Residents’ interest in pursuing fellowship instead of practice is on the rise, and with it is an influx of new fellowship program types listed by the National Resident Matching Program.
There are many different types of fellowships to pursue, from surgery subspecialties to global and community-medicine fellowships.
Physicians-in-training can research the variety of fellowship types within their desired subspecialty, even expanding their search into global fellowships, which enable learners to split their time training between the US and an international site.
The prospect of completing a fellowship is increasingly attractive, according to data released by the National Resident Matching Program (NRMP). In 2023, there were 13,365 fellowship positions, of which 86.4% were filled. Between 2018 and 2022, the number of active fellowship applicants rose 26.1%.
Along with this increasing interest is an influx of new fellowship program types to choose from.
Global emergency medicine
The global emergency medicine (GEM) fellowship, first listed by the NRMP in 2022, promotes the development of emergency medicine throughout the world, according to the Global Emergency Medicine Fellowship Consortium (GEMFC). The program emphasizes securing equity in emergency care.
This fellowship introduces global-health principles into the practice of emergency care and stresses transnational-health issues, determinants, and solutions.
Other aspects of the subspecialty include interdisciplinary collaboration and examination of the intersection of emergency care for individuals and the population, as well as systems-based interventions. Initiatives in the subspecialty focus on clinical practice, education, research, and advocacy.
The field is particularly aimed at the practice of emergency care in resource-limited areas, disaster zones, and humanitarian-response contexts.
“GEM Fellowships provide an opportunity for residency-trained emergency physicians to obtain advanced training in GEM, to build skills and develop a career niche in this EM sub-specialty,” according to the GEMFC. The consortium notes these programs usually offer an advanced master’s degree in programs like translational research, public health, or global health, with potential special focuses on pediatrics, ultrasound, health equity, or social emergency medicine.
Another fellowship that debuted in NRMP in 2022 was emergency radiology.
Massachusetts General Hospital offered the first emergency radiology fellowship program in the US in 1986. Mass General’s program description states that this fellowship involves advanced instruction in the imaging of both traumatic and nontraumatic emergencies, as well as subspecialty-level education on a variety of body and neuroimaging conditions.
"We have a fun and vibrant group, with instruction provided at daily case review conferences, weekly teaching conferences, and research meetings."
— Massachusetts General Hospital, emergency radiology fellowship
The program describes its eclectic curriculum as follows:
“Fellows also have the opportunity to attend teaching conferences of other radiology subspecialty divisions. Consultation throughout the workday occurs with our team of staff radiologists, emergency department physicians, and trauma surgeons; there is additional exposure to abundant learning opportunities through interaction with other consultative subspecialty services, such as pediatrics, oncology, & transplant surgery.”
Rotations are a special feature of the training. The program also allows ample time for elective rotations with other Mass General radiology subspecialty divisions.
In addition, these fellows experience several weeks of required rotation with the hospital’s neuroradiology service, along with “opportunities for cardiothoracic, pediatric, & abdominal imaging; ED-related AI, dual energy CT, and MRI research is encouraged and supported.”
Global health fellowship
There are various global health fellowship programs, each with distinct curricula.Related: Thriving abroad: Navigating the challenges of international fellowships
The HEAL Initiative fellowship out of the University of California San Francisco accepts US-trained physicians from many specialties, including internal medicine, family medicine, pediatrics, OB/GYN, psychiatry, anesthesiology, and surgery. HEAL (which stands for health, equity, action, and leadership) fellows split their time between the US and international sites, helping the underserved across the globe, including countries like Mexico, Mali, and Liberia, among others.
The program consists of intensive in-person training and mentorships, while simultaneously earning a graduate degree online and participating in an ongoing curriculum.
It allows physicians to be part of a community of diverse health professionals with similar interests.Related: Get a head start: Breaking down the fellowship application process
Community medicine fellowship
Community medicine fellows provide direct patient care while mentoring residents and medical students who are providing care in community health clinics, homeless shelters, and local schools.
The Kaiser Permanente community medicine fellowship program accepts applications from graduates of family medicine, internal medicine, and pediatric residency programs.
Clinical responsibilities include caring for patients at safety-net (clinics that treat patients regardless of their health insurance status) and school-based clinics and assessing the health needs of specific populations. Fellows also spearhead community-health groups and participate in bimonthly seminars on community-health topics, such as health policy, healthcare disparities, leadership development, social determinants of health, and health literacy.
"The program prepares fellows to become clinical leaders, educators, and agents of positive change."
— The Kaiser Permanente Southern California Community Medicine Fellowship program
“Fellows care for underserved patients while working with community health leaders to improve healthcare delivery and outreach,” according to Kaiser Permanente.
Medical education fellowship
Johns Hopkins Medicine offers a fellowship that exposes emergency medicine physicians to the most relevant parts of emergency medicine education. This program is designed to help improve upon the current state of emergency medicine education in medical schools and residency.
Program focus areas include design and administration of educational programs (graduate and undergraduate medical education programs), curriculum development, effective skill in feedback, mentorship, and learner assessment, and development as a skilled educator across various settings.
Fellows are formally trained in areas such as adult learning theory, curriculum development, bedside teaching, teaching methods and procedures, and learner feedback and assessment.
What this means for you
There are a variety of fellowship types, even among niche subspecialties. Fellowships that focus on global health, community health, and medical education are becoming an increasingly popular option. Fellow-hopefuls can connect with mentors and conduct their own research to find a fellowship program that is most in line with their future career goals. Location should be a factor, as well, with many fellowships offering the opportunity to practice at both US-based and international sites.