If you’re in the final stretch of your residency and starting to think of the next step in your medical career, you might be wondering what a medical fellowship entails. Most doctors feel satisfied to enter the workforce after finishing their residency, but others choose to go the extra mile and pursue a subspecialty. After carefully choosing the medical specialty you want to pursue and undergoing residency training, if you have become interested in a narrower aspect of your specialty and want to dig deeper, a medical fellowship might be just the thing for you! But what exactly does it take to become a specialist in your preferred field? Medical fellowships are extremely demanding training programs, so establishing whether they are going to be worth the effort is a big decision.

To answer all these questions and help you understand the world of fellowships, this article will walk you through the pros and cons and give you some insight into whether or not you should undertake this kind of training.

Please note: although we have made every effort to provide the most accurate information, admissions information changes frequently. Therefore, we encourage you to verify these details with the official university admissions office. You are responsible for your own results. BeMo does not endorse nor affiliate with any official universities, colleges, or test administrators and vice versa.  If you see an error here, please notify us with the updated information, and we’ll send you a FREE copy of a BeMo ebook of your choosing! You can receive our Ultimate Guide to Med School Admissions, our Ultimate Guide to MMI Prep, our Ultimate Guide to Medical School Personal Statements & Secondary Essays or our Ultimate Guide to CASPer Prep! Please email us at content [at] bemoacademicconsulting.com with any corrections, and we’ll arrange to send you your free ebook upon confirming the information.

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Article Contents
10 min read

What is a Medical Fellowship? Medical Fellowship Application Requirements Medical Fellowship Application Process Average Salary of a Medical Fellow Why Should I Pursue a Medical Fellowship? Conclusion FAQs

What Is a Medical Fellowship?

A medical fellowship is a training program that allows doctors to develop further expertise in their chosen field after finishing their residency. During this period, fellows get the opportunity to work in cooperation with experienced specialists in order to deepen their knowledge and skill in their chosen medical specialty. As promising as this may sound, fellowships are not for everyone.

Medical fellowships are quite challenging, as they are meant to provide fellows with relevant work experience. These training physicians are thus given a lot more responsibility than during their residency.

There are different kinds of fellowships, with different durations and structures. Some institutions even offer the chance to combine fellowships and become a specialist in two or more fields within a single program. For example, candidates can choose a pulmonary and critical care fellowship to expand their knowledge in both areas. 

How Does a Medical Fellowship Work? 

First of all, it is important to mention that this kind of training is not mandatory. Fellowships are optional and not required to practice medicine. However, they are necessary if you want to become an expert in certain subspecialties, such as transplant hepatology or pediatric internal medicine.

Another key aspect to consider is that not everyone is accepted to fellowship programs. Fellowships require a great deal of commitment and dedication. The number of fellowship positions available each year is rather limited. The competition is quite fierce and only a handful of applicants get selected, making it an extremely challenging process, which adds extra pressure not everyone can handle. You must be a very competitive candidate to be eligible for a medical fellowship program.

Although fellows do get paid, it is usually not financially equivalent to being a staff physician. But given the advantages of undertaking such programs, most professionals see it as a valuable investment of their time. Specialists, who are some of the highest paid doctors out there, start earning much higher salaries than general practitioners once they become physicians, so even though you do not get paid much in a fellowship, this training will result in a higher income once you become a full practicing physician. 

How Long Is a Fellowship Program?

Depending on the chosen specialty, medical fellowships have a duration of 3 to 7 years.

What Does it Mean to Be Fellowship-trained? 

The title of ‘fellowship-trained’ is considered to give doctors additional merit or prestige. Notice that a fellowship is not a degree itself –it only indicates that the physician received additional training in a specific subarea. Fellowships often involve research and opportunities to publish your work. Additionally, as a fellow, you will be able to make contacts in your field, which can be a major asset when it comes to advancing your career.

Patients who suffer from severe or rare conditions usually prefer to seek advice from specialists instead of general physicians, which means that fellowship-trained physicians have a lot more variety in terms of the cases they treat. 

If you have not yet reached the point of selecting a medical specialty, you might find these tips helpful:

How Much Does It Cost to Apply to a Medical Fellowship? 

It is usually not just time that needs to be invested in order to become a specialist in a certain medical field, but often money as well. You are already familiar with the overwhelming medical school cost, so you might be wondering how much more money you need to spend after residency to become a specialist in your chosen field.

Let’s talk about application fees and their significance when it comes to applying for medical fellowships. As it was previously stated, given the competitiveness of these training programs, candidates often choose to try to beat the odds by applying to several different programs at the same time.

In the US, for instance, it is very common to submit your applications through the Electronic Residency Application Service (ERAS). The cost of the ERAS fellowship applications is tiered. The more applications you send, the more you will be paying per application.

