Med School Minutes-Ep. 65 | How to Match Into Fellowship as an IMG | Dr. Brandon Gordon

What does it really take to match into a medical fellowship as an IMG?

In this episode of Med School Minutes, we sit down with Dr. Brandon Gordon, Saint James School of Medicine alumnus and Pulmonary & Critical Care fellow at the University of Florida Jacksonville, to discuss the journey from medical school to residency, chief residency, and fellowship.

Dr. Gordon shares what he learned navigating the fellowship application process, including why connections matter, how research and quality improvement projects can strengthen your application, and what fellowship programs are really looking for during interviews.

In this episode, we discuss:

• How fellowship applications differ from residency
• The importance of research, case reports, and QI projects
• How networking can help you land fellowship interviews
• Why social media can be a valuable networking tool
• Whether becoming a chief resident can improve your chances
• What fellowship interviews are really evaluating
• Fellowship and visa considerations for international graduates
• Why physicians choose to subspecialize

Whether you're currently in medical school, preparing for residency, or already thinking about your next step after residency, this episode offers practical insight into what it takes to pursue fellowship training as an IMG.

🎙️ Guest: Dr. Brandon Gordon
Saint James School of Medicine alumnus
Pulmonary & Critical Care Fellow, University of Florida Jacksonville

Subscribe to Med School Minutes for more conversations about medical school, residency, the Match, and life after earning your MD.


#MedicalFellowship #IMG #InternationalMedicalGraduate #MedicalResidency #SaintJamesSchoolofMedicine #MedSchoolMinutes

Transcript

Intro

SPEAKER_00 0:01

Hello, and welcome to another episode of the Med School Minutes Podcast, where we discuss what it takes to attend and successfully complete a medical program. This show is brought to you by St. James School of Medicine. Here is your host, Kashe Kuwa.

SPEAKER_02 0:19

Thank you for joining us on another episode of Med School Minutes where we talk about everything MD related with a focus on international students, specifically students from the Caribbean. So, one of the things that we've noticed is amongst our alumni, we've always noticed a higher percentage of our students going into um uh fellowships. And today we have a very special guest. His name is Dr. Brandon Gordon, who has continued on and is about to finish his fellowship in preliminary and critical care. So without further ado, let's welcome Dr. Brandon Gordon and understand what the process of getting into a fellowship actually entails. Thank you so much, Dr. Gordon, for joining us for the graduation. We're so excited. Uh this year is a very special graduation. We have uh uh Dawn Zootkeith who is graduating. She is actually going to be uh the oldest practicing uh medical doctor in the world.

SPEAKER_01 1:21

I I think I saw that this year. 72, 73?

SPEAKER_02 1:24

She's uh 73 entering residency. Um but what a what a beautiful story. She's been uh RN for 40 years, uh she's been uh a professor of uh pathology and anatomy for the nursing schools, for various nursing schools. So she's incredibly round, well-rounded. We also have uh uh Dr. Um Kelly Hurley, she's a four-time Olympian, uh, and she's graduating. Uh she's uh going to start her residency. But I think that that's this is definitely a very, very unique graduating class. And yeah, uh thank you so much for volunteering to come absolutely speak to our students about uh your journey at St. James and uh generally speaking, uh how what you see in St. James and and we want to talk a little bit about that today, too. Yeah. What you saw, what you're seeing now, and basically your path forward. Um and

Dr. Brandon Gordon’s Journey

SPEAKER_02 2:21

so why don't you start by telling a little bit about yourself?

SPEAKER_01 2:24

Sure, absolutely. Well, so yeah, my name is Brandon Gordon. Um I was born and raised in Mississauga, Canada, before moving to the US for undergrad. Um spent four years in Michigan um before finding out about St. James and going to medical school. I started at Anguilla. Um I know we're no longer there, but I started the Anguilla campus in 2017. Um and I finished in 2021 and matched into internal medicine residency at Parkview Health in Indiana. Okay. Um spent three years there, um, worked as a third year chief, um, did another fourth year chief year um in Northeast Georgia before matching in Pulmonary Critical Care Fellowship um in University of Florida in Jacksonville. Oh wow, where I'm currently at now. Okay. Um so excited um to see what what's next. Um a little bit about me outside of medicine. Um I love traveling. Okay, I've been to 43 countries. Um, hoping to go to all 191 or 195, sorry. Um most recently I went to Azerbaijan, um, which is sort of like near Central Asia. Okay. Um uh love big Formula One fan, love sports, um, and yeah, it's a little bit about me.

