Cracking the Code: Insider Tips for Matching into an REI Fellowship

Cracking the Code: Insider Tips for Matching into an REI Fellowship

The journey to becoming a Reproductive Endocrinology and Infertility (REI) specialist is both exciting and demanding, culminating in the crucial fellowship match process. In a series of recent ASRMed Talk videos, Drs. Victoria Jiang and Zach Walker, members of the Society for Reproductive Endocrinology and Infertility (SREI) and the ASRM Education Committee, offer insightful tips and strategies for navigating this pivotal stage. This overview synthesizes their expert advice across four key areas: the importance of research, geographical considerations, the SRS SREI Bootcamp, and the fellow's perspective on research focus.

Residents and Research: Laying the Foundation

Dr. Jiang and Dr. Walker kick off the discussion by emphasizing the paramount importance of research in an REI fellowship application. While research might feel like another box to tick for busy residents, they urge applicants to be strategic and thoughtful about their involvement. Key considerations include aligning research projects with personal goals, ensuring the feasibility of completion during residency, and understanding the timeline for publication.

Feasibility is a crucial aspect. The experts suggest considering retrospective cohort studies utilizing already IRB-approved databases, allowing residents to integrate into established research teams. They caution against overcommitting to time-intensive projects like extensive chart reviews, especially amidst demanding residency schedules.

For residents whose programs lack robust REI research opportunities, Dr. Jiang and Dr. Walker highlight alternative avenues. Exploring research collaborations with Maternal-Fetal Medicine (MFM) on REI-adjacent topics like adverse pregnancy outcomes in IVF or placental anomalies, or with Gynecologic Oncology on oncofertility patient care, can demonstrate a commitment to the field.

They also address the scenario of mid-career shifts within residency. For those who discover their passion for REI later, it's crucial to see existing research projects through to completion. A first-author publication on one or two well-executed projects holds more weight than being a middle author on numerous smaller ones. The personal statement provides an opportunity to explain the transition and highlight relevant prior research.

For residents in community programs with limited research infrastructure, away rotations at academic centers with established REI fellowships can be invaluable. These rotations not only expand networks and offer exposure to different practice styles but also provide opportunities to engage in research. Dr. Jiang and Dr. Walker emphasize the "three Ps" of a successful away rotation: being productive, professional, and personal, as these experiences can lead to crucial letters of recommendation. They also suggest proactively reaching out to program coordinators or fellowship directors to inquire about away rotation possibilities, even through "cold emails," as demonstrating initiative is key.

Geography: Charting Your Future Course

The second video delves into the significant role of geography in the fellowship match process, emphasizing its connection to future career paths and program ranking. Dr. Jiang and Dr. Walker underscore that personal circumstances, evolving family dynamics, and long-term career aspirations should all factor into geographical preferences.

They advise applicants to consider the type of practice they envision for their future: private practice, a private-academic hybrid, or a large academic institution. Understanding these distinctions is crucial, as fellowship programs can vary significantly in their structure and focus. While academic programs often provide stronger networking opportunities for future academic careers, exposure to different models can broaden perspectives.

The discussion also touches upon the impact of practicing in a mandated versus a non-mandated state regarding IVF coverage. Training in a mandated state can expose fellows to a wider range of protocols and treatment approaches, as financial constraints may be less of a primary concern for patients. Conversely, training in a non-mandated state often involves more in-depth discussions about the financial aspects of care. The experts encourage residents and fellows to actively engage in these financial conversations to better understand the complexities of access to care.

Finally, Drs. Jiang and Walker highlight the importance of surgical experience and how geographical choices can influence this aspect of training. With a resurgence of interest in REI surgeons, they point to programs, particularly those participating in the Surgical Scholars Track through the SREI/SRS program, that offer more extensive training in minimally invasive procedures like advanced laparoscopy, myomectomies, and endometriosis surgery. Applicants with a strong interest in incorporating surgery into their future practice should prioritize these programs in their applications and rankings.

SRS SREI Bootcamp and Wrap Up: Focusing on Surgical Excellence

The third video serves as a more in-depth look at the SREI-SRS partnership and the Surgical Scholars Program. Drs. Jiang and Walker highlight three unique benefits of these programs for aspiring REI surgeons.

Firstly, they offer significantly more hands-on experience in advanced minimally invasive surgery beyond standard hysteroscopies and basic laparoscopy, providing fellows with the necessary patient volume for comprehensive surgical training in areas like myomectomy and endometriosis resection.

Secondly, these programs incorporate robust didactic curricula specifically focused on surgical theory, providing a strong theoretical foundation to complement the practical experience. Lastly, fellows in the Surgical Scholars Program are required to complete a research project centered on a surgical question, fostering a culture of academic inquiry and preparing them for future research endeavors as attending physicians.

Dr. Jiang and Dr. Walker strongly encourage applicants with an interest in surgery to apply to these specialized programs, clearly articulate their surgical aspirations in their applications, and prioritize them in their rank lists to ensure they receive the focused surgical training they desire. They conclude by reiterating the key considerations for geographical choices: aligning with desired practice style, understanding the implications of mandated versus non-mandated states, and securing adequate surgical training for future career goals.

Fellows Perspective: Shaping Your Research Trajectory

The final video shifts to the fellow's perspective on research, with Drs. Jiang and Walker discussing the crucial decision of pursuing clinical versus basic science research and how this aligns with program selection. They emphasize the importance of understanding one's future career goals when considering research pathways.

Basic science research, involving laboratory-based investigations, may not be the right fit for everyone. Some programs offer a dedicated lab year, while others are more translational, allowing fellows to engage in research more directly applicable to clinical practice. Applicants are advised to inquire about the availability of different research projects and the previous research outcomes of fellows at each institution to determine if the program aligns with their research interests.

Highlighting specific research interests or prior publications related to established research groups within a program can significantly strengthen an application and interview. This demonstrates a potential for a smoother transition into an autonomous and productive research year.

Dr. Jiang and Dr. Walker conclude by summarizing key takeaways for all applicants: prioritize quality over quantity in research, focusing on impactful projects where you are a first author; don't hesitate to proactively reach out for away rotations or research opportunities, leveraging the connectivity of modern research; and ensure that chosen research projects are feasible and likely to lead to timely publication within the fellowship application timeframe.

By thoughtfully considering these insights from experienced REI professionals, aspiring fellows can navigate the match process with greater clarity and strategic focus, ultimately increasing their chances of securing a fellowship that aligns with their personal and professional aspirations.