Fellowships open to multiple specialties

[Poetic Silence]

Hello there SDN,

I have noticed that some fellowships are open to physicians in various specialties. Some examples that come to mind are pain medicine, critical care medicine, hand surgery, interventional neurology, neuro-oncology and hospice & palliative medicine.

My question is, if there are various specialists going into a fellowship/sub-specialty, does this not lead to inconsistency regarding how a patient is treated beyond the philosophy of one physician to another? It seems to me that a anesthesiology trained pain specialist will approach a patient from a different angle than a physiatrist trained in the same sub-specialty.

Is this inconsistency in physician education something to be worried about? What are your thoughts on the subject?

I appreciate your responses and look forward to reading them.

---

Members don't see this ad.

 

[Arcan57]

Hello there SDN,

I have noticed that some fellowships are open to physicians in various specialties. Some examples that come to mind are pain medicine, critical care medicine, hand surgery, interventional neurology, neuro-oncology and hospice & palliative medicine.

My question is, if there are various specialists going into a fellowship/sub-specialty, does this not lead to inconsistency regarding how a patient is treated beyond the philosophy of one physician to another? It seems to me that a anesthesiology trained pain specialist will approach a patient from a different angle than a physiatrist trained in the same sub-specialty.

Is this inconsistency in physician education something to be worried about? What are your thoughts on the subject?

I appreciate your responses and look forward to reading them.

If residency training failed to provide the competencies required to successfully complete a fellowship, then that specialty wouldn't be allowed to become boarded in that subspecialty. For example, an IM doc can't go into a cardiothoracic surgery fellowship. However, most fellowships that allow multiple entry points are of sufficient length and intensity that the differences in the initial training are usually moot. That is not to say that doing a fellowship in a subspecialty qualifies you to perform outside of that subspecialty. For example, an ortho+hand and a plastics+hand would both be well-qualified to work on the hand but I wouldn't want the ortho doc doing my mandibular free-flap and I wouldn't want the plastics doc rodding my femur.

Also, a fellow that can't function independently is a major liability for most programs as the attending coverage and oversight for most fellowship programs are signficantly less than in residency. A program that finds that residents from a certain specialty subpar will very quickly stop interviewing those residents.

 

[K31]

My question is, if there are various specialists going into a fellowship/sub-specialty, does this not lead to inconsistency regarding how a patient is treated beyond the philosophy of one physician to another? It seems to me that a anesthesiology trained pain specialist will approach a patient from a different angle than a physiatrist trained in the same sub-specialty.

Some may call it inconsistency; others would call it diversity.

I'd argue this is especially a good thing in academics, where training under attendings trained in a variety of primary specialties exposes you to a variety of approaches and you can adopt the best from each specialty. Take critical care for example--Pitt is one of the best critical care programs in the nation, and the multidisciplinary nature of their program is one of their major selling points.

 

[Poetic Silence]

Thank you to the two responders. Your posts were insightful and educational.

I suppose I was looking at the issue from the wrong angle.

I leave this thread a wiser and more informed student.