Post-Match Timeline: Preparing Logistically to Start Fellowship Smoothly

Post-Match Timeline: Preparing Logistically to Start Fellowship Smoothly

It’s the afternoon of Match Day. Your email just confirmed it: you matched into fellowship. The group chat is blowing up, your co-resident is crying happy tears over a cards spot, and your attending just said, “Congrats—now the real fun starts… paperwork.”

You’ve got 3–5 months before fellowship starts. It feels like a lot. It is not.

Here’s what actually happens: people stare at the NRMP result, do nothing for four weeks, then suddenly realize they’re moving states, changing insurance, waiting on credentialing, and maybe planning a wedding. They end up signing a lease they hate and begging GME to rush their paperwork.

You’re not going to do that.

We’ll walk this from Match Week to Day 1 of fellowship. At each point: what should be done, what can wait, and what, if you drag your feet, will bite you.

---

Match Week: Celebrate… and Lock Down the Essentials

Match Day to +7 days: Information, Not Action

At this point you should just gather data and keep your schedule light.

1. Read your match email carefully

   • Fellowship start date (often July 1, sometimes late June)
   • Program contact:
     • Fellowship coordinator
     • Program director
   • Any mention of:
     • Orientation dates
     • Pre-hire requirements
     • Visa needs (if applicable)

2. Reply to the fellowship coordinator (brief but adult) Something like:

   • Confirm you matched and are excited
   • Ask for:
     • Onboarding timeline
     • Expected contract date
     • Orientation dates (even approximate)
     • Any known call/vacation rules for year 1

   Do not send an essay. Coordinators are triaging 15–30 new fellows across multiple services.

3. Check your current residency contract and GME policies You’re looking for:

   • End date of current contract (usually June 30)
   • Rules for:
     • Using remaining vacation
     • Moonlighting (if you plan to keep it up for a bit)
     • Educational days for moving/boards
   • Any penalties for leaving early (rare but I’ve seen PGY-3s try to cut out 2 weeks early and get shut down).

4. Start a single “Fellowship Launch” document Keep it in Google Docs/Notion/OneNote—wherever you’ll actually use it:

   • Tabs or sections:
     • Timeline & key dates
     • Program onboarding tasks
     • Licensing/credentialing
     • Housing & moving
     • Financial & benefits
     • Personal life (family, childcare, partner job, etc.)

Your only real job this week: get visibility. No big life decisions yet.

---

1 Month Post-Match: Foundation Work (Licensing, Money, Housing Research)

Call this Match + 2 to 4 weeks. Emotions cool. This is the danger zone where people procrastinate.

At this point you should: front-load everything that has a long processing time.

Post-Match Fellowship Prep Timeline

Period	Event
Match to Month 1 - Match Week	Celebrate, contact coordinator, gather info
Match to Month 1 - Weeks 2-4	Start state license, request verifications, outline budget
Months 2-3 - Housing	Visit or virtual tour, sign lease
Months 2-3 - Credentialing	Complete HR packets, immunizations, background checks
Month Before Start - Logistics	Schedule movers, set up utilities, update address
Month Before Start - Clinical Prep	Review policies, EMR training, first-week planning
Final Week - Finish Move	Unpack essentials, confirm orientation details
Final Week - Day 1	Start fellowship

Week 2–3: Licensing & Credentialing prep

If you’re staying in the same state and same institution, this is easier. If you’re moving states or hospitals, do not wait.

1. State medical license

   • If fellowship requires a full license (cards, GI, pulm/crit often do):
     • Go to the state medical board website
     • Download or start the application
     • List all:
       • Prior licenses (training licenses in multiple states)
       • Past employment (yes, all those PGY years)
       • Disciplinary/fitness questions (be meticulous here)
   • Order/prepare:
     • USMLE/COMLEX score reports
     • ECFMG certificate (if IMG)
     • Medical school transcript and diploma copy
     • Residency verification form (your current GME must complete this)
   • Some boards are 8–12 weeks. I have seen fellows unable to start independent call because their license was late.

2. DEA registration (if required)

   • Some fellowships require your own DEA, some allow use under attending/supervising physician. Ask the coordinator directly.
   • If needed, you cannot apply until you have:
     • Active medical license number
     • Practice address
   • Mark this as a later step if the license is still pending.

3. Immunizations and health records

   • Locate:
     • Hep B titers/vaccine record
     • MMR, Varicella, Tdap documentation
     • TB testing (often annual)
   • If anything is missing or you’re unsure, schedule titers now while you’re still in residency. Much easier than scrambling in June.

Week 3–4: Money and Initial Housing Recon

You’re not signing a lease yet (usually). But you are getting clear.

