In less than two months, I am beginning the next leg of my educational odyssey, starting my rheumatology fellowship at Southwestern University in Dallas. It has been nine years since I left Poland and five since completing my residency. Currently, I practice primary care and, until a month ago, I supervised medical residents in a Massachusetts community clinic. Resuming my education after spending a few years as an attending physician, and becoming accustomed to the financial perks of practice, presents a few challenges, particularly while moving to a very different part of the country. I’ve been informed that “it is all different in Texas”—everything is bigger: beef, oil, everything. But, for me, so far, the grandeur of the Lone Star State comes from one primary aspect: its university accepted me into its fellowship program, despite a prevailing view that “old graduates” without formal research experience are less desirable choices for fellowship programs.1,2
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Explore This IssueJune 2012
Choosing a Path
I came to the US from a country the size of Texas on a student exchange visa and was blissfully unfamiliar with the fellowship application process. I knew long ago that I wanted to subspecialize, but my field of choice was a little more elusive.
It is often considered detrimental for an applicant to be undecided, and residents fear that being keen on more than one field renders them dishonest and undedicated, but in my opinion, going into internal medicine was a declaration of having multiple interests. I tested waters and tried different flavors before I decided to pursue rheumatology.
I developed research projects with an endocrinologist, a hematologist, a pathologist, a dermatologist, and a generalist and, even if these endeavors did not get me closer to securing a fellowship position, they allowed me to sample and curb my enthusiasm for some areas of medicine.
When it came to the fellowship application process, I first consulted with specialists in the field. My program director suggested that we practice the interview process in the doctors’ lounge, nervous and exposed to the quizzical gaze of grazing attendings. He criticized me, even told me to go home, regroup, and practice in front of the mirror. It made me uncomfortable, but, with the benefit of hindsight, I think his plan had merit because, as I learned shortly after, the interviews basically are medical Hunger Games. What mattered most was that he truly believed in me.
I have to say that the application process was more complicated while practicing at a community clinic, without the support and exposure often provided in academia. For me, simply being invited to the interview was a success. And here they came, the interviews—the prelude to success, or disaster waiting to happen.
During interviews, first for residency and then for fellowship, I made a few observations of the absurdities of the process and the subjective quirks of the interviewers. I once was asked to pray before the interview started and, on one particular occasion, I was almost pinned to the wall to reveal my research interest.