So, You Want to be a Fellow in Geriatric Psychiatry?

So, You Want to be a Fellow in Geriatric Psychiatry? PDF

Adapted with permission from “So, you want to be a Psychosomatic Fellow?” by Lackamp & Bialer, Academy of Psychosomatic Medicine 2010, www.apm.org 

Congratulations! You are embarking on an exciting time in career development. Specialty training in geriatric psychiatry will provide specialized skills preparing you to provide specialty care while operating within an interdisciplinary setting. The following information is intended to be helpful as you navigate the process of researching, applying, interviewing, and choosing a fellowship.

Unlike the residency selection process through the National Residency Match Program (NRMP), the fellowship application process is not standardized. As you research programs, you will apply to them individually and choose where to interview based on offers. After interviewing, there is no ranking process for applicants and programs. There are generally more fellowship slots available than applicants to fill them, so you may have many good offers to choose from and even spots offered to you before you have completed your scheduled interviews!

The Exploratory Phase

You should start investigating fellowship opportunities during your third year of residency. The March AAGP Annual Meeting is a great opportunity to explore your program options! Programs typically begin accepting applications in the summer between third and fourth years of residency with interviews in the fall of your fourth year. However, there is no firm timeline and things vary across programs (and coasts). A program with two spots may fill both if two strong applicants apply in June, so don’t delay in the application process in order to give yourself the best chance with your top choices. 

While investigating fellowships, you should also clarify with your residency how many days you can be gone for interviews (and whether you can use education and/or vacation days for these). This will be important information as you are planning your interview schedule.

Decide what elements of fellowship are important to you, including:

  • Geography
  • Reputation of Psychiatry Department and its training programs
  • Number of fellows per year
  • ACGME accreditation status
  • Program curriculum
  • Available clinical experiences
  • Research opportunities
  • Moonlighting

Like the residency application process, get input from those whose personal (partner, family, friends) and professional (Program Director, faculty mentors) opinions you value in order to help prioritize these elements. Also, while you are speaking with your professional mentors about fellowship programs, think about who you might want to write a letter of recommendation and ask if they would be willing to do so—this advance notice will give them time to begin drafting a letter (or allow to you find alternatives in the unlikely chance they decline) so they can send it out quickly once you do officially ask.

Once you’ve clarified some of your key priorities, start looking at programs! A good place to start (after the AAGP Annual Meeting, of course) is the ACGME, which maintains a list of accredited programs (https://www.acgme.org/ads/Public/Programs/Search). You can search for all geriatric psychiatry programs or limit your search by states of interest. The search will then generate a list of programs, including information such as:

  • Program Director (with contact information as well as years in the position)
  • Link to the program website
  • Accreditation status and cycle length (5-year maximum)
  • Number of positions
  • Main clinical sites

Other resources include people at your own residency program—faculty members or recent graduates may have ties to institutions with fellowship programs—as well as contacts you have met through AAGP or the APA. As you are investigating programs that may be far away, don’t forget your resources close to home, as these potential sources of “inside information” may be tremendously helpful.

Now What?

The next step is to contact programs of interest, which can be done using the contact information found in the ACGME program listing. Make sure you transition out of texting/IM mode to write a brief but professional (no typos!) correspondence indicating your interest in the program and requesting additional information. At this point, the program will mail you their application packet along with requests for letters of recommendation and your CV. Remember—when contacting a program at any point during the application process, always treat the person receiving your call or email with courtesy and respect because bad applicant behavior will be noted. (While residents interested in geriatric psychiatry are nice almost by definition, we all have bad days!)

Don’t delay in completing the application to your top programs. While there may be more open fellowship spots than there are applicants, this also means that programs may want to fill their spots as soon as possible (i.e., before you have completed your interviews).

Enlist the help of your grammarian friends and colleagues to look over your application components. You may also want to ask a mentor to review your CV—while program applications may vary, most will require a CV so make sure to have someone else review it for content and formatting. Again, be sure to submit the information in a timely manner and when in doubt, contact the programs (politely!) with any questions.

Lastly, once you think everything has been submitted confirm that it has been received! Do not ever assume that “no news is good news.”

Waiting . . .

After submitting your applications, you will return to your normally busy life as a resident. However, as you are awaiting offers of interviews (and odds are you will get one most places you apply), here are a few pointers to help you prepare:

  • Update and copy your CV to bring along (if there are significant additions)
  • Review your application for each program so you remember what you said!
  • Bring business cards if you have them so you can easily provide your contact information to interviewers or others you meet
  • Review information for each program to come up with questions you would want answered during the interview day
  • Is your suit clean?