1. Run a rough fellowship year budget

   • Look up PGY-4/5 pay or “fellow” pay at your new institution.
   • Factor in:
     • Likely rent in that city
     • Loan payments (if they restart or change)
     • Relocation costs (movers, flights, deposits)
   • Decide:
     • Do you need a signing bonus/relocation stipend advance?
     • Will you need a 0% APR card or small personal line for moving expenses?

2. Clarify relocation benefits

   • Ask GME or HR:
     • Is there a relocation allowance? Amount? Taxable?
     • Reimbursed vs upfront?
     • What’s covered:
       • Movers vs U-Haul
       • Temporary housing
       • Travel for house-hunting

3. Start housing research (not commitments yet)

   • Focus radius:
     • Under 30–40 minutes commuting at worst traffic
   • Ask current fellows (email or group chat):
     • “If you had to move again, where would you live and where would you avoid?”
   • Map out:
     • 3–5 neighborhoods
     • Typical rent for studio/1BR/2BR
     • Parking situation, if you own a car

At this point, you should have:

• License application started (or at least requirements mapped out)
• A budget estimate
• A short list of target neighborhoods

---

Months 2–3 Before Start: Lock the Big Stuff (Housing, License Progress, HR)

This is April–May for a July 1 start, roughly.

Now you move from research to decisions.

Month 2: Make Decisions and Commit

At this point you should be:

1. Pushing your license across the finish line

   • Follow up:
     • Confirm your residency program sent verifications
     • Confirm medical school credentialing sent what was required
   • Check board portal weekly:
     • If it’s been >6 weeks and no movement, call. Politely, but firmly.
   • If you need the license before orientation (for credentialing), keep your coordinator updated so they can warn hospital credentialing.

2. Signing a lease or finalizing housing Ideal timeline: 6–8 weeks before move.

   Decide:

   • Fly for an in-person visit if:
     • You’re moving across the country
     • You have kids or a partner who cares strongly about neighborhood quality
   • Use video tours if:
     • It’s a hot market and units go in 24–48 hours
     • You know current fellows in the area who can reality-check places

   Watch for:

   • Start date of lease:
     • I like 1–2 weeks before fellowship start so you can move and breathe.
   • Early termination clauses:
     • Unlikely you’ll need it, but nice to know.
   • Parking, laundry, and noise (night shifts + thin walls = miserable).

3. Planning vacation and time off from residency

   • Check with your current PD:
     • Max vacation days still allowed between now and contract end
     • Any rules about taking time off in June
   • Block:
     • 3–5 days for moving
     • 3–7 days for actual rest before you start fellowship (seriously, do this)

Month 3: Fellowship HR, Hospital Credentialing, and Logistics

At this point you should be seeing a wave of emails: onboarding, HR, credentialing.

1. HR onboarding packet You’ll likely get:

   • Offer letter / contract (sign this quickly)
   • Background check info
   • Drug screen orders
   • Employment forms (W-4, direct deposit, emergency contact)

   Do not sit on these. Hospital bureaucracy moves slowly after you finish your part. If you’re slow, everything backs up.

2. Hospital credentialing packet Often a separate beast from HR.

   You’ll need:

   • Updated CV (month-by-month, no gaps)
   • Copies:
     • Medical license (if required)
     • Training license (if applicable)
     • DEA (if you have it already)
     • Board certifications (if IM or prelim year completed)
   • References and previous supervisors
   • Proof of malpractice coverage (usually from residency GME)

   Fill it out within a week. Credentialing committees often meet monthly. Miss a cycle, and you start without full privileges.

3. Health clearance

   • Schedule:
     • Drug screen
     • Employee health visit (TB test, physical if required)
   • Bring:
     • Immunization records
     • Titer results
     • Any accommodation paperwork if you need it

4. Compare benefits and adjust insurance timing

Use a quick comparison to plan transitions:

Item	Residency (Current)	Fellowship (New)
Health insurance end	June 30	Starts July 1
Dental/Vision	Yes/Yes	Yes/No
Retirement match	3%	5%
Life/Disability	Basic only	Optional upgrade
Relocation stipend	None	$1,500 taxable

You care about:

• Ensuring no insurance gap (COBRA if there’s a weird lag—rare but check)
• Rolling over or cashing out retirement
• Updating beneficiaries and coverage if you have dependents

---

Final 4–6 Weeks: Moving, Cleanup, and Clinical Readiness

This is mid-May to June for July starters. Stuff piles up here. You want most of it already moving.