SPEAKER_02 3:27

Awesome. Wait, so after visiting this many countries, uh-huh. Do you have an Instagram? I do have an Instagram. Are you a travel are you a travel blogger in Twitter?

SPEAKER_01 3:38

I should have been, but I personally know. But I'm gonna start. I'm gonna start looking into it. Okay. I I I most of my travel stuff I did with my brother, and we sort of just keep it within the family and and friends. Um, but I feel like I should have, because I I I follow a lot of travel um stuff on YouTube and and on Instagram. So I feel like I should start documenting that a little bit more.

SPEAKER_02 3:55

I mean, uh so so Complete detour. But I have to ask you this. Uh, what's the most unique country that you visited?

SPEAKER_01 4:03

The most unique country I visited?

SPEAKER_02 4:04

I would say But not too many people have visited or don't think of it. I think Azerbaijan is definitely what I was.

SPEAKER_01 4:10

Azerbaijan would be like pretty high on my list. I am I remember when I was in the airport and when I was just like walking in Baku, which is the capital city, um, most people had never it's a very homogeneous society. Uh so they had never seen uh a foreigner um uh at all. Um so I I was I I felt like a little bit of a celebrity, celebrity there because I was getting approached like every five minutes. Wow people wanting to take pictures and and uh talk to me and stuff. Um so that would probably be like the the most unique country about I've traveled to.

SPEAKER_02 4:37

And what about the most remote?

SPEAKER_01 4:39

Most remote? Um uh Bolivia was pretty remote. Um Bolivia and South America. There's not not a ton of tourists go there, not a ton of um um in terms of industry, like they don't see a lot of foreigners there. Um and where I was at in Bolivia, um it was sort of more of a uh native um um native uh uh settlement um where it's not like your typical like Hispanic people. Um so it was pretty remote out there for sure. Okay.

SPEAKER_02 5:05

So uh I have to ask you, like you said you're doing uh your fellowship, but post-fellowship, do you envision yourself doing something like Doctors Without Borders and traveling the world or something like that?

SPEAKER_01 5:14

You know, that it's crossed my mind. It's not something that I would invest in full time, it's something that I would sort of sprinkle in my practice maybe ever uh every couple of years, get a free vacation. Um maybe uh something along those lines, but it's not something that I would um do full time.

SPEAKER_02 5:29

To be very honest with you, I don't think doctors without borders is much of a vacation because they're sending you to earthquakes, sure, exactly war zones. Yeah, exactly. But if you consider I know doctors tend to have a very skewed view than normal people, right, right, right, right.

SPEAKER_01 5:42

If they if they go to a unique country, then for sure I'll go. Okay. Um for sure I'll go. That's awesome.

SPEAKER_02 5:47

Well, I mean, speaking of all that, the reason I bring this up is because we actually in James actually do a lot of uh international rotations now, which is something at your time we didn't have. Yeah. So for example, we partnered with uh medical brigades. Uh last year students went to Belize, this year they're going to Panama. We're going to make it uh uh a permanent fixture in our undergraduate curriculum. Right. Uh for yeah, so right now we actually have uh just freshly uh accredited uh uh tropical medicine program out of Suriname.

SPEAKER_01 6:19

Oh, yeah, south like Guyana, near South South America. Yeah, yeah, yeah.

SPEAKER_02 6:22

So our students go and spend uh three weeks in the capital in Paramariva and one week in the heart of the Amazon jungle attending to their local clinics and running them. Yeah. So interestingly, some of our students may have to and will have to uh know basic dentistry as well because that's yeah their medical education. Like they do like they're taught to run an entire clinic from beginning to end.

SPEAKER_01 6:44

Right. Um that helped them a lot for residency, like having that unique asset thing on their on their CV. Not a lot of American students have that on the international travel. Um so separating themselves from uh as an IMG, um, separating themselves uh in that way is that I can see that as a tremendous asset.

SPEAKER_02 6:59

Oh really? So we also have a partnership with Pace MD and the Red Cross in Mexico where they can go and do a uh clin uh clinical rotation in San Miguel de Allende as well.

