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For any of you currently applying to pain fellowships, what's the competition level now compared to the last several years???
Thanks
Thanks
How competitive are pain fellwships right now???
- Thread starter Khalid
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I just finished applying for pain fellowships and it seemed very competitive. I applied to a mix of large and small programs all over the country and I obtained interview offers at probably about half of the programs to which I applied. If you are not anesthesia-trained it is even more competitive when applying for an anesthesia-based fellowship.
If you do not have a position lined-up at your home institution I would recommend applying to as many fellowships as you can as early as you can. Also, if you have any personal contacts or connections be sure to use them to their fullest potential. Remember that most programs have maybe 1 to 3 spots open for applicants coming for outside their own institution so you are competing on a national level for those spots.
Also, no programs offered to pay any of my interview expenses (not even validation of parking).
Good luck with the application process.
If you do not have a position lined-up at your home institution I would recommend applying to as many fellowships as you can as early as you can. Also, if you have any personal contacts or connections be sure to use them to their fullest potential. Remember that most programs have maybe 1 to 3 spots open for applicants coming for outside their own institution so you are competing on a national level for those spots.
Also, no programs offered to pay any of my interview expenses (not even validation of parking).
Good luck with the application process.
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Stimulate--
If you don't mind me asking, how many programs did you apply to and how many interviews did you get? Also, did you match into a fellowship? Also, how early do you recommend having your application out to programs?
Thanks
If you don't mind me asking, how many programs did you apply to and how many interviews did you get? Also, did you match into a fellowship? Also, how early do you recommend having your application out to programs?
Thanks
my buddy applied this year, He said he was absolutely shocked by how many applicants these programs had. most of them had up to one hundred (yes, i said HUNDRED) applicants for two or three spots. What was worse, he said, that most of the spots are going to internal people, so really, there was usually only one spot left, if even that!😱
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I would echo the observation that internal candidates have a distinct advantage at most programs.
For non-anesthesiologists applying to anesthesia-based fellowships, the competition is doubly stiff: It's a real cherry-picking experience.
I've met only two anesthesiologists who opted to do ACGME accredited fellowships at non-anesthesia programs (both wanted to see something "different") and both were satisfied so that may be an option too.
For non-anesthesiologists applying to anesthesia-based fellowships, the competition is doubly stiff: It's a real cherry-picking experience.
I've met only two anesthesiologists who opted to do ACGME accredited fellowships at non-anesthesia programs (both wanted to see something "different") and both were satisfied so that may be an option too.
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Wow, I had no idea pain was this competitive. It sounds like having to apply for a dermatology residency. Does anyone know if the RRC has made any inidcation that they may increase the number of pain fellowships since there are so few of them and there is such a high demand?
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don't worry the interest in pain will start dropping precipitously as soon as everybody realizes that within a few years it will be more lucrative to do anesthesia than pain.... i mean unless you have a serious high-volume purely interventional pain practice...
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I applied to roughly 13 programs. Be aware that there is no central application service like ERAS, nor is there a match for pain fellowship. You apply to each program individually. I received 6 interview offers without calling the programs or working any connections. People who have applied successfully to programs, other than their own institution's programs, will advise you to work all the inside connections that you possibly can. I accepted a position at my institution.
Regarding how early to apply, the earliest I have heard is UCLA which interviews in July the year prior. The earlier you apply the better.
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Yes, I wonder what's going to happen when there's a pain clinic on every corner in a few years....
Obviously there's a great interest in it now because of the $$$$. I think ppl dont realize that anesthesiologists arent the only MD's in pain now. Not even just physicians. Now there are chiropractors, etc doing it to.....of course on a different scale. But it's going to be interesting when everyone does pain and the supply is far more than the demand. Only one thing can happen then....drop in reimbursements.
Obviously there's a great interest in it now because of the $$$$. I think ppl dont realize that anesthesiologists arent the only MD's in pain now. Not even just physicians. Now there are chiropractors, etc doing it to.....of course on a different scale. But it's going to be interesting when everyone does pain and the supply is far more than the demand. Only one thing can happen then....drop in reimbursements.
