Zachary Britstone, MSIII
Sackler School of Medicine NY State/American Program
Tel Aviv, Israel
Adam A. Johnson, MD
Emergency Medicine Resident
Kern Medical EMRA Program Representative 2017-2018
Kern Medical Center
Special thanks to our 1st edition writing team
Krystle Shafer, MD
Mark R. Zonfrillo, MD, MSCE
Description of the specialty
This fellowship trains physicians to become injury prevention experts, educators, researchers, and eventually leaders in their field.
History of the specialty/fellowship pathway
In 1964, Haddon et al. published Accident Research: Methods and Approaches, a groundbreaking piece for the development of injury control research. For the first time, basic principles of research for the injury field were established. Soon after, the National Highway Traffic Safety Administration was formed, which established funding for scientific research in automobile safety. By 1985, injury research was recognized as a distinct field and the Centers for Disease Control and Prevention’s National Center for Injury Prevention and Control was established. Injury research and funding has accelerated since this time both locally and globally. It is largely due to this research that disability and mortality caused by injury has declined over the past century. As providers of care for injured adult and pediatric patients, emergency physicians are ideally situated and have the ability to affect the health of the public by being leaders in injury prevention and control.
Why residents choose to follow this career path
Residents choose to follow this career path if they are interested in developing and disseminating evidence-based strategies for injury prevention with resultant decreased morbidity and mortality.
How do I know if this path is right for me?
This fellowship may be for you if you are interested in any of the following:
- Using research to prevent injuries from motor vehicle crashes (MVCs), sports injuries, household injuries, assault, or abuse.
- Becoming an expert, public educator, and physician educator in injury prevention.
- Coordinating outreach programs or becoming part of the team at an injury prevention center.
Career options after fellowship
Career options to consider after fellowship include becoming an injury prevention research faculty member/investigator or advocate for intentional or unintentional injury.
Splitting time between departments
Traditionally, physicians hold the rank of staff physician or faculty member in the emergency department, and their injury prevention work falls under administrative and/or research effort.
Academic vs. community positions
It is common for physicians after this fellowship to work in academic positions to pursue available funding and research opportunities. In addition, a variety of injury control positions are available in the community, government, and private sectors.
IN-DEPTH FELLOWSHIP INFORMATION
Number of program
There are currently 3 fellowships for physicians:
- Alpert Medical School of Brown University (Rhode Island Hospital/Hasbro Children’s Hospital)
- Harborview Injury Prevention & Research Center (University of Washington)
- Drexel Center for Nonviolence and Social Justice (Drexel University College of Medicine Department of Emergency Medicine)
Other opportunities include internships and grants that are not necessarily geared toward physicians:
- Certificate in Injury and Violence Prevention
- Indian Health Services Injury Prevention Fellowship
- Injury and Violence Prevention Internship
- Occupational Injury Prevention Research Training (PhD), University of Minnesota
- Occupational Injury Prevention Research Training (PhD), University of Utah
- Emory Injury and Violence Prevention Certificate Program (MPH or PhD)
Differences between programs
The fellowships at Brown and Harborview require 2 years to complete. The fellowship at Drexel, while also a 2-year program, may be completed in 1 year if the fellow already has a Master’s degree or PhD and a background in research. These programs are all primarily research-based and are associated with injury prevention centers. Harborview specifically focuses on injury prevention in children and adolescents. Drexel emphasizes emergency medicine and permits fellows to focus on a particular area of interest, such as research, policy and advocacy, or program management.
Length of time required to complete fellowship
This is usually a 2-year fellowship.
Skills acquired during fellowship
The Brown Alpert Injury Control Fellowship at Brown includes a Master’s of Public Health or Master of Science in Clinical and Translational Research and is also a well-established research program with a long track record of funding.
The Pediatric Injury Research Training Program at Harborview is funded through a T-32 grant and offers a Master’s of Public Health or Master of Science as part of the training program.
The Fellowship in Injury and Public Health at Drexel allows fellows to take courses through the Dornsife School of Public Health at Drexel University and obtain a Master’s of Public Health.
Fellows traditionally continue to work a small percentage of time in the emergency department, while the remainder is protected time for research educational work, some of which may be as part of a public health curriculum. Fellows are involved in mentored research and also in public health course/advanced degree coursework.
Board certification afterwards?
There is no board certification available; this is not an ACGME-accredited fellowship.
Average salary during fellowship
Because this is not an accredited fellowship, your salary is similar to that of a part-time EM attending.
PREPARING TO APPLY
How competitive is the fellowship application process?
While there is a small applicant pool for this fellowship, there are only 3 fellowship programs. Because of the small number of programs and very limited number of fellow positions, this is a more competitive fellowship.
Requirements to apply
You must be at minimum in your last year of emergency medicine residency to apply for this fellowship.
Research completed during residency is very strongly encouraged. Performing research with ties to injury control would be particularly favorable on your application. It would be very difficult to obtain a spot in this fellowship without having some sort of research project on your CV.
Suggested elective rotations to take during residency
Consider using your elective time as research months. If your institution has an injury prevention center, it may be worth seeking out a rotation or administration month working with this center.
Suggestions on how to excel during your elective rotations
To excel on your elective rotations, it is important that you display your passion and enthusiasm. Arrive early and stay late, read daily, and take advantage of opportunities to expand your knowledge base. If you are on a research elective, strive to get as much done as possible during the month with the goal of (at minimum) having an abstract to submit by the beginning of your senior year and submitting your research for publication by the end of your residency.
Should I complete an away rotation?