SPEAKER_01 7:09

Oh wow.

SPEAKER_02 7:10

So that's uh so and then obviously we have clinical rotations in actually St. Vincent itself. So they have a pretty big size hospital with uh you know above 200 patients a day. Yeah. That's the kind of patient. Yeah. I mean, for a country with uh a hundred thousand population, we weren't expecting the exposure to be that good. And it's been not just good, it's been fantastic. Actually, like for example, with OB and PEDs, yeah, that exposure in St. Vincent is dramatically better than most of the uh exposure that we're seeing here in the US uh hubs. But OB and PEAS as you know it's been an issue everywhere.

SPEAKER_01 7:46

Yeah, of course, yeah.

SPEAKER_02 7:47

So um, but uh so we have a lot of international rotations if at some point you are interested in coming and uh reviewing them, yeah. That would we'd be more than happy to have you if you want to come to St. Vincent, just talk to our students, maybe spend and believe it or not, the St. Vincent government is incredibly enthusiastic to have licensed physicians from the USA come and meet them. Nice. So what they do is when you go there, they'll make you do CME, like not uh or your lecture will count as CME for them. I can always use some more CME, so I don't know if that'll work for you, but I mean uh we can look into that, but they would be happy to have you. We would be happy to have you. You'd get a chance to see our new campus. A lot has changed since you've left.

SPEAKER_01 8:29

Yeah. I've seen some pictures online, and it looks like a totally different, uh, totally different than your.

What Makes Fellowship Different From Residency?

SPEAKER_02 8:40

You know, your fellowship. So we've been getting a lot of interest and a lot of questions about fellowship. Um from what we know, and we don't necessarily deal with a lot of fellowships, but from what we know, it is a completely different animal.

SPEAKER_01 8:54

It is.

SPEAKER_02 8:55

So why is that? Can you tell us a little bit about why do you think fellowship is so much more different from residency?

SPEAKER_01 9:02

Yeah, so I think there's a lot of reasons as to why it's different. Uh, number one, it's a lot smaller world. Um so what comes with that naturally, like when you're in like applying internal medicine, you're you're in a world of like 50,000 other um just residents, um, but like um, you know, a lot of other PDs, a lot of other applicants, the fellowship world is very narrow. So what it what that means is or how that transpires is a lot of it comes down to connections and who you know. Um so I what I found like in in residency, uh the the review process that these uh that these um program directors had was a lot more exhaustive per se. But in fellowship, it is I they won't even look at your profile if they don't like if they don't receive like a phone call or um receive like some sort of a connection. Um or if you come from a big school or a big um institution, um that'll help. So uh I think uh in residency a lot of it comes down to your accomplishments and your scores and stuff. When you're in fellowship or when the fellowship people are looking at your PD or your application, you know, they know that you've you're capable of being a good resident, or they assume that um you're capable, you've gone through a residency, you're applying to a subspecialty, so you must be like a somewhat competitive applicant just to get there. Okay. So a lot of it in order to differentiate yourself, it's who you know. And if they don't have that connection or that phone call, you won't even get local.

SPEAKER_02 10:17

Yeah, so as far as the fellowship is concerned, and as you said, it's about who you know, yeah, how do you make those connections? Because yeah, I mean, residency can be, especially if you're um in a university system that's different, they might have their own fellowships. But if you're in a uh relatively smaller community hospital residency program where you're kind of siloed and limited and you're not meeting these physicians who run fellowship programs and stuff like that, how do you make those connections at that point?

SPEAKER_01 10:46

Yeah, and and we live in a digital world now. Um a lot, so a lot of these connections are gonna be made online. Um and I found it like personally in my way, like I I I would um follow like like certain in I I'm in Pomony Critical Care, so I would follow um um program directors or influencers in that Pulmonary Critical Care world.

SPEAKER_02 11:04

Wait, wait, wait. So program directors have Instagram accounts?