4–6 Weeks Before Start: Concrete Logistics

At this point you should:

1. Book your move

   • If hiring movers:
     • Get 2–3 quotes
     • Confirm:
       • Pickup date
       • Delivery window (some cross-country movers give a 7–10 day window)
   • If DIY:
     • Reserve truck
     • Recruit help on both ends (and then assume 30% will bail)

2. Set up your new life infrastructure

   • Schedule start dates for:
     • Internet
     • Electricity/gas
     • Water/trash if not included
   • Cancel or transfer:
     • Current utilities
     • Gym memberships
     • Parking permits

3. Address changes

   • Update:
     • USPS mail forwarding
     • Banks and credit cards
     • Loan servicers
     • State licensing board (yes, them too)
     • Professional orgs (ACP, ACC, CHEST, etc.)

4. Car and driving logistics

   • If moving states:
     • Check deadline for new driver’s license and vehicle registration
     • Insurance coverage changes (often more expensive in big fellowship cities)
   • If you’re going car-free:
     • Check call site locations and late-night transit reality, not fantasy.

2–3 Weeks Before Start: Finish Residency Cleanly

At this point you should be transitioning mentally too.

1. Close out your residency properly

   • Wrap up QI projects and research to a clear handoff:
     • Where data is stored
     • What’s pending
   • Return:
     • Pagers
     • Badges
     • Parking passes
   • Get copies:
     • Final evaluation summary if possible
     • Any letters of recommendation you might need later (yes, for jobs after fellowship).

2. Say goodbye like a grown-up

   • Thank the nurses and staff who saved your butt for three years.
   • Give your PD and key attendings a real goodbye email or short note. These things come back to you when someone calls for back-channel references.

3. Clinical prep (light touch) No need to “pre-study” like it’s Step 1. But:

   • Get the fellowship handbook and call manual from your coordinator or a current fellow.
   • Ask:
     • “What surprised you most the first month?”
     • “If you could have read 1 thing before starting, what would it be?”
   • Skim:
     • Local protocols (e.g., anticoagulation, chemo, ventilator management, etc.)
     • Common order sets in the EMR (you can often get screenshots or a PDF).

---

Final Week and Day 1: Tighten the Last Screws

This week is a blur if you’re not intentional.

5–7 Days Before Start

At this point you should:

1. Unpack aggressively, not perfectly

   • Prioritize:
     • Bedroom (bed set up, blackout curtains if you do nights)
     • Bathroom
     • Work space (desk, chair, charging station)
   • Accept that the living room might look like a box warehouse for a week. It’s fine.

2. Confirm all orientation details

   • Double-check:
     • Start time and location for Day 1
     • Dress code (some programs want business attire, some scrub-friendly)
     • Required documents to bring:
       • Government ID
       • License/DEA copies if you have them
       • Vaccination card if they’re old school

3. Money/benefits last checks

   • Verify you see:
     • Your fellowship job listed in hospital portal
     • Direct deposit info correctly entered
   • Plan for:
     • First paycheck date (often mid-July)
     • Cover that weird gap with savings/credit if needed

4. Sleep and reset If you can swing it, have at least 3 days without clinical work or moving chaos. Your brain needs to hit fellowship at >50% battery.

Day Before and Day 1

At this point you should be done “preparing” and just executing.

Day before:

• Lay out:
  • Clothes
  • Badge lanyard (if issued early)
  • Notebook and pen
• Map your route:
  • Physically or on Google Maps at the right time of day
• Go to bed earlier than usual. It will still feel too late.

Day 1:

• Show up 10–15 minutes early. No more.
• Bring:
  • Small notebook with key phone numbers you wrote down (coordinator, chief fellow, program director’s assistant, GME office)
• Goal of Day 1:
  • Learn faces, not facts.
  • Figure out:
    • Where to park
    • Where to eat
    • Where call rooms are
  • The medical complexity will come. Logistics first.

---

High-Yield Timeline Snapshot

Here’s a very stripped-down month-by-month:

Time Allocation in Post-Match Prep

Category	Value
Match Month	20
2-3 Months Before	35
1-2 Months Before	25
Final Month	20

• Match Month
  • Contact coordinator
  • Start license
  • Outline budget and housing targets
• 2–3 Months Before
  • Push license/credentialing
  • Sign lease
  • Plan vacation/move days
• 1–2 Months Before
  • Complete HR, employee health
  • Book movers/travel
  • Set up utilities and address changes
• Final Month
  • Finish residency strong
  • Move, unpack essentials
  • Light clinical prep and mental reset

---

Key Takeaways

1. Front-load anything that requires another institution or government agency: state license, credentialing, HR, and health clearance. Your delay becomes their delay.
2. Make housing and moving decisions by 6–8 weeks before your start date so the final month is about transitioning clinically, not scrambling for a place to sleep.
3. Protect a real buffer between residency and fellowship—at least a few days of actual rest. You need more than a new badge to start this next phase on stable footing.