How can a physician fellowship applicant catch a program director’s eye? The answer extends well beyond your CV.
Rachael Nicholson, MD, spent 13 years as the program director for the vascular surgery fellowship program at University of Iowa Health Care. University of Iowa Health Care is a member of the AMA Health System Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
When evaluating fellowship applicants, her program did so through a broad lens.
“What we’re looking for is someone who will work really hard, who also cares a lot about their patients and has a passion for the specialty,” said Dr. Nicholson. “We try to look for things that show evidence of that in their application. Sometimes that’ll come through in their letters [of recommendation], sometimes in their personal statement. A lot of it—we pick up in the interview.”
With December cycle fellowship applicants for 2025 preparing for interviews, Dr. Nicholson shared further insights on how residents can make the right kind of impression during the fellowship-application process.
Keep a consistent narrative
Passion for the subspecialty is important to fellowship directors, but exaggerating your interest isn’t going to do you any favors. The story your application and interviews tell about your desire to pursue fellowship should align, Dr. Nicholson said.
“If someone says in an interview, ’I was born knowing I wanted to be a vascular surgeon,’ but then they've done no research in vascular surgery—no publications, no presentations—they have nothing to go along with it, that doesn't really match up,” she said. ““But if you say, ‘I discovered my passion my second year of residency,’ and you see on their CV that they started getting involved in specialty specific things at that point, whether it's in local societies or regional societies or they began submitting abstracts and getting presentations done—that helps confirm it.”
For those looking to apply for fellowship beginning in the 2025 appointment year, make use of FREIDA™—a comprehensive AMA tool that captures data on more than 13,000 residency and fellowship programs accredited by the Accreditation Council for Graduate Medical Education.
Letters may not resonate
Letters of recommendation are a requisite part of the fellowship-application process. Picking the best letter writer—one who knows an applicant well and can write about specific qualities that aren’t necessarily tangible—can go a long way.
“If I see someone with a glowing letter from someone who rarely writes glowing letters, that stands out,” Dr. Nicholson said. “But letters are generally hard to compare, and a bland, blasé recommendation is really hard to get excited about.”
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Be forward-looking
In Dr. Nicholson’s view, a fellowship applicant’s interview day carries heavy weight. A strong performance includes ample preparation and reflective answers about your field and how you can help it evolve.
“Lots of folks who come in and are pretty thoughtful about the specialty they are going into and how they can contribute to the specialty—if you can articulate that well, it tends to be viewed as a big positive,” she said.
Ace in-service exams
While fellowship selection is moving toward a holistic model, one’s track record as a resident, including test scores, is still going to play a role in getting you in the door for an interview.
“In-service scores count for a lot,” Nicholson said. “If you do poorly routinely on your in-service, we're worried that you may not pass your written boards, and that definitely raises some concern.”
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Show scholarly ambition
The role of applicants’ research experience is becoming increasingly important in fellowship selection, as is the case with residency selection. Your body of work doesn’t need to date back to medical school, but there should be some demonstrable proof that you have pursued scholarly endeavors in the field and are equipped to do so going forward.
“Most programs want someone who wants to be out there and publishing and representing their institution,” Dr. Nicholson said. “We are looking for curious people who wants to add new information to the field who have questions about outcomes for conditions or procedures and why things work the way they do.”
Sincerity matters
Dr. Nicholson said her program is receiving more applications and interviewing more fellowship candidates in the era of virtual interviews. Because of that, identifying applicants who are genuinely interested has become a bigger part of the evaluation process.
As part of the secondary fellowship application, Iowa’s vascular fellowship asks applicants why they want to be a part of the program.
Instead of a canned response, doing your prep work on a program and a region can resonate.
“During the interview, you can tell who’s done their homework about the faculty, our program and at least looked up the area online to see what’s around and see if that’s an environment where they’d want to live for a couple years,” Dr. Nicholson said.