SPEAKER_01 11:07

Some of them have Instagram, some of them they're they're influencers. A lot of them they're influencers. PDR assistant program directors, and I I would follow them and what I would do is I would sort of build my way in. Um I would maybe respond to a couple of their stories and you know, like, you know, like uh say, oh, that was really insightful. Thank you for sharing. Okay. And then as we got closer to application season, I would um send them another message and say, hey, um, you know, like I'm interested in your program. Uh here's my C V. If you if you uh if I you feel like I'm a good fit for your program, um, or you know a good fit that I would be part of, um I'd be happy to, you know, uh escalate the conversation further. And through that alone, I got like two or three interviews just from um, you know, uh sending out DMs. Um I the yeah.

SPEAKER_02 11:49

So this is so counterintuitive. Usually people are like, oh, it's usually LinkedIn. LinkedIn is the only but you you got your uh several interviews through Instagram. Instagram.

SPEAKER_01 11:58

Yeah, Instagram. Like I the the interview came through like the the the NRP at the website, but I I'm pretty sure these guys wouldn't have even or uh people would not even looked at me had I not like sent that message. Um because I didn't like signal them per se um or like uh have any other connection. It's just I I said that I would be I had that conversation built over the year um of me responding to their stories. So when they saw my DM, it's like, oh yeah, I I I remember him when he sent me this message. Um let me see if there's uh something I can do for him.

SPEAKER_02 12:24

Okay, wow. Yeah, and uh what about research and stuff like that? Does that matter for fellowship?

SPEAKER_01 12:30

Yeah, so it depends on which

Research, Case Reports & QI Projects

SPEAKER_01 12:31

fellowship. So in the internal medicine world, research really is gonna matter for your cardiology, uh your gastroenterology, um, pulmonary critical care on HE Monk. Some of the other ones, uh like uh like maybe like nephrology or endocrinology, you don't necessarily have to have like you know 10-page manuscripts and um a bunch of um you know like uh narrative reviews and whatever. Um you can just have a couple case reports. Um the those those four big ones in internal medicine, um you're gonna have to have something behind your name to show that you're interested in like advancing the field. Okay.

SPEAKER_02 13:00

How would you do that? Like how how would a candidate do that? And like let's focus on a candidate who a hypothetical candidate who's in a relatively small community residency program. Yeah. How does that person go about building? I know, I know residency you do require two research articles to graduate from most residency programs?

SPEAKER_01 13:20

Something along those lines, yeah.

SPEAKER_02 13:21

So uh and I think it and I think that also varies because some uh programs I know have a higher requirement. Yeah, of course, yeah. Some of the university programs in particular tend to have a higher requirement. It's not just two, you have to have five or two a year or something like that. But um, how would a you know person, say in internal medicine, really focus on or even family medicine, yeah, show that they are interested or signal to a pro potential program director that they're interested with research? Yeah. Like how would that be?

SPEAKER_01 13:52

Yeah, so w when you're on in in when in your residency, you're gonna come across interesting cases. Um so your your best bet to start off is to get some case reports, um, which is basically you found an interesting case, um, you write it up, you submit it to a journal. Like PubMed. Exactly, PubMed or like some of the conferences, um, like ATS or chest, which are some of the big um pulmonary critical care ones. Um and uh and you you once you stack up some case reports, um that alone will show some interest. And another thing that a lot of um students tend to neglect or residents tend to neglect is QI, which is quality improvement projects. And I felt that along my um my interview trail, um, that uh in pretty much all of my interviews, um, they centered around a QI project um that I did in residency, um, which it still technically counts as research. Um and uh quality improvement they they a lot of programs want to see um that you're not only trying to advance the field, but you want to advance whatever institution um you're part of or you want to be or you will you be part of.

SPEAKER_02 14:49

So expand on a QI project. What is that? How does a resident even get involved with that?

SPEAKER_01 14:53

Yeah, so quality improvement, uh QI is uh basically uh you identify a weak link or a pr a problem, uh whether it's um the process or systems in the hospital, and you come up with a solution to to um ad um admonish that problem. Um so in my my case, uh the QI project that um I was part of was basically COPD and asthma readmissions and working with respiratory therapists to try to um um lower that readmission rate.

SPEAKER_02 15:19

Okay, wow. Yeah. And uh who determines the QI project? Is it like your uh attending or your PD will come and say, Hey, I have this in mind? Or can a uh a fellow actually say, Hey, yeah, I think, or not a fellow, a resident come and say that, hey, I want to do this kind of a study. Well, how does this work?

