Smith L G, Feit E, Muller D
Department of Medicine, Mount Sinai Medical Center, New York, New York 10029-6574, USA.
Acad Med. 1997 Feb;72(2):152-4. doi: 10.1097/00001888-199702000-00026.
The application process for fellowships in internal medicine subspecialties begins approximately 18 to 24 months before the start of training, requiring residents to decide on a career by the beginning of their second year of residency. The authors surveyed the internal medicine residents at Mount Sinai Hospital to assess their attitudes toward the fellowship application process.
A survey instrument was designed and given to all 121 residents in 1994-95. The instrument surveyed the residents' career plans and the timing of their decisions, inquired about the effect on their residency of applying for a fellowship, and asked the residents to assess and comment on the timing of the fellowship application process.
In all, 80% (97) of the residents responded. Nearly two-thirds intended to apply for fellowship training; however, 17% of the first-year residents had changed their minds about their fellowship plans, and 50% of the second- and third-year residents had changed career plans. Whereas 79% of the first-year residents intended to apply "on time" during their second year, only 29% of the second-year residents intended to do so; 25% of the third-year residents planned to delay entry into a fellowship. Nearly two-thirds of the first- and second-year residents felt uncomfortable making an informed fellowship decision in their second year. In all, 60% of the residents felt they had to do research in order to get a competitive fellowship, and 68% said they had to change their assigned residency schedule to "get credentials" for fellowship applications. The consensus of nearly all the residents was that the timing of fellowship applications was much too early and should be moved to the middle of the third year.
As the current system of applying for medical fellowships is generally experienced negatively by residents, the authors recommend that the process be moved to the middle of the third year and that medical schools, residency programs, and fellowship training programs reconsider the entire fellowship application process.
内科亚专业奖学金的申请流程大约在培训开始前18至24个月启动，这要求住院医师在住院医师培训的第二年年初就决定自己的职业方向。作者对西奈山医院的内科住院医师进行了调查，以评估他们对奖学金申请流程的态度。
1994 - 1995年，设计了一份调查问卷并发放给所有121名住院医师。该问卷调查了住院医师的职业规划及其决策时间，询问了申请奖学金对其住院医师培训的影响，并要求住院医师对奖学金申请流程的时间安排进行评估和评论。
总共有80%（97名）住院医师回复了问卷。近三分之二的住院医师打算申请奖学金培训；然而，17%的第一年住院医师改变了他们的奖学金计划，50%的第二年和第三年住院医师改变了职业规划。虽然79%的第一年住院医师打算在第二年“按时”申请，但只有29%的第二年住院医师打算这样做；25%的第三年住院医师计划推迟进入奖学金培训。近三分之二的第一年和第二年住院医师认为在第二年做出明智的奖学金决策让他们感到不适。总体而言，60%的住院医师觉得他们必须进行研究才能获得有竞争力的奖学金，68%的住院医师表示他们必须更改指定的住院医师培训日程以“获取”奖学金申请所需的资质。几乎所有住院医师的共识是，奖学金申请时间太早，应该推迟到第三年中期。
由于住院医师普遍对当前的医学奖学金申请系统体验不佳，作者建议将申请流程推迟到第三年中期，并建议医学院校、住院医师培训项目和奖学金培训项目重新审视整个奖学金申请流程。
