on more things. And usually once you can show them what you're doing, most of the time, I won't say all the time, most of the time they'll be okay to kind of meet you halfway and help you kind of get to where you wanna go. Thank you guys. Sorry, I'm kind of typing and multitasking. As you can tell, I'm still recovering from my red eye flight back from Phoenix last week, but thanks everybody for joining tonight. Like I said, I'm glad we had a lot of people show up, but I would have been stoked if it was just, the six of the panelists just kind of catching up and getting to know each other better too. So I think everybody dropped their emails in the chat. Like we all said, feel free to reach out anytime, whether through email, social media, or in person. The message I'm typing in the chat here is that the member community, the current and future fellows community. So the way the member communities work is that there's a chair who serves a two-year term. So my term will be running out in annual assembly, which is good. So I've been training for 10 years. I think it's time for me to get a job and not be a fellow anymore. But I've talked to some of you guys, but I think ideally it would be somebody taking over that it would be applying for a fellowship now. So a rising fourth year, because that way your term would run while you're a resident and then as a fellow. I think obviously somebody who is going to be a fellow next year would do a great job, but I think you'll have more important things on your mind than running the fellows member community when you're entering your practice here. So just, if somebody's interested, reach out. I'm sure there'll be more announcements coming out of member may, because I think most of the communities will be going through the same process. But just something to put on your radar. Thanks everybody for joining. And like I said, don't hesitate to reach out anytime. And thank you for all the panelists for joining wherever you might be in the country. Yeah, thanks for putting this together, Charlie. Yeah. Thanks, Charlie. Good luck to everyone.

transition from residency to fellowship

sports medicine

panel discussion

application process

interview experiences

networking

instincts

program alignment

opportunities for growth

job search process