From the Research
There is no significant difference in fellowship rates between graduates of three-year versus four-year emergency medicine residency programs, with approximately 10-15% of emergency medicine residency graduates pursuing fellowships, regardless of whether they completed a three-year or four-year program. The decision to pursue a fellowship is more dependent on individual career goals and interests rather than residency duration. Both three-year and four-year programs provide comprehensive training to practice as an emergency physician. The extra year in four-year programs typically allows for more elective time and research opportunities, but does not necessarily lead to higher fellowship rates. Factors that influence fellowship pursuit include desire for subspecialty expertise, academic career aspirations, and interest in fields like critical care, toxicology, or pediatric emergency medicine, as noted in studies such as 1. Fellowship choices are primarily driven by personal preferences and career objectives rather than residency program length. Residents considering fellowships should start exploring options early, ideally by their second year, to allow time for applications and interviews, and discuss fellowship opportunities with mentors and program directors to make informed decisions about their post-residency career paths. The most recent and highest quality study, 2, found that four- and three-year emergency medicine residency graduates perform similarly in their first year of practice compared to experienced physicians, suggesting that residency duration does not significantly impact clinical competence or fellowship pursuit. Overall, the evidence suggests that the length of the residency program has a minimal impact on the decision to pursue a fellowship, and that individual career goals and interests are the primary drivers of this decision, as supported by studies such as 3 and 2.