Finding Focus in Fellowship

Leslie S. Kersun, MD, MSCE, MSEd, discusses finding the right fellowship program; the challenge of balancing research, patient care and education as an intern; and finding your focus during fellowship.

Like many doctors, Leslie S. Kersun, MD, MSCE, MSED has known since childhood that she wanted a career in medicine. She found her calling in pediatric oncology when she was a student at Dartmouth College in Hanover, New Hampshire, while volunteering with child protection services at a local hospital. The program provides developmental encouragement, support, and advocacy for children’s emotional and psychological needs.

“I’ve met a lot of kids with cancer because they were in the hospital most of the time,” she said. “Then in medical school I found that I was really interested in cancer and blood disorders as we did those sections. Things all fit together over time. I didn’t have much to decide; every step of the way sort of fell off.” more appropriate.”

She received her MD from Albany Medical College in New York and was a pediatric resident at the Children’s Hospital of Philadelphia (CHOP) in Pennsylvania. She completed her first year pediatric hematology/oncology fellowship at Children’s Regional Medical Center, now Seattle Children’s Hospital, in Washington and returned to CHOP to complete her education. During her training and early in her faculty appointment, she realized she had a passion for medical education.

“As a fellow, I enjoyed teaching residents and medical students,” she said. “Shortly after finishing my fellowship, I had the opportunity to assist with resident rotation at our oncology unit. My job was to find out and adapt how the residents were trained as they participated in their oncology rotation.”

Shortly after, she became a medical director in oncology and became more involved in the fellowship program. She was later named associate fellowship director and now serves as program director for one of the largest pediatric hematology/oncology fellowship programs in the country. In addition to the year she spent in Seattle, Kersun has been with CHOP since 1996.

She recently took on the role of Associate Designated Institutional Officer and, along with the Graduate Medical Education leadership team, helps oversee more than 70 training programs at CHOP. Working at CHOP is fantastic, she said. “It’s a great place to work. There is a lot of expertise and dedication to education there. We have a great culture and there is always someone who can help you with a patient or a question.”

Kersun sat down with Oncology Fellows to talk about finding the right fellowship program; the challenge of balancing research, patient care and education as an intern; and finding your focus during fellowship.

Oncology Fellows: You didn’t struggle figuring out your career path, but how do you help fellows find their focus when they get into the program?

Kersun: One of the most important things to consider when looking at a fellowship program is what kind of mentorship is available to help you develop professionally. You should think about the clinical mentorship structure of the program as those faculty members will help you learn how to care for the patients. Two of the three-year fellowship programs are research-oriented. Depending on the type of research you are interested in – be it strictly lab-based, more translational research, or clinically oriented research – you should consider what type of mentors and resources are available. This is critical as you plan your career and determine who at that institution can help guide you on your desired path.

Then, of course, there are the life coaches. These may not be one of your assigned mentors for a particular area. They are faculties that have either chosen a similar path, structured their lives in a way that suits you, or have advice that can help guide you.

What should residents look for in a fellowship program?

Fellowship is for most the last step in their education before transferring to a faculty position. It is critical to have mentors, resources and a program that can help support your career interests and a culture in which you can thrive in training. Those are really important questions to ask if you’re considering applying for a program or if you’re interviewing at a program; [it’s important] nasty [understand whether] that program can support your development and the areas of your career that are most important to you. It’s a bit different from residency training. The interview process and the aspects most important to the program can be very different.

Usually people who go on a fellowship want academic medicine, but is there any value in fellowship for people who want to become community doctors?

There is value in whatever you choose to do, so we don’t feel that those doctors who do research in an academic center are more valuable than those doctors who choose to have a primarily clinical career. Our fellowship would definitely train you for whatever career path interests you. In pediatric oncology, there are far fewer opportunities in public medicine or private practice — it’s just not how most practices are structured. Children with cancer and blood disorders are most often seen in a hospital setting because you need a blood bank; laboratory-based diagnostics; multiple specialties such as radiology, pathology, surgical specialties, radiotherapy-oncology; and different disciplines to care for the patients as best as possible. It’s not that there aren’t community or private practices available; it’s just less common.

A man who comes up to you in his third year and says, “Dr. Kersun, I’m not sure how to get a job.” What do you tell them about taking that next step to actually get started as a doctor and researcher?

We talk to them about it from the start. Our division chief will give a lecture on the process of finding a suitable job for each intern. He looks at how he can help read cover letters and reach out to potential employers to help our fellows connect with opportunities that will fulfill their career goals. He also discusses what fellows should keep in mind during training and how to choose a faculty position that will help them continue to advance their careers. Our research mentors and clinical mentors talk to the fellows as they progress in their education about what their interests are and what opportunities are available to them.

Our program also has instructor positions, which serve as a transition period lasting 1 to 3 years before we get a faculty position. This type of position is primarily intended for fellows who have an interest in research. With only 2 years of fellowship devoted to research, many interns have not had enough research experience to apply for a scholarship to support their salary at the end of the degree. They can use this transition time to further develop their projects and work towards independence with their mentors. They can also serve as attending physicians during this time as they further develop their research projects. When they are done with that period, they are ready to apply.

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