Get a head start: Breaking down the fellowship application process

By Joe Hannan | Fact-checked by Barbara Bekiesz

Published June 23, 2023

Key Takeaways

Data indicate that an increasing number of residents are seeking subspecialty training in fellowship.
The fellowship application process is long and sometimes onerous. Begin the application process one year in advance, and remember that some fellowships may have unique requirements.
Familiarize yourself with the application process while also researching requirements for specific programs of interest—this will give you the best odds of matching.

Thinking of applying for a fellowship? if so, you're in good company and part of a growing trend.

According to the National Resident Matching Program, 2023 saw a record number of applicants (nearly 14,000) seeking a total of 13,365 positions.^[] Eighty-three percent of those applicants matched across a total of 73 fellowship specialties, and a total of 86.4% positions were filled.

Applying for and obtaining a fellowship is a lengthy but manageable process—especially if you allow yourself ample time to complete it. Before you decide to begin, familiarize yourself with what the fellowship application process entails.

Select a specialty and check eligibility

First, you’ll need to determine a specialty of focus for your fellowship. The type of residency you completed will determine your eligibility for your specialty of choice during fellowship.^[]

For example, oncology and gastroenterology both require an internal medicine residency, and forensic pathology requires a pathology residency, to name a few.

If accepted into fellowship, you’ll be working alongside a specialist in your chosen area, absorbing the skills and knowledge needed for a career in the field.^[] In addition to this hands-on training, you can expect a great deal of responsibility.

Of course, you need to have more than just the right residency to become a fellow. And each fellowship has its own specific requirements, which you will need to verify. Generally, you will need to be a licensed physician and be board-certified or board-eligible.

Do your research

Prestige is just a part of the fellowship-selection equation—not all of it, according to Sameer Avasarala, MD, in an article for Doximity.^[]

Your task is to clarify your goals and find the program that best supports them.

For example, if you know you want to do bench research, find fellowships with clear research tracks. Or, if you know you’re headed for private practice, you’ll likely want to select a subspecialty that prepares you for the breadth of disease and conditions that you'll manage.

Set up ERAS and prepare documents

Doctors seeking fellowships will want to set up an account with the Association of American Medical Colleges’ Electronic Residency Application Service (ERAS), which is a service that routes applications and documents to open fellowship positions.^[] For $115, ERAS will route up to 10 applications. There’s a tiered fee structure for additional applications.^[]

Most fellowships use ERAS, but some do have unique requirements. Be sure to study program websites for specific application guidance.

You'll also want to plan on devoting some time and thoughtful consideration to the following aspects of your application:^[]

Letters of recommendation: Consult program requirements for specifics, but four is a good number to have on hand. These letters can be provided by your residency program director, colleagues, or project supervisors. The earlier you ask for these letters, the better.
Update your CV: Make sure it reflects recent work, projects, publications, and your training.
Create a personal statement: This is a window into your personality for fellowship programs. Use your voice to paint a cohesive picture of the facts in your application and CV. Keep it to a single page, and ask peers for feedback.

Apply and interview

In most cases, you can submit your applications through ERAS. But, once again, not all fellowships are partnered with ERAS, and some have their own requirements. Don’t wait until the last minute to find out.

And just as you prepared painstakingly for your applications, devote the same attention to gearing up for interviews.

Be sure to schedule interviews for a time you’ll be well-rested. Give the person conducting your interview your full attention, and reflect on what you might say in advance, considering factors such as personal strengths and weaknesses, difficult patient interactions and how you handled them, and your personal biography. You may also be asked about career goals.

Come with questions of your own, and remember, thank-you notes are good form.

With your interview wrapped up, your final to-do is to submit your rank list, which will place your list of fellowship applications in your preferred order of priority. Then it’s just a matter of waiting, hoping, and (hopefully) matching.

A final reminder

It bears repeating that this article is a general, high-level overview of the fellowship application process.

Fellowships may have their own unique requirements, and some fellows may elect to use centralized matching services, such as the National Resident Matching Program or SF Match.

Regardless of which options you choose and where you set your sights, applying for fellowship is not something to procrastinate over. Begin the application process at least 1 year in advance.

What this means for you

If trends continue, more residents will seek fellowships in the years ahead, making these comparatively rare spots even more coveted. The potential scarcity underscores the necessity of proper preparation and attention to detail in the application process. If you’re seeking fellowship, give yourself at least one year to complete the application process. Do your research to select the best program, and be mindful of its unique application demands.