After speaking with PGY-3 in the operating room the other afternoon, he told me about a pain management fellow that was offered a starting salary of $825 K! I recognize my ignorance concerning the field and that this example may be extreme, but why is there such an astronomical difference in pay? How does a one year fellowship after an anesthesia residency simply increase your starting salary by half a million dollars in this case? Anyone in a pain fellowship or in the know for that matter, I would be much obliged. Thanks.