My recent neuroradiology fellowship interview trail was truly enjoyable — a chance to meet neuroradiologists I admire, reunite with old friends, and deepen my appreciation for the neuroradiology division at my current institution. Despite this pleasant experience, I feel the fourth (R4) year of residency would be better suited for fellowship interviews and the match.

Prior to restructuring the ABR board examination, it seemed logical to position fellowship interviews in the third year of residency. There was enough time to establish the next step in a resident’s life before becoming lost in the oral exam “board frenzy”.^1-3 Now, our third year residents take on the new ABR Core Exam, AIRP, meetings, projects, and clinical rotations/call in addition to the “fellowship frenzy”.⁴ And let’s not forget life outside of work. That’s a tall order for one academic year.

Moving fellowship interviews and the match to the fourth year would address problems not only related to applicants’ busy third year schedules, but also issues in the fourth year stemming from the new timeline of the ABR exams. Programs across the country are now stocked with a surplus of bright fourth year residents who have passed the boards and matched to fellowships. While these senior residents maintain an internal drive for success, the ambition and hunger seem to have dampened in some. Delaying the fellowship match may prolong residents’ eagerness about the field and desire to maintain a competitive edge.

The current timeline has its advantages. I am thrilled about the match results. Now I can take advantage of my last year with my residency institution and connect with my fellowship institution. Additionally, my husband and I have time to plan ahead for my fellowship year. However, a full year of advance notice is a luxury, not a necessity.

We have proven ourselves capable of relocating in a short time frame, doing so after the March residency match in the fourth year of medical school. Most of our peers take on fellowships late in their training — with 18 of 27 subspecialties participating in the match in the last year of residency.⁵ Furthermore, the largest number of respondents for the Association of Program Directors in Radiology survey (35%) believe the optimal time for fellowship interviews is the fourth year.⁴ If we cannot change the timing of other third year tasks, perhaps it is time for neuroradiology to relocate the fellowship interviews and match to the last year of residency.

References:

1. DeStigter KK, Mainiero MB, Janower ML, et al. Resident clinical duties while preparing for the ABR core examination: position statement of the Association of Program Directors in Radiology. J Am Coll Radiol. 2012:911:832–34.
2. Iafrate G, Kaye A. Timing of the oral radiology boards. J Am Coll Radiol. 2004:17:527–28.
3. Schultz KA. The short-shortsightedness of the new radiology boards. J Am Coll Radiol. 2014:119:842–43.
4. Rozenshtein A, Mullins ME, Deitte LA, et al. “What Program Directors Think” II: Results of the 2013 and 2014 Annual Surveys of the Association of Program Directors in Radiology. Acad Radiol. 2015:226:787–93.
5. The Match. nrmp.org. http://www.nrmp.org/wp-content/uploads/2015/03/SMS-Master-Calendar.pdf Accessed July 11, 2015