Of graduating obstetrics and gynecology residents, 40% apply for fellowship training and this percentage is likely to increase. The fellowship interview process creates a substantial financial burden on candidates as well as significant challenges in scheduling the multiple interviews for residents, residency programs, and fellowship programs. Coverage with relatively short lead time is needed for some resident rotations, multiple residents may request time off during overlapping time periods, and applicants may not be able to interview based on conflicting interview dates or the inability to find coverage from other residents for their clinical responsibilities. To address these issues, we propose that each subspecialty fellowship within obstetrics and gynecology be allocated a specified and limited time period to schedule their interviews with minimal overlap between subspecialties. Furthermore, programs in close geographic areas should attempt to coordinate their interview dates. This will allow residents to plan their residency rotation schedules far in advance to minimize the impact on rotations that are less amenable to time away from their associated clinical duties, and decrease the numbers of residents needing time off for interviews during any one time period. In addition, a series of formal discussions should take place between subspecialties related to these issues as well as within subspecialties to facilitate coordination.
The problem
Subspecialty fellowship programs have overlapping interview dates without coordination across programs for applicants. This creates challenges with multiple residents requesting absences from their residency program during the same time period. Furthermore, multiple trips are required to interview within the same geographic area. There is currently no clearly defined governing body coordinating fellowship interview season.
A solution
The fellowship interview season should be broken into discrete time periods and geographically close programs should coordinate their interview dates. This will minimize conflicts and facilitate scheduling. A governing body facilitating and overseeing this process will help coordinate and sustain this effort.
A solution
The fellowship interview season should be broken into discrete time periods and geographically close programs should coordinate their interview dates. This will minimize conflicts and facilitate scheduling. A governing body facilitating and overseeing this process will help coordinate and sustain this effort.
The presentation
Applying for subspecialty fellowship during residency in obstetrics and gynecology is expensive, stressful, and time-consuming for all parties involved. Applicants are spending a significant amount of time away from their program. A survey of obstetrics and gynecology subspecialty fellows in February 2014 found that over half (51.5%) of the 169 respondents spent at least 10 days away from residency interviewing with 16% missing >15 days ( Figure ). Fellowship candidates must juggle their clinical schedules and requirements while incurring the significant costs associated with traveling (potentially with multiple cross-country flights). Many fellows surveyed emphasized the lack of coordination between programs in the same geographic area as a major challenge. One respondent noted “Programs should have to group their interviews by region. I flew out to California 3 separate times, Boston twice, etc, because programs even in the same city interview on different days. Everyone I interviewed with had a similar issue. To compensate for this many applicants work for >24 hours at a time and then fly to their interviews, or come back from an interview and go straight to work.” Of 170 fellowship candidate respondents, 11.8% spent >$3000 on hotel rooms in addition to 44% stating that they spent >$3000 on airline tickets (with 16.5% spending >$5000 on airline tickets). In a different survey of fellowship applicants, Iqbal et al noted that matched candidates spent on average $5286 with applicants who matched spending more than those who did not ($5818 vs $3786, P < .001). This was believed to be likely due to the difference in the number of interviews between these 2 groups of applicants. Candidates must schedule their fellowship interviews based on the widely variable (and often last-minute) dates offered. Residency programs with a significant number, or percentage, of residents applying for fellowship have the challenge of scheduling absences from clinical rotations at unpredictable times. Multiple residents may all request to be away for interviews at the same time, placing significant demands on the coverage system and rotation schedule. There is minimal communication concerning the application process between most fellowship programs within each subspecialty, and even less between the different subspecialties, within obstetrics and gynecology. Candidates who might wish to interview at a specific fellowship program may not be able to, based on conflicting interview dates or the inability to find coverage for their clinical duties within their residency.
The Committee on Fellowship Training in Obstetrics and Gynecology (COFTOG) was established in 2011 to serve as a forum for discussion of issues common to all fellowships. A COFTOG-sponsored panel discussion took place at the March 2015 annual meeting of the Association of Professors of Gynecology and Obstetrics and the Council on Resident Education in Obstetrics and Gynecology (CREOG), and included representatives from 6 different obstetrics and gynecology fellowships.
The panel reviewed barriers and opportunities to decrease the burden associated with the fellowship application process. The wide variation in number of applicants, match rate, and outcomes from the 2014 through 2015 match year between different subspecialties and fellowships were acknowledged ( Table 1 ).
