Many different forms of postgraduate training are available. A fellowship usually designates a period of training that includes specific academic requirements. To be accredited, a fellowship must last a minimum of 12 months. By comparison, a preceptorship is a period of more informal training and is not usually subject to the same academic requirements. A preceptorship does not permit formal recognition of a level of training.
The decision to apply for a fellowship should be made carefully. Fellowship training is not for everyone. Some of the reasons for taking a fellowship include the desire to develop special skills and interests in a subspecialty area or to pursue the opportunity to do further research and writing in preparation for an academic career.
If you decide to pursue fellowship training, the following considerations should be weighed. A fellowship program closely associated with a residency program at a teaching hospital allows wider contact, more opinions, and an increased emphasis on formal teaching, conferences and professional interaction. A nonaffiliated fellowship, on the other hand, offers the potential of a close personal relationship with the director and the opportunity to learn a surgical method in depth. You should determine if the fellowship is accredited by the Accreditation Council for Graduate Medical Education (ACGME) or if application for accreditation has been made and, in addition, if this is important to you.
Research activity is an important aspect of a fellowship and is generally a requirement for accreditation. The type of research, how much time is devoted to it, and whether it is clinical or basic science, should be investigated.
Exposure to patient evaluation and clinical decision-making is as important as the surgical experience and should be considered. The surgical experience of a fellowship needs to be broad and varied with a sufficient caseload to enable you to develop the skills needed for your discipline. You will also need to inquire as to how resident and fellow responsibilities are balanced.