SPEAKER_01 15:39

Yeah, so usually at most residency programs you'll have some sort of um research, someone on the faculty who's like manages the research. Um so like my what I would recommend is bringing that idea to to them. Um another idea would be like whatever field you're interested in getting that fellowship in, um, whether it's GI or cardio or whatever, um going to someone in that field, um, like one of the attendings um at that hospital and saying, Hey, I I uh you know I've identified this as a problem. Um I uh what are your thoughts on uh expanding this into a QI project?

SPEAKER_02 16:07

Okay. And hypothetically, what if it's a no?

SPEAKER_01 16:12

Yeah, you know, that's all uh always a possibility. Right. Um, you know, uh for in my experience and and from what I've been told, like you know faculty are usually pretty open to at least like maybe they'll say no to uh your initial project, but they can kind of like guide you in a direction um which they can like say yes in. Um so if if they do say no, it's not something that I would take offense to or something that you know I would use um to you know bring me down or whatnot. I would uh try to use that as a platform to navigate into uh um a more you know willing direction.

What Fellowship Interviews Are Really Looking For

SPEAKER_02 16:40

So I know when we um talk to students about residency interviews, the residency interview is uh very much honestly personality test. Yes, 100%. You know, uh apparently Steve Jobs very famously had would I like uh the beer test? Would I like to have a beer with this person? Yeah. Um typically I'm my background is in consulting. Yeah, our consulting test was uh the airline test where would I want to uh sit next to or be stuck at an airport with this person for over five hours? Yeah. That's a good one. Yeah, these are some of the tests that we were told. Uh and for residency, I say that the real test is not if you get an interview, all they're trying to gauge is can they tolerate you for three years at 70 to 80 hours a week.

SPEAKER_01 17:22

Yeah. Uh-huh.

SPEAKER_02 17:23

Um is there what are what is a fellowship interview really testing for, do you think, or looking for?

SPEAKER_01 17:31

And I I would sort of echo sort of similar, you know, uh sentiment to what they look for in residency, probably to a higher regard. Um and the reason is as sort of what I was saying, like in order to get some of these fellowship interviews, they know that you're a competitive applicant, you know, they've seen your app, you've gone through a residency, they know that you know you like this guy or this girl um can handle a residency program. So what it comes down to is is this pre-candidate a good fit um for the culture we're trying to cultivate um at our institution? Um, is this someone um that we we we would see that could, you know, as you're mentioning, have a beer with or like sit on a flight. So the way I I approached my fellowship interview, I sort of changed my strategy a little bit compared to my my residency interview. I felt like I was a little bit more formal um in my residency interviews and a little bit more stoic because I just wanted to be as professional as possible. Uh but in my fellowship interviews, like I was just like laid back and um you know cracking jokes and um uh I f I felt like I had better results um to a more relaxed way.

SPEAKER_02 18:25

Yeah, but you were a resident. I mean I mean not just a resident, you were basically you took an additional chief resident year. Right, yeah, that helped too. So yeah, okay.

Chief Residency, Visas & Career Strategy

SPEAKER_02 18:33

And so I want to get back at that. Uh the additional chief resident year seems like a completely voluntary thing. It's not like you have to do it. Why did you choose to do it instead of becoming an attendant? You would have exponentially made a lot more money.

SPEAKER_01 18:46

Yeah, so there's two two like two main reasons as to why I did it. One was some for some visa reasons. I'm on a J1 visa. Um so that's sort of like um I I couldn't start working as a hospitalist right away. Um and I had a little bit of a um uh career uh switch into what I uh was uh I was originally thinking GI was what I was wanted to do, and then later in my residency, um pulmonary critical care um you know was came to the forefront. So I just needed that additional year. Okay. And I knew that uh having that chief year um would benefit me when it came down to interviews. There's actually a box on ERAS um that asks, like, were you a chief resident? Uh yes or no. And from what I know, some programs they filter it out like they'll only interview like chief residents first. Um so just having the ability to check that box um and get through that filter, that's the reason why a lot of people do a chief year.

SPEAKER_02 19:33

I see, I see. And um, so generally speaking, um so a little bit uh taking a step back, asking about the visa process, we have a lot of Canadian students and they're gonna ask. Yeah. Um if you don't do a fellowship, yeah. Uh without a fellowship, do you have hurdles or significant hurdles to jump over post-fellowship to get your visa, being able to stay here, being able to get a job as a Canadian?

