Fellowship Overview

A resident who wants to become a fellow must complete residency training and become eligible for board certification. A fellowship program, on the other hand, is legitimized either by accreditation or certification. The difference between these approval processes is important to understand.

Accreditation is a voluntary peer-reviewed process (e.g. accreditation by Society of Urologic Oncology, Society of Endourology, etc.), whereas certification is a formal standardized evaluation process designed to ensure that “a certified medical specialist has successfully completed an approved educational program (e.g.certification for Pediatric Urology by the ACGME).” Until recently no subspecialty certification was available in the field of urology. Certification in pediatric urology is to be launched in 2008. All other currently available urologic fellowships are accredited—not certified—programs. To make things more confusing, some well-respected fellowships are unaccredited altogether. Importantly, a physician who has not been certified or accredited in a particular subspecialty still can practice within that subspecialty. For example, a general urologist is not in any way prohibited from resecting a malignant renal mass nor repairing hypospadias.

General Strategies for Applying to Fellowships

One should strive to make a decision regarding fellowship training sooner rather than later. It is best for the decision to be finalized by the end of the PGY3 year for those in a 5-year program and by the end of the PGY4 year for those in 6-year programs. Having an early conversation with your chairman and/or program director regarding your goals is critical. The earlier your mentors probe their contacts and introduce your name to the right people the better.

Late summer/early fall of the year prior to graduation (i.e. PGY4 in a 5-year program and PGY5 in a 6-year program) contact the fellowship directors at each fellowship program where you wish to apply. Express interest in the fellowship and inquire into the logistics of the application process. Most program directors will reply within several days and tell you exactly what they want as part of your application. The typical requirements are 3 letters of rec and a CV. Some fellowships want a personal statement -- an insanely painful exercise for any self-respecting physician. The program directors will likely let you know at this point when to expect your interview. Be sure to keep track of the match registration deadlines for fellowships that select through a match process (e.g. peds, endourology).