Abstract
BackgroundFellowship training follows certification in a primary specialty or subspecialty and focusses on distinct and advanced clinical and/or academic skills. This phase of medical education is growing in prevalence, but has been an “invisible phase of postgraduate training” lacking standards for education and accreditation, as well as funding. We aimed to explore fellowship programs and examine the reasons to host and participate in fellowship training, seeking to inform the future development of fellowship education.MethodsDuring the 2013–14 academic year, we conducted interviews and focus groups to examine the current status of fellowship training from the perspectives of division heads, fellowship directors and current fellows at the Department of Medicine, University of Ottawa, Canada. Descriptive statistics were used to depict the prevailing status of fellowship training. A process of data reduction, data analysis and conclusions/verifications was performed to analyse the quantitative data.ResultsWe interviewed 16 division heads (94%), 15 fellowship directors (63%) and 8 fellows (21%). We identified three distinct types of fellowships. Individualized fellowships focus on the career goals of the trainee and/or the recruitment goals of the division. Clinical fellowships focus on the attainment of clinical expertise over and above the competencies of residency. Research fellowships focus on research productivity. Participants identified a variety of reasons to offer fellowships: improve academic productivity; improve clinical productivity; share/develop enhanced clinical expertise; recruit future faculty members/attain an academic position; enhance the reputation of the division/department/trainee; and enhance the scholarly environment.ConclusionsFellowships serve a variety of purposes which benefit both individual trainees as well as the academic enterprise. Fellowships can be categorized within a distinct taxonomy: individualized; clinical; and research. Each type of fellowship may serve a variety of purposes, and each may need distinct support and resources. Further research is needed to catalogue the operational requirements for hosting and undertaking fellowship training, and establish recommendations for educational and administrative policy and processes in this new phase of postgraduate education.
Highlights
Fellowship training follows certification in a primary specialty or subspecialty and focusses on distinct and advanced clinical and/or academic skills
Certification in the subspecialty of Nephrology requires completion of medical school, 3 years of Internal Medicine specialty residency and 2 years of Nephrology subspecialty residency, with success in the certification exam of each discipline. This residency training occurs under the auspices of the College of Family Physician of Canada or the Royal College of Physicians and Surgeons of Canada in partnership with Canada’s 17 Faculties of Medicine
This paper explores fellowship training across all divisions in one department of medicine to describe the breadth of fellowship activity, and to identify the purpose of fellowship programs in an academic institution
Summary
Fellowship training follows certification in a primary specialty or subspecialty and focusses on distinct and advanced clinical and/or academic skills. Graduates of specialty and subspecialty residency programs, having achieved Royal College of Physicians and Surgeons of Canada certification and the prerequisites for independent practice, are choosing to pursue additional non-accredited training to attain distinct and advanced clinical and/or academic skills. This phase of medical education, confusingly called “fellowship training”, has been an “invisible phase of postgraduate training” [1] lacking standards for education and accreditation, as well as lacking funding. This has been well documented in the surgical disciplines; surveys indicate that 60–85% of Canadian residency graduates from general surgery [6], radiology [7] and urology [8] intend to pursue a fellowship, with similar findings from studies in the UK and US [9, 10]
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