Advice for Graduating Fellows

Steven J Walsh, MD
Philadelphia Poison Center
Division of Medical Toxicology, Department of Emergency Medicine
Einstein Medical Center  
Philadelphia, PA

Like most fellows, I completed an emergency medicine residency and an acute care medical toxicology fellowship. Also similar to most graduating fellows, I was privileged enough to have wonderful and supportive role models at my training program. These mentors encouraged me to consider my post-fellowship plans very early on in my training.

What I have assembled here is a short list of unsolicited pointers from a young toxicologist for those of you who are beginning their post-fellowship career planning.

  1. Figure out what’s important to you. Any major choice begins with introspection. Be honest with yourself regarding what it is you’re looking for, both professionally and personally. If you have critical family considerations (geographic restrictions, etc.), take those into account. If compensation is important to you, don’t downplay that. While recent statistics show that more than 70% of new graduates will leave their first post-training job after two or less years, do everything you can to maximize your happiness!
  2. Trust your mentors. You chose your fellowship based on many things--the type of training program (“bedside” versus poison-center-centric); the geography; and the program history--all being important to most applicants. However, there is a good probability that one of the most critical reasons you chose your program was based on the people! Trust them. Solicit and listen to their advice, leverage their contacts at other programs, and learn from their mistakes.
  3. Make contacts at meetings. National meetings are a great place to network. It’s much easier than you think – toxicologists are generally a friendly group! Go to most of the sessions to get an idea of who’s doing what kinds of work and where they are doing it. That way, you can align your clinical, teaching, and research interests with what’s happening at given programs. Strike up a conversation at an interesting poster, say “hi” and introduce yourself. Don’t be shy – that seemingly minor conversation may be the key to your next job!
  4. Stay up-to-date with the literature. Keeping current with who’s doing what and where is also helpful in getting a “lay of the land” with respect to career planning. Fluency in today’s research will help you find a mentor whose interests are aligned with yours. Similar to fellowship, you want to end up somewhere that you will fit in from a clinical/research/teaching standpoint. Continued mentorship is an underappreciated aspect of early-career planning.
  5. Be open to various career options. The most “obvious” career choice for most of us is to pursue an appointment at an academic division of medical toxicology in a department of emergency medicine/internal medicine/psychiatry/pediatrics/etc. Many of these opportunities are advertised and therefore easy to find, and your fellowship mentors will likely have a myriad of contacts. However, other career routes are available! Research-based careers (particularly for those with MD-PhD degrees) and other opportunities in the pharmaceutical industry are out there. These offer a “change-of-pace” from the typical clinical medical toxicology career and may prove very attractive to those with business backgrounds and interests. A variety of governmental consulting positions (with CDC/ATSDR, etc) also exist. Additionally, consider striking out on your own and venturing into the world of private-practice medical toxicology. Understand that this option may be best suited for adventurers, since much of the private practitioner’s income is dependent upon legal/industrial/other consultative work, independent medical evaluation, and other non-guaranteed revenue sources.
  6. Keep your curriculum vitae and teaching portfolio up to date. This could be an entire column in itself! While your CV is obviously critical, don’t neglect the teaching portfolio. More and more academic institutions are interested in your non-research contributions to our field; the teaching portfolio is a great way to demonstrate your academic involvement. There are many online resources regarding constructing a teaching portfolio. A few quick tips would be to keep your didactic evaluations, seek out correspondence from your learners, and try to accept invitations to teach at extramural institutions. The bottom line is that it’s always a good idea to keep your application materials current. You never know when your dream job will come available, and it’s best to be prepared.

Be advised, this list is based simply on my own experience as a young faculty member; while it’s certainly not comprehensive, I think it’s a good starting point!


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