Regional Anesthesia Fellowship

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I think holding it against someone is not good reasoning.

Agree with most of above. Not usually necessary, but should only help in the job search.

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I think holding it against someone is not good reasoning.

Agree with most of above. Not usually necessary, but should only help in the job search.

in my humble experience, every resident i knew without exception that did a non-mainstream fellowship (ie regional, OB, trauma, transplant, preop clinic!!) was noticeably weak in the OR - this is why I would hold it against 'em.
 
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They probably don't call it a pre op clinic fellowship. It's perioperative medicine now man, get with the program. Everyone should do a perioperative medicine fellowship year. How else will you know how to properly prepare the patient pre procedure and be able to generate a reasonable plan for optimal post op management...
Hmmm, Maybe we should start a peds periop fellowship. I bet we would get a fellow within 2 years, and I can't stand managing the pre op clinic while dealing with patients.
 
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I have a friend who did a fellowship at HSS and it really expanded his options.

I think a regional fellowship can be helpful if you go to a top program (HSS , Duke, or UPMC) or find one that
lets you work 1/2 time as an attending. Otherwise its a waste of time.
 
if a new grad interviews at my pp group c a regional fellowship it would not be an edge. it might even be a negative - why didn't this grad learn blocks/confidence during residency? that is an expensive addition to your CV. 300+K early in your career is worth far more than 300+K later in your career.

for academia, yes.


I think it depends on the institution. At the institution that I am currently at, the weaker residents actually go straight to private practice. The stronger residents are the ones that are actively recruited within the department to do a fellowship and stay on as faculty. They would rather fill all of their fellowships internally with their own residents. Where I did residency, the residents that choose regional were all very strong. PP groups actually recruit from all of our fellowship spots, even regional.
 
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if a new grad interviews at my pp group c a regional fellowship it would not be an edge. it might even be a negative - why didn't this grad learn blocks/confidence during residency? that is an expensive addition to your CV. 300+K early in your career is worth far more than 300+K later in your career.

for academia, yes.

I think that is interesting.Where I am working they hired two regional fellowship trained guys and started them at a higher base salary just for being trained in a fellowship. Its not that they can do blocks that everyone else can't but I think the chairman likes how it looks on paper when he talks about the services we provide. Its interesting to hear your different opinion.
 
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I think that is interesting.Where I am working they hired two regional fellowship trained guys and started them at a higher base salary just for being trained in a fellowship. Its not that they can do blocks that everyone else can't but I think the chairman likes how it looks on paper when he talks about the services we provide. Its interesting to hear your different opinion.

i assume that when you say chairman and base salary you are referring to your academic training program? that is really the only place nontraditional fellowships are of any value (i would hope so, given that the academic programs are the ones that profit most from the indentured servitude)...

i was talking about pp
 
I don't think there's anything more important in medicine in general than recognizing where you have inadequacies. Yes we should be learning blocks in residency, and it is definitely possible to learn during practice. But I think it only looks good when someone either wants to strengthen skills that they aren't terribly confident in, or expand their knowledge base with skills that they can then teach to future partners.
 
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I don't think there's anything more important in medicine in general than recognizing where you have inadequacies. Yes we should be learning blocks in residency, and it is definitely possible to learn during practice. But I think it only looks good when someone either wants to strengthen skills that they aren't terribly confident in, or expand their knowledge base with skills that they can then teach to future partners.
This is true however, there are also residents out there that can't manage to land a good job and therefore, choose to stay on as a fellow. I remember the days when a peds or OB fellowship were full of these people.
 
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Which fellowship has the most upside potential?
 
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Please explain.
Look at the job market. Either there are a ton of cardiac cases (which I doubt), or everybody thinks that a cardiac-trained anesthesiologist is the best since sliced bread. They are the Chuck Norrises of anesthesia.
 
Look at the job market. Either there are a ton of cardiac cases (which I doubt), or everybody thinks that a cardiac-trained anesthesiologist is the best since sliced bread. They are the Chuck Norrises of anesthesia.
Most groups and AMCs in small to midsize hospitals are faced with the dilemma of providing cardiac anesthesia coverage because the hospital requires having an open heart program mainly to cover their invasive cardiology services.
The majority of anesthesiologists in these groups are not cardiac anesthesiologists and have not done any cardiac anesthesia in years, and it is unlikely that they know TEE.
So, this creates a sweet market for the cardiac guys that allows them to find jobs in the more desirable areas and with better compensation packages.
On the other hand these guys are often on call more frequently than the other members of the group.
 