It may be worth completing an away rotation at Drexel, University of Washington, or Brown as a way both for you to check out their program and for the program to “audition” you.
What can I do to stand out?
Ensure that your application displays a strong interest in research and target both your research and other activities toward injury control. Having activities on your CV that display your leadership capabilities is also helpful.
Should I join a hospital committee?
If the opportunity to participate in a hospital committee arises that interests you and allows you to have meaningful contribution, then this is strongly recommended.
Publications other than research
Case reports, blog posts, and magazine articles are highly encouraged as well. This is a great way to educate both yourself and others and to start getting your name out in this academic space. Especially consider publishing about topics within the injury control field.
How many recommendations should I get? Who should write these recommendations?
Applicants traditionally submit 3-4 letters of recommendation. One of these letters must be from either your residency program director or department chair. You may also consider asking your residency research mentor to write a letter. Make sure that you choose faculty who know you well and are willing to write you a strong letter of support.
What if I decide to work as an attending before applying? Can I still be competitive when I apply for fellowship?
Absolutely. The key is to keep working on research and other projects, especially those related to the injury prevention field. Ensure that the list of activities on your CV does not stop after you graduate from residency. Also, be ready to explain your decision to practice as an attending prior to applying for fellowship.
What if I am a DO applicant?
There are no known barriers to DO applicants.
What if I am an international applicant?
Contact each program to inquire whether they accept international applicants. Make sure you have completed your USMLE steps, have your ECFMG (education commission for foreign medical school graduates), and have acquired a visa to work clinically in the U.S. Of note, Harborview only accepts applications from U.S. citizens and permanent residents.
How many applications should I submit?
Applicants should apply to all programs s/he would consider attending.
How do I pick the right program for me?
Pick a program that matches your educational and career goals. You should feel comfortable at the program and you should be surrounded by mentors and a leadership team dedicated to helping you succeed. Finally, ensure that a program is in a geographic location where you and your significant other will be comfortable and happy.
Common mistakes during the application process
- CV does not demonstrate an interest in injury control.
- No involvement in research.
- Impersonal or unfocused personal statement.
- Having letter writers who are not completely supportive of the applicant.
- Missing application deadlines as set by the program.
- Submitting an incomplete application.
Please contact each program regarding their application deadlines. Traditionally, applicants begin to apply in July the year before they plan on starting fellowship.
Tips for writing your personal statement
The best personal statements read more as a story that explains your interest in the field of injury prevention and discusses your career goals. Do not simply repeat what can be found in your CV. This is your chance to show your personality and also your dedication to the field. Consider describing a patient and/or perhaps a research mentor who sparked your interest in the field. Ask multiple people whom you trust to review and critically edit your personal statement. Make sure there are no grammatical mistakes.
Is this a match process?
What happens if I do not obtain a fellowship position?
If you do not obtain a fellowship position, take a step back and critically review your application. Consider asking your residency program director to critically review your application with you to identify ways to improve it. You may also consider gently asking the programs that did not offer you a position if they have any suggestions for improvement. Spend the next year addressing these areas of weakness and apply again. You can also consider getting a master’s degree (such as an MPH) after fellowship or perhaps investigating a traditional research fellowship instead. It is also possible to build your niche in the field without completing a fellowship. Seek mentors and look for a career that allows you to spend time working in an injury prevention center.
How do I stand out from the crowd?
The best way to stand out from the crowd during your interview is simply by being yourself. Make sure you are able to articulate your interests and passions but avoid being overbearing. Also, be prepared to ask questions about the fellowship that are insightful and cannot be easily found on their website.
What types of questions are typically asked?
- Why are you interested in an injury control fellowship?
- Why are you interested in attending our fellowship program?
- Please tell me more about [fill in the blank] on your CV.
- What are your 5- and 10-year career goals?
How many interviews should I go on?
It is recommended that you attend any interview offered by a program that you would seriously consider attending if offered a fellowship position.
PREPARING FOR FELLOWSHIP
Textbooks to consider reading
- Rivara F, et al. Injury Control: A Guide to Research and Program Evaluation. Cambridge University Press: Cambridge; 2010.
- Doll L, et al. Handbook of Injury and Violence Prevention. New York, NY: Springer; 2008.
- Gielen AC, Sleet DA, DiClemente RJ. Injury and Violence Prevention: Behavioral Science Theories, Methods and Applications. San Francisco, CA: Jossey-Bass; 2006.
- Hemenway D. While We Were Sleeping: Success stories in injury and violence prevention. Berkeley, CA: University of California Press; 2009.
Important skills to practice while in residency to prepare for fellowship
Practice your research, leadership, and educator skills during residency. But above all else, make sure you leave residency as a strong, confident, and capable emergency medicine physician.
Tips on how to succeed as a fellow
Take advantage of all opportunities offered to you during fellowship. Use your protected educational time to complete coursework such as a MPH or other Master’s degree. Your research mentor is a wealth of information for you to learn from and to help you complete a research project during fellowship. Work hard during these two years and develop your skills as a leader and as an educator. Make sure that you stay balanced and spend time with your family, which will help protect you against burnout.
- Children’s Hospital of Philadelphia Center for Injury Research and Prevention Research in Action Blog
- SAVIR annual conference:
- Comprehensive Children’s Injury Center (Cincinnati, OH) - April 15-17, 2019
- Penn Injury Science Center (Philadelphia, PA) - Spring 2020
- World Conference on Injury Prevention and Safety
- IOC World Conference on Prevention of Injury and Illness in Sport
How to find a mentor
SAVIR offers a mentor program to match you with an appropriate mentor.