In the past five years, 100% of Tulane’s residents seek fellowship training have been placed in a fellowship. Twenty percent of our graduates are hospitalists, and twenty percent are general medicine primary care physicians. Sixty percent of our residents will pursue fellowship training in some of the best programs around the country. Have a look at the distribution map for fellowship training to see where they go.

How do you ensure fellowship placement? As someone who reviews applications each year, let me tell you what it takes to find your fellowship of choice.

First, your application has to be more substantial than your application for residency. Fellowship directors want to know that they will not have to waste time teaching you internal medicine: you should have learned that in residency. Residents who have trained on the wards at our three hospitals easily satisfy this requirement: if you can handle the diversity and volume of patients seen at Charity, you can practice medicine anywher.

Second, you need to demonstrate that you know, at the very least, the fundamentals of research. Again, the fellowship director does not want to waste time training you in these fundamentals: he or she wants to be able to plug you into a research project from the very beginning of fellowship. Even if a career in research is not in your long-range plans, it is still worth mastering these fundamentals, if only to better appreciate the importance and limitations of medical research. All of our residents will finish with a national presentation or a publication. This is made possible by having enough elective time in all three years to begin a research project (3 months in the intern year, for example). The strength of Tulane’s subspecialty and general internal medicine sections has vastly increased the number of mentors and research opportunities.

Third, most academic fellowships want fellows that have the ability to teach, since this is what makes them exponential. Tulane residents are required to do one teaching assignment each year; most will do three or four. Two-thirds of all preceptors for the first and second year students are Tulane Internal Medicine Residents. Teaching has a just reward for those who engage in it, for it clearly defines the limits of your knowledge. Once defined, and gaps filled in, the teaching resident becomes the stronger clinician.

Finally, you will need two strong advocates when it comes time to make that telephone call to the fellowship director of your chosen program. It will be too little too late if the program director and chairman try to learn your name and everything about you in the ten minutes before that call. Tulane’s greatest strength is in the personal involvement of the chairman and the program director in the residents’ lives from the very beginning of their residency. The program director (or coach, as Dr. Wiese is called) meets with each resident twice a year in addition to the frequent interactions on the wards and in Friday School and about town. The Department Chairman, meets with each resident once a year. Career planning begins from the outset, and this makes all the difference in getting you the fellowship of your choice. There will be many great applicants vying for that position you want; you will need more than just good letters of recommendation, you will need (and frankly, you deserve) a couple of strong advocates who will go to bat for you via that personal phone call. You won’t find this at very many programs, especially those that are monstrous in size; but you will find it at Tulane.