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Most groups won't hold a fellowship against you. It's a tough job market so all you need to say is "my backup plan is academics so I did a fellowship" as almost all new graduates need a fellowship to get an academic position.

A few groups will value that Regional fellowship so don't be deterred if that is your passion in this specialty.
 
A few groups will value that Regional fellowship so don't be deterred if that is your passion in this specialty.

Agree. I know that the general consensus is to knock anyone who does a regional fellowship but I also know groups where the fellowship can be very helpful.
 
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Top programs: Duke, HSS, Virginia Mason

I know some of these posts are a few years old, but times are changing for sure. Since acute pain/regional fellowships will be ACGME accredited in the next 2-3 years, regional fellowships are becoming much more competitive. Two programs at which I interviewed showed that their fellows are all above the 90th percentile on their ITE's, so the idea of regional fellowships attracting sub-par applicants is inaccurate. In my residency program, we do a TON of blocks, but we still have a good number who still want to do a regional fellowship to add to their CV in an anesthesia market that is moving toward hiring fellowship-trained personnel.
I would highly recommend doing an acute pain/regional fellowship if you enjoy procedures and a fast-paced working environment.
 
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Top programs: Duke, HSS, Virginia Mason

I know some of these posts are a few years old, but times are changing for sure. Since acute pain/regional fellowships will be ACGME accredited in the next 2-3 years, regional fellowships are becoming much more competitive. Two programs at which I interviewed showed that their fellows are all above the 90th percentile on their ITE's, so the idea of regional fellowships attracting sub-par applicants is inaccurate. In my residency program, we do a TON of blocks, but we still have a good number who still want to do a regional fellowship to add to their CV in an anesthesia market that is moving toward hiring fellowship-trained personnel.
I would highly recommend doing an acute pain/regional fellowship if you enjoy procedures and a fast-paced working environment.


I commend you on your pursuit of a fellowship. But, IMHO the best fellowships in terms of job opportunities and income are the following:

1. Peds
2. Pain
3. Cardiac
4. Critical Care

Any of the 4 listed above is a much better way to spend an extra 12 months in training for the man.
 
The only ones that are worth it are pain and critical care.Both of these fellowships make you a whole other doctor. the other fellowships you are just another anesthesiologist
 
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The only ones that are worth it are pain and critical care.Both of these fellowships make you a whole other doctor. the other fellowships you are just another anesthesiologist


Plenty of good jobs available for a Cardiac Anesthesiologist (fellowship required) in the USA. In fact, I'd say for many private practices Cardiac is the fellowship to do after residency.
 
I was just in the job market for an attending position in the New England area, and several hospitals really valued (even required) a regional fellowship, which makes me really wish I had done one. A few years ago, I would've said that a regional fellowship is a complete waste of time, but I was wrong... Doing a regional fellowship will give you an edge in this market.
 
I was just in the job market for an attending position in the New England area, and several hospitals really valued (even required) a regional fellowship, which makes me really wish I had done one. A few years ago, I would've said that a regional fellowship is a complete waste of time, but I was wrong... Doing a regional fellowship will give you an edge in this market.

Not sure about that and probably completely location dependent. For us it's irrelevant.

When we hire, the specialties we would prioritize most would be...

1) Peds, mostly peds cardiac capable
2) Pain
3) Cardiac
4) Regional

(we don't do any ICU because it's a money waste). Peds hearts are the hardest cases to cover and then complex peds. Pain is a completely different animal. Cardiac is something most anesthesiologists can do the basics of, but complex cardiac requires a fellowship trained person. Regional is nice, but not going to get much attention (at least from us). We all do regional without fellowships. I didn't do a fellowship but got plenty of training in residency and am comfortable with single shot and catheter techniques for just about anything you can dream of and I can do it way faster and more efficiently than somebody coming out of a fellowship. PP experience is more relevant for regional than a regional fellowship if you are interviewing for a PP job. For an academic position, they obviously want the fellowship.
 
Honestly, you have to be some sort of a j.o. to do a regional fellowship. Unless of course you are severely deficient
 
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I was just in the job market for an attending position in the New England area, and several hospitals really valued (even required) a regional fellowship, which makes me really wish I had done one. A few years ago, I would've said that a regional fellowship is a complete waste of time, but I was wrong... Doing a regional fellowship will give you an edge in this market.

