AN INTERVIEW WITH JAMES NAPLES, MD
What criteria did you consider when looking at applying for a Fellowship?
When looking for fellowships, there are a variety of factors to consider. Location, clinical experience, and research opportunites were probably the most important criteria for me. The relative importance of each of these factors is largely based on the personal interest of each candidate. Location is particularly relevant if you have a family or other reason to be in a certain area of the country for your training, but it is not important to everyone. As for the other criteria, some fellowships encourage more research, while others put more focus on the clinical experience. I had experience with translational research, so in addition to a comprehensive clinical experience, I sought opportunities in clinical and basic science research. This led me to seek out programs that had lot of resources and a track record of clinical and research productivity. I wanted the opportunity to mature my own ideas and surround myself in an environment where people would encourage this process. What this boiled down to for me was program infrastructure. I was looking for an institution that had a system in place to foster my clinical, translational, and basic science interests and provide me with the autonomy to execute some of these ideas.
How did you approach researching the different programs to determine which fit your interests?
I think the process of research programs for fellowship is more of a continuous process that starts as you become interested in a particular specialty. Going to national meetings like COSM and AAO-HNS and specialty specific society meetings (ARS, ANS, ABEA, ALA, AHNS) is a great way to “research” programs because it offers insights as to what type of experience is available to you at each program.
I was fortunate to find my passion early within my residency training. I knew within my first year, I wanted to pursue a fellowship in neurotology, so I was able to start researching programs throughout my residency. Once I had some background information on each program, I spent about three to four months really researching programs before fellowship interviews. This was as easy as looking at the departmental website and knowing who the faculty are. I then reviewed the faculty educational background and publications to see if there were trends in publication patterns and any overlap with interests of mine. This type of research about a program provides insights to each faculty member, and it offers easy conversation topics for an interview.
Who did you speak to and get advice in guiding your decision?
I talked early and often with my mentors from residency. My mentors were people from very different backgrounds, which provided a nice contrast in perspective on what to look for during this process. I also made it a point to meet in person to have these discussions. It demonstrates an elevated level of commitment to have a conversation face-to-face, and I think the conversation can be a bit more organic.
The other people that I owe a great deal of gratitude to during this process are some of the fellows at institutions I applied to. A current fellow can be a great resource because they are not far removed from the application experience, and they can often be easier to approach and contact than many of the faculty members or program directors. Similarly, they are often open and honest about their experience, which makes the process more personal for you as a candidate and helps eliminate uncertainties.
What strategy did you use to match your interests with the different programs?
The strategy for me that facilitated matching my personal interest with each program was looking at the program’s history. More broadly, the institutional history and track record of success. For example, I knew I wanted a fellowship that offered me the opportunity to succeed clinically and academically with various types of research. While the fellowship, itself, was newly established, the institution has an incredible amount of resources and robust histories of successful individuals. These factors were congruent with the vision of who I wanted to become. While this description may sound a bit idealized, there is a component of intuition that factors into this process. Often it is difficult to verbalize why you felt a certain way about a program, but ultimately, if you feel that the people you met during your interview day are representative of the person you want to become, the place is likely right for you.
Are there any tools or resources you would recommend?
I did not use any specific tools. I think society specific website and fellowship program websites provide the best resource for learning about programs. The concerns with some of the online forums available is that it can create anxiety in a lot of ways and the information may be misrepresented, so it may not all be accurate. In addition to society websites, attending society specific meetings is really important to make introductions and meet people. I know that I had to break my comfort zone quite often to introduce myself to people, but it turned out to be a great experience because I still keep in contact with many of the people I met. It is such a small world in otolaryngology that I think people appreciate the courage it takes to make a face-to-face introduction.
How did you evaluate the different programs to decide where to apply?
My experience on deciding where to apply was a bit different than most. Since the number of neurotology fellowship programs is so small, I ended up applying to all of them. However, I used advice from my mentors about what to be expect at some institutions. A good mentor should be open about his or her training experience and be honest with the candidate about how their traits match up with some of the programs. If there is a program that has opportunities that seem to fit with what the candidate is looking for, the mentor should emphasize the good fit. Similarly, if a program lacks some of what a candidate is looking for, that should be discussed as well.
The reputation of a program certainly influences most candidates’ decision to apply. However, it should not be the only factor. If a great program is in a location that is not best for your family, then you would have to strongly consider the pros and cons of this situation. The other thing that influenced my perception of a particular program was the people and faculty at the program. This is why it is important to be proactive about meeting people at society conferences before the application process. Creating the opportunity to introduce yourself to people prior to the application process can go a long way in influencing how you feel about a program. A positive introduction before an interview can make a big impression on a candidate and a faculty member. Ultimately, I felt that an evaluation of the people you would work with at each institution was more important than the reputation of the program or institution.
What advice would you offer residents or medical students about applying?
My advice to residents applying would be to really know yourself. It is difficult to make any decision if there is uncertainty about what you want. If you are on the fence about whether or not you want to apply, think more about the big picture. Ask yourself, “What do I want my practice to be like in 5, 10, 15 years?” If you think fellowship can help you build that practice, then do it. If you feel like you do not need fellowship to reach your career goals, you may need to reconsider your options.
Be confident and prepared. If you are applying to fellowship, be confident in explaining what you can offer to the program and how your skills will enhance the program. You are contributing to the legacy of a program just as much as the program is contributing to your experience. If you anticipate a passive experience where you rely on a program to make you successful, that will easily be detected on an interview. Instead, sell your assets to the program, and tell them how you can continue contributing to the program’s success.
Finally, choose a mentor wisely. It does not have to be a friend or someone you like. It should be someone who puts you on the path of opportunity but does not necessarily hold your hand as you explore that path. You need to find someone who will give you advice, but also provide you with latitude to experience things on your own. The person should be honest, even if it is not always what you want to hear. They should provide insights to the process, and ffer personal insights that you might not be aware of.
What part did family concerns/preferences play?
My family was hugely important in this decision process. Being happy and successful in a career requires that you address you family and personal needs as well. I spoke openly with my wife about the potential fellowship options and the reality of each one. Her input certainly had influence on my rank list.
About James Naples, MD
James Naples, MD, is currently in a neurotology & skull-based surgery fellowship at the University of Pennsylvania after completing an otolaryngology residency at the University of Connecticut. Dr. Naples will be moving to Boston to join the staff at Beth Israel Deaconess Medical Center in the summer of 2019.