Fellowship training: a necessity in today's academic world.

You now are at the point in your training where you are beginning to believe that there is life after medical school and residency. This is an exciting time; you are about to get your first job as an attending emergency physician. The next decisions you make may be critical and could shape and define the remainder of your career. Before making these decisions and selecting a position, you should ask yourself several important questions. First, define as best you can your long-term career goals and aspirations. This should include your vision of the ideal emergency medicine (EM) faculty position , and should be as detailed as possible. Consider specifics, such as how you want to spend your workweek, and what percentage of your time you want to devote to various aspects of your job (i.e., direct patient care, medical student or resident education, administrative tasks, research, writing, committee work). Next research and answer the question, ''What is the best way to ensure that I will be able to attain these goals?'' If your goals include a career in academic EM, then the answer to the second question is easy—the best way to ensure your success and happiness as an academician is to obtain postgraduate training. If you want to pursue a specific clinical discipline such as pediatric EM, toxicology, or sports medicine, the need for fellowship training is obvious. But what if you want to focus your academic career in research or educa-tion? Is postgraduate training necessary for these career paths? The answer is an unqualified ''yes!'' (at least if you want to maximize your chances of success and career satisfaction). Now at this point you may be cringing at the thought of extending your training and delaying the financial rewards of a full-time faculty position. You may have significant debts hanging over your head that you are anxious to pay off. Despite this temporary economical sacrifice (and this is the only disadvantage to fellowship training), there are numerous rewards and advantages. I would like to take this opportunity to describe the benefits you are sure to reap if you pursue postgraduate training. First, fellowship training will allow you to attain a mastery of knowledge and skills in a given area well beyond that developed in residency. It will provide you with a level of expertise such that your colleagues will frequently look to you for advice and teaching. …