Similar to the Electronic Residency Application Service (ERAS) match process for residency, the San Francisco Match Program (SF Match) also has a match system for fellowships. Residents rank fellowship programs they interviewed at, and fellowship programs rank all the candidates they chose to interview. Once these lists are submitted by both the applicant and each institution, an algorithm “matches” the resident to a fellowship program.
Going into my fellowship interview trail, I knew I wanted to train at the same institution for both critical care and cardiothoracic anesthesiology. Since I officially chose to start with critical care, I was subject to the rules outlined by the Society of Critical Care Anesthesiologists (SOCCA), which offers six instances where candidates can be offered a place outside of the traditional San Francisco Match.
- Active military service at the time of application
- Commitment to come to the institution of the critical care fellowship for more than one year
- Enrolled in an anesthesiology residency outside of the USA
- Reside outside the USA who are not eligible for ABA certification due to non-US training
- Spouse/partner is applying for a GME-approved post-graduate training program in a medical specialty in the same region as the critical care fellowship
- Internal candidates
The reason I received an offer outside of the match was instance #2 – I’ll be spending two years at the same program. 🙂 The program will rank me to match (meaning that if they have 10 fellowship positions, I will be ranked no lower than #10). On my end, I not only rank this program as #1 but rank NO other programs. After completing the agreement, I received the following email:
This is to confirm that both of you have entered into an agreement whereby Dr. (Program) will ensure your acceptance into the ACCM fellowship program (through the SF match) and Dr. (Applicant) will only be ranking (Program) in the SF Match. If your understanding is different from this, please contact me at once. Thank you and congratulations.
So this May, I’ll be matched to the only program I ranked for critical care. Next year, I’ll also enter the match for cardiothoracic anesthesiology and, again, only rank this program.
Regarding tips for people considering dual training in both fellowships, here are some tips and things to consider during the application and interview season.
- Consider doing both fellowships at the same institution. Besides the out-of-match exemption process, I think there are benefits to working with colleagues over the course of two years. It’s easier to get to know the city, program, and people over that time rather than worrying about moving to another program after only one year.
- Have everything prepared ahead of time and submit the application materials as early as possible.
- Stay organized! I had a spreadsheet with columns like program name, program directors for both fellowships, secretary contact information, important dates (submitted application, secondaries, interview, etc), and notes where I would leave my thoughts after an interview.
- Your personal statement should reflect your interests in both fields and how you want them to tie together to achieve your career goals. 🙂
- Inquire about the formal didactic curriculum. Is this time protected? Do you receive formal training in echocardiography, advanced airway techniques, bedside procedures (thoracentesis, paracentesis, lumbar punctures), etc?
- What are the types of attendings you’ll be working with? Do they come from diverse backgrounds (e.g. anesthesiology, emergency medicine, surgery, internal medicine)?
- During the ICU fellowship – what’s the team structure like? Do you lead rounds? What disciplines are involved with rounds (physicians, nurses, dietitians, pharmacists, etc.)
- During the CT anesthesia fellowship – what’s the balance between doing cases solo versus supervising residents? It’s important to have this balance… especially if you end up doing academics.
- What’s the educational allowance? Those exams and membership expenses add up quickly. 😞
- What’s the alumni network like? Where did recent graduates end up?
- What kinds of electives can you pursue in both fellowships?
- Are there opportunities to moonlight? I know as an ICU fellow (especially before oral boards), I wanted some OR shifts to brush off the rust. 😂