I am in the "thick" of application to fellowship and I thought I would write a few notes on the process. The application process is quite similiar be it for medical school, residency, fellowship or whatever else. Though I am done with the actual applications and interviews, I will reflect on the process.
Once you have decided that you are going to apply for something, you need to take a look at the criteria that will be used for evaluation of your application. For medical school, this means your undergraduate grade point average, your score on all sections of the Medical College Admissions Test, your extra curricular activities, your letters of recommendation and your personal statement. For residency, the players change to your grades in medical school and your scores on USMLE/COMLEX exams (Steps 1 & 2) and for fellowship, your evaluations during residency and scores on in-training exams.
You need to look carefully at what you bring to the application process. You cannot change your grades so if you are an undergraduate and reading this, you need to get the highest grades that you can possibly achieve. Do whatever it takes and make thorough mastery of your undergraduate subject matter (along with your pre-med coursework) your major priority. Contrary to popular belief, great letters of recommendation or wonderful extracurricular activities will not erase a poor undergraduate performance (nor will obtaining a graduate degree). You have one shot with your coursework so make the most of every opportunity to show your excellence.
As I have written elsewhere, you need to thoroughly prepare for and take the Medical College Admissions Test. This test should be taken after complete knowledge and preparation using the same manner of questioning as on the actual exam. Do not believe that you can take this exam once for practice and then once for "real". Nothing sounds an application "death-blow" like more than one mediocre MCAT attempts (or several attempts unreported). This is not an exam for "practice" but a measure of your suitablity for medical school. Whether you believe this test is valid or not, it's a stepping stone that is quite important.
Once you reach your sophomore year, you should have a good idea of where you stand in terms of preparation for medical school. If you have taken the pre-medical courses in sequence, you should be done at this point. You should start writing your personal statement too. The reason for this is that when you request a letter of recommendation from your pre-med science professors, you should include a copy of both your CV (curriculum vitae) and personal statement. These two documents allow your letter writer to get an idea of you and your outside of class achievements. You should also include a deadline and waiver of inspection of the letter. For most undergraduates, these letters should be sent to your pre-medical advisory committee/office where they will be stored in your folder. (If you have not made contact with this office, you need to do so as soon as you know that you want to attend medical school).
During your junior year, you should be solidifying your knowledge in your undergraduate major and preparing for completing your AMCAS/ACOMAS application. This usually involves obtaining unofficial transcripts from every institution that you have taken courses at since secondary school without exception. Even if you took a typing course at a local community college, you need to request and obtain a transcript because that course needs to be listed on your application.
Choose your medical schools in early fall of your junior year and make sure that you have taken 0r are scheduled to take the required coursework to make application. Some schools require courses like genetics, biochemistry or calculus in addition to the traditional pre-med courses. A consult of the MSAR (Medical School Admissions Requirements) should keep you informed on these additional requirements.
In terms of a choice of what major is best for you, choose the undergraduate major that interests you most. It is a huge chore to attempt "engineering" because you "heard" that it was more impressive to members of a medical school admissions committee. Nothing is more unimpressive than a mediocre undergraduate performance in a major that doesn't interest you. I often say to myself, if I had it to do over, and I knew that I would be going straight to medical school, I would have majored in American Studies, minored in Spanish and took my pre-med courses.
These thoughts are only fleeting because I attended college with the notion of preparing myself for a career in scientific research (not medicine). My undergraduate majors of Analytical Chemistry and Biology with minors in Physics and Math were my preparation for graduate school. I also loved and was quite passionate about those subjects. I enjoyed hours of working on problems in applied differential equations class and higher algebra/advanced calculus. If these courses are not for you, head into something that DOES excite you. After all, you are spending thousands in tuition dollars so you might as well get your money's worth.
I also cannot emphasize the importance of exploring the nature of your fellow human beings. College is a great time to gain exposure to a diversity of ethnicities and ideas. Immerse yourself in another culture by spending a semester or two abroad or studying the art, language and music of another culture. These experiences are easy to find on the campuses of universities and are a great source of stress-relief. There are literally millions of ideas out there to explore and enjoy even if the experience makes you a bit uncomfortable. Your life will be richer for the experience.
Application for residency closely parallels application for medical school except the deadlines are more unforgiving. In the allopathic system, the ERAS (electronic residency application service) deadlines have to be exceeded or you miss out on interview opportunities. You have to be thinking about your choice of residency shortly after you complete first year.
The reason why I give the end of first year as a deadline, is that you can use your summer between your first and second year as a means of exploring some of the specialties. Do not choose a specialty because you believe it will be prestigous or pay loads of money. Dermatology is often sought after as a prestigous and highly paying specialty but I would be a miserable dermatologist. I enjoy my colleagues who pursued this specialty but it was not for me. (See my posts on why I chose surgery).
Don't choose a specialty because you believe it will be in demand. Demand in terms of specialty comes in cycles and by the time you are applying for residency, the demand could be poor. I remember when I started medical school, the demand for anesthesiologists and anesthesia residency was pretty poor. Now, this specialty is fairly sought-after and in a couple of years, the field will be saturated. (Anesthesia is not a rapid turn-over specialty).
Choose a specialty because you love it and you can't imagine doing anything else. Sounds just like the reasons that you choose to apply to and attend medical school.