Residency Mini-fellowships in the PGY-5 Year: Is There Added Value?

With the restructuring of radiology board certification, many residencies created PGY-5 "mini-fellowships," during which residents spend focused time pursuing advanced subspecialty training or developing nonclinical skills in leadership, health policy and health-care economics, education, quality improvement, informatics, research, or global health. We surveyed graduates of an academic diagnostic radiology residency to assess the relative value and impact of PGY-5 mini-fellowships on career satisfaction and success.

From 2012 to 2016, 39 radiology residents at our institution were offered the opportunity to pursue a 3- to 6-month mini-fellowship during the PGY-5 year. Thirty of 39 radiology residents (77%) participated, whereas 9 of 39 (23%) opted out. Of 39 residents, 13 completed two clinical mini-fellowships, 3 completed research mini-fellowships only, and 14 completed one nonclinical and one clinical mini-fellowship. Through SurveyMonkey, 23 of 39 residents (59%) responded to a questionnaire that collected basic demographic information and asked respondents about the value of this experience as it relates to fellowship choice and career using a five-point Likert scale.

Of 23 respondents (14 male, 8 female,1 not specified), 78.3% practice in an academic university-based setting, with 8.7% in a community-based hospital practice, 4.3% in the veterans system, and 4.3% in a private practice setting. Of 23 respondents, the most popular clinical mini-fellowships were magnetic resonance imaging (31.6%), neuroradiology (21.1%), and interventional radiology (15.8%). For nonclinical mini-fellowships, the most popular were research (10.5%), education (10.5%), global health (5.3%), and healthcare economics (5.3%). Of 23 respondents who did mini-fellowships, 95% felt that the mini-fellowship prepared them well for their career, 85% felt it gave them the necessary skills to succeed, 85% cited that it gave them additional skills beyond their peers, and 40% felt it helped them create a life-long connection to a mentor. Ninety-five percent of respondents would choose to do the mini-fellowship again. Respondents suggested increasing the duration to 6-9 months and to develop a more structured curriculum and mentorship component. Only one respondent felt that the nonclinical mini-fellowship took away time from furthering clinical skills.

Graduates of a university-affiliated academic radiology residency who participated in clinical and nonclinical mini-fellowships during the PGY-5 year of residency greatly value this experience and uniformly recommend that this type of program continue to be offered to trainees given its ability to develop skills perceived to be vital to ultimate career satisfaction and success.