Forging Ahead: Tips on Applying
for the Neurocritical Care Fellowship Match
By Anand Venkatraman, Alexis Steinberg and Kristine O’Phelan
Applying for your fellowship can be one of the most stressful times
during residency. If it weren’t hard enough to have to navigate a
busy program, family life and keeping up with your reading, now
you have to send out emails, set up interviews and book flights
around the country.
The process of fellowship applications has certainly become easier
since NCC joined SF Match. A match provides structure, while also
taking out the stress of deciding when to accept an offer. That said,
it is still a process that each class of residents must learn to navigate
anew, with the same degree of anxiety and confusion.
To help provide insight to this process and guide you through
the fellowship application season, we interviewed Dr. Kristine
O’Phelan, chief of neurocritical care at the University of Miami
Medical Center, for her advice.
The mark of a good applicant, Dr. O’Phelan says, is: “Fund of
knowledge and sincere intellectual curiosity are essential. The
willingness to work hard and the humility to realize that there will
be a steep learning curve and handle that transition gracefully are
also highly valued.”
This is where your letters of recommendation need to highlight
both your clinical acumen and how well you work and interact with
colleagues in the clinical setting. It is unlikely that an interviewer
will directly probe your knowledge base, but they may get a sense of
it when you describe your experiences in neurocritical care through
patient cases or research interests. Your personal statement should
be used to express your curiosity and motivation for going into
neurocritical care and what your future career vision holds.
We then asked Dr. O’Phelan what factors she considered concerning
in an applicant. She said: “I call the nursing staff on the floors where
residents work. If I don’t hear that they are helpful, caring and
responsive, I am concerned.”
Neurocritical care is a multidisciplinary field requiring the
collaboration of colleagues at all levels. Thus, attracting a
fellow that exemplifies those characteristics is very important to
programs. When you interview for fellowship, many programs
have you meet with nursing and other ancillary staff. Make sure
to take these interviews just as seriously as the ones with the
attendings. You will be interacting with the staff a lot, and they
need to come away with the impression that you are going to be
respectful and easy to work with.
There are dozens of programs out there. How is a resident to know
how to pick a good one? To that end, Dr. O’Phelan listed out some
characteristics of a strong program: “1) Diversity in the patient
population; 2) exposure to multiple attendings with different
backgrounds allows fellows to see a variety of perspectives; and
3) acuity that is high enough to assure they will acquire excellent
critical care skills during their training.”
When considering the clinical strengths of a program, Dr.
O’Phelan’s advice is very important. A diversity of patients means
you learn to take care of a variety of diseases. Multiple attendings
at an institution helps you to see both consistencies and variations
in practice to help you form your own decision-making style for
the future. Neurocritical care fellowship should most importantly
prepare you to feel comfortable dealing with emergencies, so that
when you are faced with very ill patients, you are ready to handle
those situations in practice with ease. On the other hand, you
should be cautious about choosing a program solely based on
specific attendings since they may move institutions.
Another very important thing to remember is that you are
evaluating the program just as much as the program is evaluating
you. So, you need to watch out for concerning signs in a program
too. Dr. O’Phelan states: “If there is any hesitation about giving you
access to the current or recently graduated fellows to ask questions,
that is a red flag.”
In a parting bit of advice, Dr. O’Phelan counsels applicants to: “Take
time to learn about the aspects of the program that are unique, and
think about how you would take advantage of them to make your
training fit your ultimate career goals. It is important to be able to
think three to five years out and make sure you are going in the
right direction.”
It’s important to think deeply about what you want for yourself
in the future, see where the program’s previous fellows currently
practice, and assess how the program can help you meet your
personal and professional goals. Every program is very different,
and each program can offer something unique to an applicant.
So, it is important to investigate the distinctive features of a
program, especially before you go interview there. For instance,
some programs focus more on general critical care, whereas other
programs focus more specifically on neurocritical care or even
vascular neurology.
The involvement of the fellow in different types of procedures
also varies among programs. There are variations in the amount
of “out of ICU” time and opportunities available to fellows to
develop other skills beyond clinical neurocritical care. For example,
some programs have specific research tracks or provide quality
improvement, teaching opportunities or master’s training during
fellowship. Understanding your career goals is imperative in
choosing your perfect program.
Finally, in preparing for interviews, it can be helpful to create a list
of questions that you want to ask attendings and fellows. This can
help with deciding if the program will provide you with the training
you are looking for. Current fellows may be the most informative,
so don’t miss out on asking them, as well. On average, applicants
interview at five to 12 programs. If you are really interested in a
program, we recommend sending follow-up emails and maybe even
phone calls to express your interest and thank them for interviewing
you.
Winter is coming, friends. And that means interview season is
coming, too. Good luck!
CAREER ADVICE SERIES:
Anand Venkatraman Alexis Steinberg Kristine O’Phelan
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