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Every specialty in medicine is facing reduced reimbursements. True there is a lot of money in pain but that isn't necessarily why everyone goes into it. Pain, like critical care, gives an anesthesiologist a whole different set of skills. This is why pain is appealing.
If you think that anesthesiology isn't facing some major challenges ahead, think again. There will always be CRNA vs. anesthesiologists, there are anesthesia management companies coming into the scene, and reimbursements for anesthesia care certainly aren't increasing.
At least with pain you have your own set of patients, you can own your own business, and you can hire mid-level providers to work for you rather than be an employee or partner at best. If pain becomes overrun with other providers, anesthesia trained pain physicians can always go back into the ORs and provide anesthesia care. That is a pretty good "back-up" plan.
Lastly, there is a starbucks on every corner and you don't see them closing for lack of customers... 🙂
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It really does just come down to what you enjoy doing. Unless you are going into plastics or derm and are going to be paid in cash, the future holds cuts in reimbursement across the board. This will prob be especially true in pain, where reimbursement issues for many procedures are even now developing. Money in medicine will always be good, just not what we believe we are worth after all the years of investment and sacrifice while our non-med friends are living life.
Pain vs. anesthesia just boils down to what your priorities are. Most people go into anesthesia precisely to not have to deal with running a clinic, investing in a practice, following up longterm with patients, dealing with insurance companies. Some people find these things rewarding. If these things are less annoying to you than dealing with surgeons and CRNA's, and you don't mind taking a hit on the $250,000 you'd be earning as an anesthesia attending your first year out, then think about a pain fellowship. Just don't do it cause you expect to make a mint, because most people seem to think that pay for gas and pain ends up being about the same, on average.
Pain vs. anesthesia just boils down to what your priorities are. Most people go into anesthesia precisely to not have to deal with running a clinic, investing in a practice, following up longterm with patients, dealing with insurance companies. Some people find these things rewarding. If these things are less annoying to you than dealing with surgeons and CRNA's, and you don't mind taking a hit on the $250,000 you'd be earning as an anesthesia attending your first year out, then think about a pain fellowship. Just don't do it cause you expect to make a mint, because most people seem to think that pay for gas and pain ends up being about the same, on average.
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Agreed that all specialties in medicine are facing reimbursement issues and pain certainly has some hurdles to overcome in the next few years. My reason for choosing pain was that I truly enjoy it. I felt less stressed out, more respected, more appreciated, and having a fellowship on my CV will afford me the option of accepting a position in academics when I am semi-retired (many years from now). I think it would be fun to have the option to go back and do some teaching when I get older.
Next, no matter what happens with pain in the next 5 years, I can honestly tell you that when I called some anesthesia groups as a graduating generalist, there wasn't half the interest in hiring me as there was once I mentioned the pain fellowship. Being a pain fellow significantly increases your marketability. The anesthesia job market is still strong right now but there are some markets where getting gas jobs isn't easy. Why not spend a year where you have little call and weekend responsibility, make decent money, and acquire a whole new set of skills and options?
Regarding the financial aspect, yes there is a cost to doing any fellowship. But lets say you pass up $250K starting salary in anesthesia, you can always add some locums income during fellowship which can bring your salary up into the $80-100K region. Therefore the cost of the fellowship is pre-tax $150-175K and after taxes is about $90K. To me, that is not a huge sacrifice to leave some doors open down the road.
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Reimbursement for pain procedures performed in the office took a 8-10% hit this year.
ASC and and HOPD fees remained about the same, but are next on the chopping block.
Reimbursement for E&M codes (including those for pain) went up a bit.
Many insurers and especially Worker's Comp will not pay for the newer procedures (e.g. intradiscal procedures) and no one is currently doing RCTs to combat this.
👎
ASC and and HOPD fees remained about the same, but are next on the chopping block.
Reimbursement for E&M codes (including those for pain) went up a bit.
Many insurers and especially Worker's Comp will not pay for the newer procedures (e.g. intradiscal procedures) and no one is currently doing RCTs to combat this.
👎
