A fellow finds greater career opportunity after seeking an extra year of training
Dr. Neringa Kunigonis, DPM spoke with senior editor Samantha Williams about the experiences, responsibilities, and everyday intricacies of a fellow.
Dr. Neringa Kunigonis
SSC Sports Medicine Fellowship- Irvine, California
Dr. Kunigonis always knew she wanted to go into medicine, but was still deciding which specialty to pursue during her undergraduate education. She volunteered at many hospitals, but it wasn’t until she stumbled upon a podiatrist who made a very good impression on her that she decided to pursue podiatry. She attended Scholl School of Podiatric Medicine in Illinois.
When selecting her externships and potential residencies, Dr. Kunigonis primarily focused on the Chicago area. “As I went through externships”, Dr. Kunigonis explains, “I had a better sense of what was important to me in residency.” She was looking for an environment where the attendings surrounding her were willing to teach and were enthusiastic in doing so. It was also important, she explained, to fit into the culture of that particular residency. After prioritizing those interests, Dr. Kunigonis landed at Mt. Sinai Hospital for her three-year residency.
“There wasn’t anyone in my residency that was a strong proponent of fellowships”, Dr. Kunigonis explains, “but I think everyone was supportive of how residents chose to further pursue their career and education.” She expressed that after completing her residency, she wasn’t offered employment opportunities that she was excited about. However, after gaining extra skills and specialization through her fellowship, she was placed on a different plane. “When you’re going into a big group or private practice, having that on your CV makes you more attractive to your employer”, Dr. Kunigonis conveyed.
She knew she wanted a surgical fellowship, so Dr. Kunigonis primarily focused on ACFAS-accredited programs. When she would visit the ACFAS website, she found that there wasn’t enough information available to narrow her search. She consistently used the contacts available with each program to communicate with either the coordinator or director themselves to find the answers to her questions. This is also how she would set up program visits.
Dr. Kunigonis describes the fellowship application process as “not as centralized as the residency application”. There is a specific ACFAS application that the applicants send to the programs of their choosing, but after this is completed, the process is rather program-specific. However, there is a posted hard deadline on the ACFAS site for the programs’ final decision. She landed at SSC sports medicine fellowship in Irvine, California with director Dr. Adam Hewlett.
As a fellow at this program, her primary responsibility is to cover the surgeries at the specialty surgery center. When she isn’t in surgery, she is in the clinic. “As a fellow”, Dr. Kunigonis expresses, “I get to spend a lot more time focusing on my own skills to evaluate what I’m efficient in and what I need to work on.” In residency, she was constantly coordinating with her eight other co-residents and students visiting the program, which she felt was a good experience. However, a lot of the teaching and oversight took away from focusing on her own skills. “Fellowship is a great time to focus on this without having any other distractions”, Dr. Kunigonis states.
When describing how fellowship differs from residency, Dr. Kunigonis explains that she has a lot more autonomy and trust placed upon her by her attendings. “When I was a resident, sometimes I would have to work with an attending for months before they handed me the blade. In fellowship, “this process is accelerated”, she explains. In the clinic, there is even more of this. She sees patients, works them up and develops a treatment plan without having to report back to an attending each time. The granted independence has been a nice transition for her.
The great benefit of fellowship is learning different skills from different perspectives than what is seen in residency.
By the end of her fellowship, Dr. Kunigonis plans to complete about 300 procedures. A majority of these cases are elective, such as bunions and hammertoes, but at SSC, she sees a lot of sports type injuries as well. Dr. Kunigonis appreciates that it is not a tunneled type of environment, but rather an array of pathologies with a diverse patient population.
She advises anyone seeking a fellowship to define the motivation and goals behind doing so. “Doing a fellowship just because you want to”, Dr. Kunigonis explains, “does not translate well to directors and doesn’t convince them of your motivation in pursuing this extra education.” The great benefit of fellowship is learning different skills from different perspectives than what is seen in residency. Dr. Kunigonis feels she is expanding on surgical and clinical skills, as well as more practical knowledge for private practice, such as coding and billing. Because of this, she feels much more prepared for the next step. The fellowship was teaching her to communicate with an array of medical staff and understand the role each member has in the health care system. “This is a year out of your life”, Dr. Kunigonis stressed, “so if you want to do it, be ready to get something out of it.”
By Samantha Williams
New York College of Podiatric Medicine
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