Preparing for the Future: Pursuing Fellowship After Residency

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Medical students considering a residency with Duke Head and Neck Surgery & Communication Sciences have many opportunities for career development and mentorship. It is never too early to become familiar with these resources as they establish goals for after residency and consider how their time at Duke can help achieve them.

William Reed, MD, MPH, a chief resident in Duke’s Otolaryngology Residency Program, completed his residency in June and will be taking his next steps at the University of Alabama, where he’ll be a fellow in the Head and Neck Oncologic and Reconstructive Surgery Fellowship Program.

In a recent interview, Dr. Reed offered insights and advice for prospective residents.

How did your residency prepare you for pursuing a fellowship?

I feel well prepared. The point of surgical residency for me has been to equip me with foundational skills and competencies that I can mold into what my practice is going to be.

We do a lot of different things in ENT. We do ear surgery, we do facial plastics, sinus surgery, surgeries on babies, and surgeries on 100-year-olds. For me, residency was less about mastering all of those things and more so discovering what makes me excited to get out of bed.

What appealed to you about pursuing a head and neck cancer fellowship?

I really enjoy being the person that somebody counts on. When I meet a new patient that has head and neck cancer, I become one of the most important people in their life. I see that as a sacred space.

I'm convinced that people just crave a human connection. And I think that's never more true than with cancer. People want a person to talk to. You can go online and download a PDF of the treatment plans and staging guidelines, but people don't want that — people want to see a human being and trust them.

Why should a medical student think about a residency in otolaryngology?

As a medical student, what I loved about my subspecialty of Head and Neck is that it’s one of the few areas that you can be really helpful. It's a big incision, a big open surgical field — you can have a hand in there and retract. That's when surgery really came alive for me — feeling like I could actively participate, which I think makes anyone a more engaged learner. It's intricate and beautiful anatomy. And I like the problem-solving aspects of it.

Why did you choose Duke for your residency?

I came to Duke because of the people. There are a lot of great programs out there for ENT. It just so happened that an acquaintance of mine, Dave Straka, was a resident here. As I was finishing up medical school, I asked him how he got into Duke. I was thinking about doing general surgery to go into surgical oncology or maybe medical oncology. Dave said, “You should spend a month at Duke this summer as a rotating student and you should be an ENT”. And that’s what I did.

It was when Dr. Francis first arrived. It was an exciting time to be at Duke, with a lot of changes and growth. We were on the precipice of launching our department. For me, thinking about the next steps in my life and trajectory, I thought, this is a train that is moving. I should get on board.

What sets Duke apart from other residency programs?

Duke believes in all sorts of academic success and career success. Residents here get rich and broad exposure to all of the different subspecialties within ENT. That's not the same everywhere. And all of the ways we work hard are not equally respected or valued in other places. Residency is hard. If you feel valued as a team member, you'll be a lot happier.

I think a huge strength of Duke is that you get to try a lot of different things. I spent months doing just pediatrics or just ear surgery. And if you want to take the dive, you get to. A strong asset of our training experience is that you can swim as deep as you want. You have people who are experts and world-renowned surgeons, researchers, and scientists. We also have multidisciplinary collaborations with other strong departments and divisions — neurosurgery, plastic surgery, and general surgery, for example.

Outside of the hospital and health system, Duke University itself is an academic powerhouse. I got involved with the engineering school and the business school to do things like medical device design. At a place like Duke, all you need is an idea, and the resources are there. We have an institution that is bursting at the seams with smart people and tons of resources.

How have the faculty helped you in pursuing a fellowship?

Mentorship was most important for me before I even selected what kind of fellowship I was going to do. They helped me take inventory of what is it that I care about. What is it that I love or find satisfying about my work? And they wanted to know how they could help me. That’s good mentorship.

Dr. Francis is great. Dr. Woodard, our program director, is always advocating for us and going to bat for us.

Dr. Kahmke was one of the big reasons why I wanted to go to Alabama because I look up to him a lot. I admire his practice and the way he operates and takes care of people. Following in his footsteps would be a great thing. Dr. Kahmke provided candid, honest feedback as I decided what my next step should be.

What advice do you have for prospective residents?

You don't get to choose your family that you're born into, but you do get to choose your residency family. It’s one of the most important decisions that you'll make. It really is the launching pad for your professional career.

I challenge our applicants to think about what it is that they value and what they want from their careers. When thinking about a program, look at the people who are graduating, or the faculty who they're hiring. Ask yourself, is that who I want to be like? Are they doing things that I want to do? Are they taking care of the people that I want to take care of? Do they have careers that are balanced and rich and satisfying? And if the answer to those questions is yes, then that's a green flag.

I spend a lot of time with my coresidents. All hours of the day and night. Some significant bonding happens. Residency can be difficult in terms of the hours and some of the trying emotional circumstances that can happen. But you get to grow into being surgeons together. We're doing a variety of things. One person is doing a head and neck cancer fellowship, another is going to do a voice and swallowing/laryngology fellowship, and then another person is going directly into a great private practice job. I'm just really proud of how we've all grown up.


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