No year looks the same in the life of a UVM REI fellow; indeed, no two days in the life of a fellow look the same! Over three years, our fellows move from learning the system to leading within it.
First Year: Building Foundations
Your first year is about immersion: learning the flow of REI, developing clinical instincts, and gaining comfort with ultrasound, ovulation induction, and patient counseling.
A typical day might look like:
Morning
- Early morning monitoring: ovulation induction ultrasounds, labs, cycle management
- Review plans with attending, learning how to adjust medications and counsel patients
- Perform IUIs and begin developing procedural confidence
- New patient consults and follow-ups in REI clinic
- Exposure to female and male infertility workups and complex endocrine conditions
- Assist in and progressively lead complex REI surgeries
Afternoon
- Perform office-based procedures, including hysteroscopy and HSGs
- Ovulation induction cycle management and IVF cycle reviews
- Lead and present cases during didactics and core curriculum conferences
- Structured teaching sessions, including weekly didactics
- Begin to identify areas of academic interest, including research focus and quality improvement projects
Focus of the Year:
Learning how to think like an REI, how to evaluate, counsel, and manage patients thoughtfully while building early procedural skills and clinical confidence. At the same time, beginning to define your interests and trajectory within the field. And, importantly, getting to know our beautiful state! Make the most of your free time - find your routines, your community, and the spaces outside the hospital that will sustain you over the next three years.
Second Year: Focus, Flexibility, and Finding Your Direction
Second year looks different, and that’s the point. With most of your time protected for research, your days shift from the pace of clinic to the rhythm of building something of your own. This is the year where you step back, just for a bit, to ask bigger questions. This doesn’t mean stepping away from clinical care completely. You stay connected, just more intentionally.
A typical day might look like:
Morning
- Start experiments, dig into data, or pick up where you left off the day before
- Check-ins with mentors or collaborators
Afternoon
- Writing (and rewriting…!) abstracts, manuscripts, or grants
- Data analysis, troubleshooting, refining your project
- Meetings with your research team or interdisciplinary collaborators
- Progress that feels slow, until suddenly it isn’t
Throughout the Year:
- Stay clinically grounded through targeted clinical sessions, including ultrasound monitoring, procedures, and clinic
- Continue to build procedural skills and confidence
- Follow patients longitudinally and stay connected to their outcomes
- Present your work, defend your ideas, and learn how to think critically about data
- Work closely with faculty as mentors, collaborators, and sounding boards
Focus of the Year:
This is where research begins to shape how you think. You learn how to ask better questions, interpret evidence with nuance, and make decisions grounded in data rather than habit. Whether you pursue academics or private practice, this year fundamentally changes how you approach problems, making you a more thoughtful, analytical, and effective clinician.
Third Year: Independence & Leadership
By third year, you are frequently functioning at the level of a new attending - leading care, mentoring your junior fellows and residents, refining your clinical and procedural expertise, and building a panel of patients who know you, trust you, and ask for you by name. You’ll perform oocyte retrievals and embryo transfers with increasing autonomy; indeed, by graduation, many of our third year fellows are approaching triple-digit transfer numbers, providing the confidence, efficiency, and judgment needed for seamless transition into independent practice.
A typical day might look like:
Morning
- Run IVF monitoring independently, finalize plans with attending
- IVF retrievals, transfers, and cycle reviews
- Emergent fertility preservation consults
Afternoon
- Lead patient counseling and shared decision-making conversations
- Dedicated research time as needed to wrap up projects and finalize manuscripts and your thesis
- Advanced procedures and surgical exposure
Throughout the Year:
- Review outcomes and refine clinical approaches
- Administrative/leadership exposure within the division
Focus of the year:
Transitioning to independent practice - clinically, procedurally, and professionally. This is the year where everything comes together. You leave our UVM REI fellowship not just able to perform procedures, but able to manage complexity, lead teams, and make independent decisions. Whether entering academic medicine or private practice, you’ll graduate prepared to build a practice, contribute to a program, and care for patients with both competence and confidence.