You will also need to consider additional fees, such as transcript orders and interviews, the last being the most expensive element of this process. Fellowship applicants spend an average of $4,000 on interviews. Needless to say, this number doesn’t cover incidental expenses like transport, meals, or attire. 

When to Apply to Fellowships 

Residencies are often mandatory to practice medicine, while fellowships are completely optional. The purpose of a residency is to become a board-certified physician, while fellowships consist of further training in a certain specialization. If you only intend to practice medicine, a residency will be enough, but if you want to enter academic medicine, a fellowship becomes a must.

You can only start applying to fellowships once you have completed your residency, although that doesn’t mean you shouldn’t start planning your application even in the early stages of your residency.

Some residency programs offer mentorships. Mentors can be extremely helpful when it comes to introducing you to other colleagues, helping you find research opportunities and basically serving as a valuable source of knowledge and information. Finding a mentor who completed the fellowship that you are interested in would represent a great advantage. 

What Are the Requirements to Do a Medical Fellowship? 

If you plan on pursuing a medical fellowship, you should get to work on your application as soon as possible. Keep in mind that some applicants start preparing themselves years in advance. Start your preparations in the early years of your residency. The medical staff, as well as your program director, can guide you through the application process by giving you advice, referring you to the right people, or rearranging your schedule so that it can adjust to your application process.

Before finally moving on to the technical requirements, it is essential to mention that you must be extremely motivated and passionate about your field. You must determine whether or not a fellowship is the right course of action for you in the long term. Fellows should also be self-sufficient and possess strong interpersonal and leadership skills.

Keep in mind that in order to have a solid chance of getting into a fellowship, your background and experiences—such as extracurriculars, rotations, and electives—should demonstrate that you actively sought out to build skills and experiences in this field.

Every program is unique and candidates often have to apply to a variety of fellowship programs to increase their chance of getting accepted.

Regarding academic requirements, the list is always the same:

  • 16 years of undergraduate schooling (grade school, high school, and college)
  • Medical school
  • Post-graduate year or internship
  • An active medical license (if in clinical practice)
  • 4 years of specialty training, most commonly known as residency

Other eligibility requirements:

  • Professional activity in your chosen area
  • Experience in clinical practice or in an academic position for a certain number of years
  • Publications
  • Additional educational activities
  • Some type of teaching experience 

Medical Fellowship Application Process 

Needless to say, if you’re finally determined to apply for a fellowship, you will have your work cut out for you. In addition to the application requirements we list below, don’t forget that you must also prepare for interviews.

1. Medical CV

Your medical CV should be very similar to the residency CV you submitted as part of your residency application. As you go through your residency training, make sure to amend and add new skills and experiences to your CV to prepare it for your fellowship application. Try to stick to 2-4 pages at most to highlight your greatest achievements and suitability for the fellowship and the subspecialty you want to pursue.

Make sure to include details of your current employment, as well as previous work experience, qualifications, awards, courses, conferences, and publications.

Last but not least, all great CVs must include references. Most frequently your current and/or last employer. You should include their full names, their positions, and full contact details.

2. Letters of recommendation

Ideally, you should include at least four strong letters of recommendation. Make sure to ask people who know you well. Ideally, someone you have worked with, and who can emphasize your strengths. They don’t necessarily have to be doctors from your chosen specialty, although it would be preferable.

Letters from friends, relatives, or other students are strictly discouraged. You might also want to keep in mind that recent contacts are much more relevant than old ones. Get in touch with the contacts you made during your last years of residency and be clear about what you need from them. Try to prepare this with enough anticipation, as it might take the writers a while to send their letters.

Don’t be afraid to ask, all experienced physicians and faculty members are used to writing this kind of letter all the time.

And if you ever have someone ask you to write your own letter of recommendation for them to review and sign, here's how you can do so:

3. Application form

Every application process involves filling out an online form. They are usually easy to access on each program’s website and request some basic information about the applicants.

4. Personal statement

Similar to a cover letter, a personal statement is a brief summary of your aptitudes and qualifications for a certain position. You have already written a residency personal statement which outlined your interest in a chosen specialty and you fellowship personal statement will be similar to this. Remember, personal statements are meant to help you stand out from the other candidates who want to pursue the same subspecialty as you.

The whole purpose of a personal statement is to sell yourself to the reader, by highlighting your traits, skills, and experience that make you the perfect fit for your chosen specialty and the program.

Try asking yourself questions such as why you would be the perfect candidate for that specific program and specialty, or what makes you special, and use them as a guide to write a short essay (around 600 words). It must be brief, but concise and convincing at the same time.

Medical Fellowship Interview 

One of the defining steps of your application process will be an interview. You never get a second chance to make a great first impression, so you must be prepared. Fellowship interviews can take many forms, including traditional one-on-one and panel, so make sure to prepare for the specific interview format of your chosen programs.