SPEAKER_01 20:03

Yeah, so post-fellowship or sorry, post-residency. So post-residency. Yeah, I wouldn't say any significant hurdles. Um you're gonna have to the um uh you have two choices. You can either return to do a couple years in Canada or do what's called a waiver, um, where you work in like an underserved area um for a a few uh a few months or sorry, for three years um to do your waiver. Um so the biggest hurdle is just that processing time once you get it started. I haven't seen uh or heard of a case where someone was unable to get their waiver approved. Likewise, exactly. Yeah, and so I usually uh yeah, it may not be in the idea uh area um that you you you envisioned, um, but uh you know it's part of the process.

SPEAKER_02 20:38

But I will say though that um uh the salaries that I've been hearing, and I wouldn't even go as far as underserved areas, I would say just relatively smaller jurisdictions to say Boston, uh Chicago, Houston, New York, uh like for example, even relatively smaller cities like Kansas City, which is obviously hosting the World Cup. They're a big metropolitan area. Um they are paying three to four times what Chicago pays for certain not certain, pretty much a lot of special cities.

SPEAKER_01 21:16

So that's like the the the the good thing is like it's because a lot of the American grads and um the people that don't have to do the waiver, they want to be in like the big cities and stuff. Yeah, I mean understandably so. Um so in order to provide some incentive, um the some of the more rural or um less served areas uh they'll they'll get the bump the payoff.

SPEAKER_02 21:35

Yeah, but I do want to point out that that almost triples or quadruples the payout that you're getting because you're probably getting two to three times more than you would say. Let's take Chicago for an example. If you were to go to a place like Kansas, from my understanding, yeah, especially for fellows, yeah, the pace I heard three times.

SPEAKER_01 21:52

Yeah, yeah, it's gonna be higher for sure.

SPEAKER_02 21:54

And yeah, and Kansas is dramatically cheaper than Chicago. Yeah. There's no question about it.

SPEAKER_01 21:59

Cost of living way cheaper.

SPEAKER_02 22:00

So you're literally like you're not only getting two to three times more, you're actually saving two to three times more. Yeah. And it's like a compounding effect.

SPEAKER_01 22:08

Yeah. It's a lifestyle trade-off. It's because it's like you get paid more, but you know, you're in you're in the middle of Kansas, you're in the middle of like Missouri. Kansas City is pretty nice. Kansas City is pretty nice, yeah. Like I I would have no complaints about Kansas City. I can see why some people wouldn't want to be in some, you know, some some other areas. Um but like the the payoff is you'll get you know salary will be higher.

SPEAKER_02 22:30

Well, if you're interested, I mean I know uh some of the partners we work with, they're always uh asking us. And we're like, well, we only really deal with residents. If you're looking for residents, we can totally help you. Sure. But uh fellows, we don't necessarily do that. But you know, after this podcast, I'll definitely get you in touch with some of the folks. Sure. Yeah. Uh because uh a lot of them are actually looking for pulmonary critical care.

SPEAKER_01 22:53

I'll take it. I'll take it.

SPEAKER_02 22:55

Um yeah, I can definitely I'll I'll shoot an email out to them and see. Uh, because they were literally asking me for this about uh three, four months ago. Yeah. But anyhow,

Why Pursue a Fellowship?

SPEAKER_02 23:06

uh going back to the whole uh fellowship, why do you think a student should act or a resident should even do a fellowship?

SPEAKER_01 23:12

Yeah, so the number one reason why you should do a fellowship, um, regardless of what everyone says is if you're passionate about um whatever you're subspecializing in. So um I know a lot of like sure it pays more um to subspecialize for the most part, like uh internal medicine doctor, um, say they get a 300, 350. If you're going to cardiology, you can easily double that. Um but I wouldn't uh strongly advise, recommend doing it for this for the money.

SPEAKER_02 23:35

I'm just laughing because you just threw out that number as it's like yeah, you're getting 350. That's a lot of money. It's a lot of money.

SPEAKER_01 23:42

But for some people, like uh, you know, the their lifestyle, like you know, they need that double amount. Yeah, um, so um I would not why wouldn't you?

