By ��Dr. Tijjani Magashi (MBBS, MSc, FMC Ortho, FAOSpine )

HUNTING FOR MEDICAL FELLOWSHIPS

Outline

• Introduction
• Medical fellowships
• Types
• Benefits
• Phases (I, II , III )
• Post fellowship period
• The guide / hunt
• Early career decision
• Professional associations
• Networking
• My Personal experience
• Challenges
• Finance
• Institutional policy
• Conclusion

Introduction

• What are medical fellowships
• Medical fellowship is typically a highly focused, immersive training experience designed to provide sub-specialized skills beyond core residency
• Typical can be ;
• Short term : From 4 weeks to 6 month
• (Many being 3 - 6 months).
• Long term: Typically to 1 - 2 year.

Introduction

• Can also be clinical or research fellowship
• Clinical : mainly clinical skill acquisition

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• Research : mainly addressing a research question

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• Combine: both clinical and research.

Clinical fellowship

• The fellow is integrated into the clinical service as a super-specialized trainee.

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• Theater/Laboratory: The fellow spends the majority of their time in the operating room, cardiac cath lab, endoscopy suite, etc.
• Observing and then performing procedures under direct supervision.

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• Clinics : Participating in specialized outpatient clinics to learn patient selection, pre-operative counseling, and post-operative / procedural management.

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• Ward Rounds: Managing inpatients specific to the sub-specialty.

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• On-Call Duties: Often participating in a consultant-level or fellow-level on-call roster to manage co manage emergencies

Research fellowship

• The focus is on a dedicated a particular project, involving
• Refining the research question
• Protocol development
• Ethics approval.
• Data Collection & Analysis
• Intensive period of gathering data, running experiments, or conducting audits.
• Manuscript Writing.

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• The goal is often to produce one or more publishable papers or presentations.

Benefits

• Insight into how a world-class center functions
• Career-definition.
• Mentorship
• Academic promotion.
• New job opportunities
• Networking and collaborations

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Phases of fellowship

• Phase I : Pre-Arrival & Onboarding

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• Identification and Application: · The fellow identifies a specific skill, technique, or area of research they want to master.

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• Identify experts, professional organization / renowned institutions with high-volume that offer training in that are

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• Submit a formal application - CV, letters of recommendation, personal statement, and sometimes a proposal for their learning objectives.

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• The host institution may interviews candidates and extends an offer.

Phase I cont.

• May includes a contract or letter of agreement outlining the terms, duration, stipend (if any), and responsibilities. ·

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• Administrative:
• Credential screening
• Temporary medical license (if required)
• hospital privileges.

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• Visa/Work Permit: For international fellows, this is a critical and often time-consuming step. ·

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• Housing & Logistics: Arranging travel, accommodation, and local transportation.

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• Pre-Arrival Communication: The fellow connects with the program director or supervisor to discuss goals. They may receive reading materials, protocols, or access to the institution's online learning system

Phase II

• The Immersive Training Period (The "Core" Phase) This is the heart of the fellowship, characterized by intense, hands-on learning. ·

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• Orientation (First Week): Introduction to the team (consultants, nurses, allied health, research staff).

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• Issuing identification card and access limit.

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• Tour of the facility (OR, cath lab, wards, clinics, simulation center).

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• Review of safety protocols, emergency procedures, and specific departmental rules.

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• Structured Integration into the Clinical/Research Service.

Phase II cont

• The Learning Progression (The "See One, Do One, Teach One" Model):

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• Observation: Initially watching the expert and the team to understand workflow and techniques.

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• Assisted Performance: Performing parts of a procedure under close supervision (e.g., doing the conduit harvest in cardiac surgery, assisting with device deployment).

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• Supervised Performance: Performing the entire procedure or key parts with the supervisor scrubbed in and guiding.

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Phase II cont.

• Independent Performance (with oversight): For long term fellowships, the fellow may reach a point of performing standard cases more independently, with the supervisor immediately available.

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• Teaching: Towards the end, the fellow may help in teaching the technique to residents and medical students.

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• Academic Activities: · Attending and presenting at specialized journal clubs, morbidity & mortality (M&M) meetings, and departmental grand rounds.
• Preparing and delivering a talk or lecture on a topic relevant to the fellowship

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Phase III

• Completion & Post-Fellowship (The "Transition" Phase)
• This phase is about consolidating the experience and planning for the future.

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• Consolidation of Skills: Focusing on achieving a level of proficiency and confidence in the core techniques.

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• Project Completion: Finalizing data analysis, submitting abstracts to conferences, and completing draft manuscripts.

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• Logistics Wrap-up: Returning hospital / institution property, completing any required administrative forms.

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• Exchanging contact information with the team to build a lasting professional network

Phase III cont.

• Evaluation and Certification: · The fellow receives a formal evaluation from their supervisor.
• The fellow may also evaluate the program.
• The host institution provides a certificate of completion, which is a crucial document
• Some programs may also provide a procedure log (important for residents )

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Post fellowship period

• Post-Fellowship Integration:
• Primary goal is to implement the new skills and knowledge, starting a new service line or enhancing an existing one.

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• Maintaining communication with the host center and trainers for complex cases (a "tele-mentoring" relationship)

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• Navigating local challenges

The Guide / Hunt

• Early career decision :
• Make a decision on the career choice

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• It help to stream line practice and hunting for mentors in that field

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• Identify a local mentors for guidance and connections

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• Identify the needs of the home institution / society

The Guide / Hunt cont.

• Professional Associations
• The easiest way is through international professional association
• Majority offers fellowship opportunities
• Become and member and be paying the membership dues
• Attend conference
• Read the guidelines and strive to fulfill the requirement for the fellowships

The guide / hunt cont. �Some specific examples

• International Society for Orthopedic Surgery and Traumatology (SICOT)
• AOSpine / AOTrauma / AORecon
• American Academy of Orthopaedic Surgeons (AAOS)
• American College of Cardiology (ACC)
• Society for Cardiovascular Angiography and Interventions (SCAI) · Fellowship: interventional cardiology
• Heart Failure Society of America (HFSA) · Fellowship: Advanced Heart Failure and Transplant Cardiology (a 1-year fellowship after general cardiology).
• American Gastroenterological Association (AGA) · Fellowship: Gastroenterology (3-year fellowship).
• American Society of Hematology (ASH) · Fellowship: Hematology (often combined with Oncology in a 3-year fellowship)
• American Society of Clinical Oncology (ASCO) · Fellowship: Oncology (often combined with Hematology).

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My personal Experience

• SICOT – Istanbul 2017 - 2018
• AOSPINE – Istanbul 2018 - 2019
• Personal networking – Ankara spine center – 2019 - 2020
• Personal networking – South Africa 2023
• AOSPINE / Personal networking – Cairo 2025

SICOT fellowship – Istanbul 2017 - 2018

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Istanbul 2018 (Arthroplasty/ spine)

AOSPine fellowship Istanbul 2019

Aospine fellowship

Ankara – 2019 - 2020

South Africa - Spine Endoscopy 2023

South Africa 2023

Cairo 2025- Spine Endoscopy

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Challenges

• Finances : Initial funding
• Not all fellowships are funded

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• Institutional policies
• Pre / post fellowship
• Units level
• Hospital level

Conclusion

• The most efficient way to find a high-quality fellowship is belonging to the leading international society for your field of interest.

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• Check "Education" "Training " or "Career" sections for accredited programs and application details.

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• Leverage major congresses, as attending international conferences / congress is one of the best ways to meet potential fellowship directors and learn about opportunities.

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