Make sure to practice your answers beforehand. They should be short and concise. Try doing a mock interview with a trusted professional to practice. It is also crucial to study the program in depth, as you might be asked about what makes you the best candidate for that specific fellowship. Last but not least, work on your body language. Sit up straight and do some breathing exercises to calm your nerves before the interview. You should look relaxed and confident.

Interested in an overview of some of the key steps you will need to take? This infographic is for you:

Average Salary of a Medical Fellow

Pursuing a fellowship training program is not just academically but also financially rewarding.

As a fellow you should expect to earn between $50,000 and $66,000, which doesn’t differ much from the salary of an advanced resident. Even though it is considerably lower than what a staff physician can make, you should also consider how much you would be earning as a specialist once you finish your fellowship.

Here’s a list of the average fellowship-trained physicians' salaries by specialty:

Why should I Pursue a Medical Fellowship? 

There are many reasons why you might be thinking about pursuing a fellowship training program, but the truth is that not every doctor is an ideal candidate. Consider the following advantages and disadvantages:

Pros of a Medical Fellowship

  • It represents a worthwhile learning experience.
  • On average, fellowship-trained specialists earn $106,000 more per year than general physicians.
  • It is an excellent opportunity to make contacts in your area.
  • It involves valuable additions to your medical CV, such as research and publications.

Cons of a Medical Fellowship

  • Longer training means more years without being able to take your income to the next level.
  • Highly competitive and expensive application process.
  • Demands a considerably higher level of commitment and responsibility than a residency, for a fairly similar financial compensation. 

You Should Consider Doing a Medical Fellowship If…


The title of ‘specialist’ is very prestigious in the field of medicine. Specialists tend to have much higher salaries than general physicians and are sought out by patients who need expert hands. In order to become one, you must have a strong interest in a particular subspecialty and receive special training for 3 to 7 years.

During your time as a fellow, you will be able to work alongside experts in your area, which will provide you with valuable work experience, not to mention you will have the opportunity to make contacts, which are an essential asset in the field of medicine.

But all that glitters is not gold, as medical fellowships are extremely competitive and involve an exhaustive application process. You have to be willing to undergo a series of interviews and collect relevant documentation, such as recommendation letters, and publications.

Fellows don’t tend to earn much more money than residents and fellowships take a minimum of three years to complete, so it has to make sense to you financially as well as academically.

Overall, fellowships are extremely rewarding experiences and represent outstanding professional achievements. If you truly feel passionate about your specialty, pursuing a medical fellowship might be the right course of action for you. One thing is for sure: you will not regret it!


1. Are Medical Fellowships Mandatory?

No, fellowships are optional, unless you want to enter academic medicine, in which case special training might be required.

2. Are Medical Fellowships Paid?

Yes, the salary of a fellow is similar to that of an advanced resident, if not a bit higher.

3. Can any doctor choose to do a medical fellowship?

Only doctors who have finished their residency can apply for a medical fellowship, although the opportunities are scarce. Only the best candidates will be offered the opportunity to undertake fellowship training.

4. Is a Medical Fellowship Worth Pursuing?

Depending on your professional goals, a fellowship might be the right path to follow. If you’re passionate about narrowing your focus and expanding your knowledge on a certain subspecialty, this type of training will help you achieve your long-term career objectives. On the other hand, if you’re not willing to invest the first few years after finishing your residency, you might prefer to stick to general practice.

5. Do Fellows Get a Degree?

After finishing your medical fellowship, you will earn the title of ‘fellowship-trained’. Fellows are certified physicians who obtained their medical degrees and finished their residency. A medical fellowship only represents additional training, although it represents a major achievement in the medical community.

6. What’s the Difference Between a Fellow and a Resident?

Fellows are fully independent physicians who have already finished their residency. They are completely capable of practicing medicine, while residents are still considered to be in training. Fellows, therefore, are often given much more responsibility than a resident.

7. When Should I Decide If I Want to Do a Medical Fellowship?

Ideally, you should make up your mind during the first years of your residency in order to have enough time to make the right contacts and decide which subspecialty interests you the most. However, it doesn’t necessarily have to be right after you finish your residency.

8. Can I Specialize in More than One Subspecialty?

Yes, some programs offer combined fellowships that allow you to receive training in two subspecialties at the same time.

To your success,

Your friends at BeMo

BeMo Academic Consulting

Source for fellowship lengths: Washington University School of Medicine

Source for application fees: ERAS official website

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Hi, I am ECFMG certified and currently doing my training in internal medicine in the UK to obtain certificate of completion of training (CCT). Can I apply to fellowship programs in the US without doing US residency and use my CCT from UK as evidence of completion of training ? All the best Mohamed


BeMo Academic Consulting

Hello  Mohamed! Thanks for your question. It really depends on the fellowship, but if you plan to stay and practice in the US, you will have a better chance with residency training in the US.