SPEAKER_02 23:48

You guys paid your dues. It's not I mean, let's face it, it's not easy going through med school, it's not easy to spend residency, and it is not easy like working 80 hours for three years. You guys totally earned it.

SPEAKER_01 24:02

It's it's tough, thank you. Um but uh I I would definitely recommend um number one is is if you have a passion for the subspecialty. Um second reason would be if you want to advance the field, um whether through academics, uh through research, um, and that sort of ties into um their passion um for the field that you are interested in.

SPEAKER_02 24:20

Okay. So uh Dr. Gordon, um you know, we kind of briefly talked about uh the salaries a little bit, but what are the expectations? If you spend one to how long are fellowships typically to uh one year to three years. One year to three. Yeah. If you spend that much time, do you potentially expect exponentially that much more money than a regular resident post-residency doctor?

SPEAKER_01 24:47

So yeah, it honestly depends on the f fellowship. Um so so there is uh at least in the internal medicine world, there's four or five of um of like HEMON, cardiological GI Um Crit Um and nephrology um that pay more than a hospitalist. Some of them will actually pay pay less um than just working as a hospitalist. Like it's how does that make sense? Yeah, and it it's it it's it sounds counterintuitive. Yeah. Um that this is um, you know, based off what I I've seen online on like Doctivity and stuff, um they like infectious disease and some of those other specialties, they they can pay less. Um so it people that go into those fields are typically very passionate.

SPEAKER_03 25:21

Okay.

SPEAKER_01 25:22

Um so that's that's a a barrier that someone would have to overcome, is showing their passion um for those fields.

SPEAKER_02 25:27

Um So just out of curiosity, since you've obviously delved into this, is it less competitive to get into those kinds of specialties?

SPEAKER_01 25:36

They tend to be a less competitive in terms of um uh the stuff that the schools look for or the programs look for. Okay. Um they tend to be a little bit less competitive. Um they're equally as important, um, but they could they they tend to be a little bit less competitive.

SPEAKER_02 25:49

Okay. That's interesting. So um what was the reason you went into fellowship?

SPEAKER_01 25:54

Yeah, for me, like I I I was initially attracted to the ICU um for my first day there. Okay. Um I I remember I started in ICU, I think, in like maybe like August or September of my intern year. Um and it was the first rotation that sort of wowed me. Um I was sort of just going through the emotions of the other ones. When I got to the ICU, I was like, wow, this is like this is this is where I belong. Um so yeah, it sort of just like compounded from there and um ended up in ICU.

SPEAKER_02 26:18

Okay. Where did you do your rotations, if you don't mind my asking? Um when I was in residency? Yeah, no, when you when you were in uh medical school, yeah.

SPEAKER_01 26:26

Um mostly in Chicago. Oh, yeah. Um I did most of them. I did some at uh Jackson Park. Okay. Um some at um uh what's the other one in Oak Park? Um West Suburban. Yeah, West Suburban. Uh I did quite a few there. Okay. I did some outpatient ones. Um I also did a few in um Genesis um in uh Michigan. Yeah. Someone did EM there, and a couple internal medicine ones there.

SPEAKER_02 26:46

That's awesome. And then um and and you the rotations you were talking about uh were for residency, right?

SPEAKER_01 26:53

Yeah, residency, yeah. The one I was referring to, yeah.

SPEAKER_02 26:55

Are are uh residency rotations dramatically different from undergraduate medical rotations?

SPEAKER_01 27:01

I I wouldn't necessarily say, of course, as a resident, you have a lot more responsibility. Of course. Um the medical student you can sort of like hide under the umbrella a little bit. Um as a resident, you're not gonna be able to do that. But dramatically, no, I wouldn't say so. Okay.

SPEAKER_02 27:13

Um so do you think because a big complaint that students tell us is that hey, when I'm in undergraduate medical education, it's a lot of information. I just have to keep absorbing. Yeah. When you do residency, I know yes, you're working incredibly long hours. You're not working that long hours, at least uh in the clinical rotations, yeah. In undergraduate medical education. But residency, yeah, you're kind of I mean, I I I kind of get uh joke that it's called a resident because you're residing in the hospital.

SPEAKER_01 27:43

I think that's where the term came from.