I could walk into just about any hospital in the country and be able to do the same Regional techniques of those Attending Anesthesiologists in 2 weeks (3 weeks tops). But, there is no way I'd say that about my TEE skills vs the people I consider top level Cardiac Anesthesia attendings. I'd need several months at least to get up to their speed (if not longer) and even then I'd likely fall short.

Bottom line is Regional can be learned on the job vs Echo/Complex Cardiac which is best learned as a fellow; that's not to say there aren't solid people out there who learned on the job as well but the learning curve is steep.

Peds
Cardiac
Pain
Critical Care

I'd do a Regional or OB or Neuro fellowship for Academics. Don't forget about transplant fellowships.
 
I'm not sure where you guys practice, but I can tell you that I interviewed at 2 academic programs and 2 pp that were looking for a regional-trained anesthesiologist for their ambulatory surgical center/ortho OR's.
I'm simply speaking as someone who has no ties to regional fellowships... Objectively speaking, a regional fellowship would've helped me get a job at one of these 4 hospitals. I'm by no means implying that it's better than Peds, cardiac, or pain... Just saying that if you want to do a regional fellowship, go for it... It's NOT a waste of time, and don't let people tell you otherwise.
 
I'm not sure where you guys practice, but I can tell you that I interviewed at 2 academic programs and 2 pp that were looking for a regional-trained anesthesiologist for their ambulatory surgical center/ortho OR's.
I'm simply speaking as someone who has no ties to regional fellowships... Objectively speaking, a regional fellowship would've helped me get a job at one of these 4 hospitals. I'm by no means implying that it's better than Peds, cardiac, or pain... Just saying that if you want to do a regional fellowship, go for it... It's NOT a waste of time, and don't let people tell you otherwise.

For every 1 private practice who wants a "regional fellow" there are 4 or 5 who want or need a Cardiac Fellow for the difficult cases. Go online today and see for yourself the number of jobs requesting "regional fellowship" vs Cardiac. I'm confident that its 5:1 or more right now in favor of cardiac.

Any fellowship can help secure the right job at the right time at the right location. That said, a Cardiac trained Anesthesiologist can learn to do blocks and adapt to the practice much faster than the Regional trained Anesthesiologist can learn advanced TEE and do complicated heart cases.

In this difficult job market I certainly don't blame anyone for doing a Regional Fellowship vs not doing one at all because the ability to land a decent academic position is a smart move in my opinion.
 
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For every 1 private practice who wants a "regional fellow" there are 4 or 5 who want or need a Cardiac Fellow for the difficult cases. Go online today and see for yourself the number of jobs requesting "regional fellowship" vs Cardiac. I'm confident that its 5:1 or more right now in favor of cardiac.

Any fellowship can help secure the right job at the right time at the right location. That said, a Cardiac trained Anesthesiologist can learn to do blocks and adapt to the practice much faster than the Regional trained Anesthesiologist can learn advanced TEE and do complicated heart cases.

In this difficult job market I certainly don't blame anyone for doing a Regional Fellowship vs not doing one at all because the ability to land a decent academic position is a smart move in my opinion.

I agree with Blade on this one. Personally, regional intimidates me because I didn't do it enough in residency and never do it in practice now (outside of spinals/epidurals). I've actually been reluctant to pursue certain jobs because it'll say "strong regional required" and I know that's not me. On the contrary, I did a bunch of cardiac as a resident and parlayed that into my fellowship. I'm confident with 95-99% of hearts and if arm twisted I could fumble my way through a basic peds heart.

The are "Block Jobs" out there and if that's your bag then I say go for it. But just make sure when you're out looking for a job, you find a job where you get to exercise your skill the majority of the time, ie, ambulatory center or ortho hospital.

I also agree with this order....
1) Peds, mostly peds cardiac capable
2) Pain
3) ICU
4) Cardiac
5) Regional

I put ICU 3rd because it's so specialized that, as another poster put, you become a completely separate doctor that way...

my 2c
 
Doggy style
 
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Doublelumentube12, thanks for sharing your job search experience. It's good to know that there are plenty of programs out there that value a regional fellowship. I have also heard from a regional fellow that while he was recently job searching, he was able to find the perfect job that allowed him to mainly do blocks because he did the fellowship.

Criticalelement, I know what j.o. stands for... I was simply wondering why you would make an inappropriate comment like that.
 
You think the statement, "You have to be some sort of a jerkoff to do a regional fellowship" is appropriate? I feel bad for the people who work with you.
Don't. Several are fags and the rest are jerk offs.
 
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