After several weeks, if you haven’t heard about an interview (but you have confirmed that it was received), it would be reasonable to politely contact the program to inquire about their application timeline.

The Interview

You may be given several interview dates to choose from for each program, so consider organizing a circuit of interviews. This will help you plan your travel and time away from residency efficiently. Don’t delay as you select interview dates, as other applicants may be considering these same slots and the available times may fill up. And since you’ve been soliciting advice from your Program Director all along and have also clarified the number of interview days available, requesting these interview days will hopefully go smoothly.

Just as you did for residency interviews, plan your travel carefully. Allow ample time for air or land travel between programs, pack wisely (and avoid checking luggage if possible, to prevent your luggage from taking a different trip than you do), and confirm all airplane, rental car, and hotel reservations prior to your trip. When dressing for your interviews, it is always wise to err on the side of formality. Suits are the accepted attire for interview days. Just because a program is in a relatively “casual” location, never assume that it’s ok to show up for an interview in khakis and flip-flops.

During the interview day, be yourself and enjoy the experience. This is your chance to tell programs about yourself and your interests, and it’s the interviewer’s chance to tell you what their program has to offer. Be sure to get your questions answered, and talk to any available current fellows to get their impressions. Keep your interview itinerary and ask for the contact information of the people you meet, if not provided--this will prove helpful as you are reviewing/comparing programs and have follow-up questions to ask subsequently. It is always polite to send thank-you notes to those individuals who interviewed you, though this is neither required nor expected. If you are particularly interested in a program, by all means convey this with a follow-up hand-written note or carefully composed email to the Program Director. It also is wise to extend thanks to any program coordinators that assisted in your interview scheduling and/or travel plans.

After the interview process is completed and you’ve conveyed your interest to the appropriate Program Director(s), relax and await offers for a fellowship position. You may get several offers, so be prepared to weigh the pros/cons of each program in order to help make your decision. Again, input of friends/family can be helpful during this time.

Offers

Congratulations! You may be lucky enough to be offered positions at several different institutions. It is also possible that you may be offered positions before you have completed your interviews or heard back from other sites. If there are programs in which you are interested but still haven’t heard back, contact them and gently inquire as to your standing, letting them know about offers from other programs. You should promptly reply to each program that makes an offer to thank them. If you’re not prepared to answer immediately, explain that you need some time to think and weigh your options. Talk about the process and timeline openly with programs rather than accept an offer because you fear it may be your only one. Ultimately, a program should want a happy fellow, which hopefully means allowing you time to make a well-informed decision, considering all of your options.

Being up-front and open is the best policy, so maintain polite lines of communication throughout the application and interview process. The field is close-knit, so you may encounter many of these people as colleagues throughout your career and may even return to some of the same institutions to interview for post-fellowship jobs. Be courteous and timely as you navigate the process!

Once You Accept a Position

You are now an incoming fellow in geriatric psychiatry for the next academic year. Touch base with your Program Director and letter writers to update them on your decision and thank them for their assistance. Most fellowships start on July 1, so if you need a few days off to move and/or for orientation, check with your residency program about arranging this.

There are many issues to be clarified prior to starting fellowship, most of which should be described by the individual fellowship program. For example:

  • Find out which permanent licenses you will need prior to starting your fellowship
  • Is it mandatory that you get a permanent DEA number prior to starting fellowship?

Either of these can take months, and you don’t want to jeopardize your fellowship start date by not being fully accredited. You can find contact information for the relevant state medical board on the website for the Federation of State Medical Boards (www.fsmb.org). If you need to get your own DEA number, check the website for the DEA (www.deadiversion.usdoj.gov) to get specific information.

Apart from the licensing issues above, you will face several of the same decisions as when you started residency:

  • Housing—should you rent or buy?
  • Banking—open new accounts?
  • Benefits—what sort of health insurance coverage is provided? If you are completing a combined clinical/research fellowship, ask if/how your benefits change across fellowship years.
  • Personal Matters—what about employment options for your partner? Childcare options for children?

 Wrapping Up

We hope this guide has been useful to those of you contemplating fellowship training. While this is certainly not exhaustive, hopefully this guide has covered some of the key topics so you can start the process with confidence.

Overall, we hope you remember to:

  • Be prompt throughout this process—in researching fellowships, contacting programs for information, applying, interviewing, and responding to offers.
  • Be open and polite in all realms of communication—by email or by phone, whether with the Program Director or the assistant answering his or her phone.
  • Be thorough in your investigations and clear in your search for the fellowship that best matches your interests.

Good luck and welcome to the field!

Posted June 2013