SPEAKER_02 27:48

Because every time I talk to Alan and they're like, what are you doing? It's like one o'clock at night. Oh yeah. Still a nice, still working. Yeah. I got I got uh two 12-hour shifts back to back. Yeah. Oh, that's crazy. Yeah. So um then do you do you really think that uh when you are in residency, it's it feels easier at least? Uh in a way it does.

SPEAKER_01 28:12

And I I think it's just number one, you're doing what you love. Okay. Um, you know, a lot of uh medical education when you're not in residency, like still in a lot of it's like book work, um sitting at a desk just grinding, you know, you world and stuff. Um but when you're uh it feels like you're like you know, we're actually working um when you're a resident. So in a way, I felt like I felt like residency was easier um than medical uh medical school, especially like the the third year. Okay. Um second year was pretty tough. Yeah, you know, just like uh you know, no longer an intern and whatnot. But um I thought as a whole, medical school, you know, you're learning a lot of uh information that you may not necessarily be practicing um you know in the future, but when you're in in residency, it's what you wanted to do. Um so it's just that enjoyment of it makes it

The Fellowship Application Process

SPEAKER_01 28:54

easier.

SPEAKER_02 28:54

So I I want to switch gears a little bit and ask you a little bit about the fellowship application process. I know you mentioned ERES a little bit, where you said you kind of have to check, you can check off a box if you're a chief resident. Um is it a centralized platform like uh US residencies are? Well, now US residency, you have your residency cast and you have ERS too now. Is it uh different? No, it's the same, same ERAS platform. Same ERAS platform, okay. That's it. And uh how many so for undergraduate medical res uh residency, USA has anywhere between 34 to 37,000, maybe even more uh total residency slots. Um and they're usually about uh 45 to 50,000 applicants for those slots. Yeah, so it's pretty complicated.

SPEAKER_01 29:39

They're a big world, I was saying, yeah.

SPEAKER_02 29:41

But uh for uh fellowships, I can't imagine it's that many, right?

SPEAKER_01 29:46

Yeah, it's a lot smaller world, okay. Um which is why it's it's it's so important to make those connections um because you're you know you're uh those connections go so much further in fellowship um than they would necessarily in residency. Okay. Um so yeah, it's a lot smaller world. Okay.

SPEAKER_02 29:58

And and is the application process just as expensive as the residency?

SPEAKER_01 30:02

Uh oh well it's it's less expensive because you're applying to less programs. Um in residency, um, you know, especially as a not not a visa requiring IMG, you have to cast your net pretty wide. Okay. Um but fellowship, um, you know, it's a l it's significantly cheaper. Okay.

SPEAKER_02 30:18

And was the visa even a part of the conversation? Or it's like, hey, we don't care what the visa is, you just come over and we'll take you kind of.

SPEAKER_01 30:27

Yeah, so like uh when you apply to a program, you know what kind of visas they'll offer. Um so i uh you usually, at least in my case, it it wasn't really part of the discussion just just because they um when I was applying, they knew that I uh part of my requirements was to uh be able uh uh opportunity to practice under a J1 visa.

SPEAKER_03 30:43

Okay.

SPEAKER_01 30:44

Um so it wasn't really part of the conversation and uh I I haven't seen it being a major hindrance.

SPEAKER_02 30:49

Okay. Thank you so much, Dr. Gordon, for uh very insightful conversation. Um we always get a lot of uh questions from uh alumni who are currently in residency asking about potential uh opportunities and the process of getting into residency. So today I think uh with this conversation, Dr. Brandon Gordon, you have definitely uh shed some light on the prospects of uh fellowship and how that process actually works. I hope this really illuminates uh before our alumni specifically uh the process needed to become a fellow and get into those really, really hyping uh positions called fellowship. Thank you so much, and give us a like and a follow because it means a lot for the production team and it goes a long way for us, and it helps keep this podcast running. If you like what you heard today, uh please uh download your podcast from anywhere that you uh get your podcast, including Spotify, YouTube, and Google. Um and remember, there's no shortcut to becoming an enemy.

SPEAKER_00 31:54

Thank you so much for tuning into our show. We hope you enjoyed another episode of Med School Minutes. If you like our content, please follow us and receive notification when a new show is posted. This podcast is brought to you by St. James School of Medicine. For a video version of this podcast, please check us out on sjsm.org/slash video.