William Levine, MD
December 4, 2019
Fellowship is a unique component of our surgical training in orthopedic surgery. Almost all of us do at least one fellowship and many more now are doing two! This post is designed to help guide you through your fellowship and maximize the opportunities to be as successful as possible during that year and preparing you for the future. Here is the road map to success in the three spheres of your fellowship: Clinical, Education and Research (even if you are not going into an academic job, research can be very helpful to help jump-start your career as a “content expert” in your field).
1. Operating Room
- Indications conference (or equivalent): review the cases ahead of time and mentally go through each step before you actually perform the procedure (please refer to my partner Dr. Chris Ahmad’s book, “Skill”).
- Know your role: are you going to be the primary surgeon, second surgeon?
- Keep a case log (necessary for most fellowships now anyway). This is a critical opportunity for you to catalog steps, instruments, unique aspects of case for you to use later when you do similar case. Make it a habit to keep it up to date.
- Debrief – after EVERY case you should do a debrief – what went well, what didn’t go well, what could I do differently next time. Take notes and don’t be defensive – this is when you have a safety net *you won’t the very next year!
- Get constructive feedback early and often. You cannot get better if you do not know how you are being perceived from others.
- Treat everyone on the team with respect and kindness. Effective team building is crucial to your success as a fellow.
- Invaluable tips/pearls are available in spending time in the office with your mentors.
- Take copious notes!
- What is the template for patients for each mentor? How many new patients per half-day session? Are the number of patients capped? Can you double-book, triple-book? Spend some time with the appointment scheduler to learn how this is done.
- Be a clone of the attending (same as OR).
- Learn how the person you’re with takes their history, performs physical exams, reviews images and speaks to the patient and then do it the same way!
- Develop your own treatment plan and compare it to the attending.
- Plan for your own clinic/office time – how do you want it to look? Take the best from each of your mentors and delete the parts that you don’t like!
1. Increase your fund of knowledge – you are becoming an expert in the specialty.
- Know the literature
- Become a “content master” so that you can easily gain the trust of patients given your grasp of the topics.
2. Teach Residents/Medical students.
- Mentorship allows you to help other members on your team.
- Your ability to teach someone without “showing them” in the operating room separates the good from the great.
- Pay it forward – remember the fellows and attendings who have paved the way for you to succeed.
3. Steal (borrow) all the PowerPoint talks you can from your mentors to allow you to build a library for when you are on your own.
4. Give as many talks as you can during your fellowship.
- Indications conference, technique conference, core curriculum – again, this helps build your confidence, your repertoire, and gives you a library of talks for when you start your practice.
1. Start EARLY! The year goes by very quickly.
- Most successful fellows in research sphere get started even before the actual year arrives.
2. Apply for grants in your PG-5 year for your fellowship year.
3. Pick two projects that you have passion about and want to complete during your fellowship.
4. Do NOT fall into the “I’ll finish after my fellowship” trap.
- It can be very difficult to make those things happen!
5. Understand what your resources are.
- Statistician? Research assistant? Motivated medical students?
6. Hold yourself accountable.
- Present weekly to make sure that you don’t let things fall through the cracks.
DISCLOSURE: Dr. Levine is Editor-in-Chief of the Journal of the American Academy of Orthopaedic Surgeons, Rosemont, IL, and the Frank E. Stinchfield Professor and Chairman, Department of Orthopedic Surgery, Columbia University Medical Center, New York, NY.
Dr. Levine or an immediate family member serves as an unpaid consultant to Zimmer Biomet.
Read the AAOS Discussion Group Terms, Conditions and Disclaimers HERE