Fellow applicants and previous applicants,
What are the most important things to find out about a program on interviews? I know this is different for everyone, but what are you specifically looking for in a program and why?
Yes it's different for everyone - Depends on what you believe your career to be like after you graduate fellowship. Do you want to join a chill practice in a rural setting back home doing bread and butter pain? Do you want to be in PP churning out procedures? Do you want to be the neuromodulation guy at your practice/town? Do you want to do end-of-life cancer pain? Do you want to conduct basic science pain studies? Do you want to get involved with clinical studies? You should tailor your search for a fellowship based on your goals. This is obvious.
For me, I looked at the following:
1. What is the procedural volume and how interventional is the program? - These are two different things. The procedural volume can be high in that you are doing a lot of injections, but the array of interventions may be low. For example, doing 10-20 LESI's, MBB's, TPI's per day is fine but you also want to make sure the complexity is there (gasserion ganglions, trigeminals, ultrasound-guided peripherals, sympathetics, neurolyses, etc.)
2. How many SCS/pumps? - All the residents want to know but all the fellows/attendings hate hearing this question because fellowship is more than just stims/pumps. But you want to be sure that they are getting at least a good number of these so you can feel proficient. And if their numbers are high, they usually have no problem letting you know that they are high. Yes, there are national cadaver courses where you can learn this but there is nothing like learning first hand from an experienced attending in the OR where you can operate together and pick their brain. You also want to be honing basic techniques and making mistakes when you are a fellow, not when you are in PP where time=$$ and your colleagues and RNs are judging you at your own ASC. You also need a relatively high n value of implants before you see complications come through the ED. If your n=5 in terms of total implants/year, it's rare you'll see the 3-5% of postop infections that will need to be dealt with.
3. Where did past fellows go after completing fellowship? - I wanted to be in a highly desirable urban area after graduation and wanted to make sure the program had a good track record in placing fellows in these types of areas. Some programs are more "national" when it comes to grads (eg. Harvard) where as other equally good programs are more "local" (eg. Mayo, Wake). It's easy enough to go "national" from a more "local" program and vice versa but having alumni already established in many of the cities I was looking at is an extremely easy way to get your foot in the door for job interviews and getting the scoop on other practices in those areas. The pain world is teeny tiny and word of mouth can be huge.
Try this if you're having trouble comparing programs. Have a list of 5-10 different CATEGORIES that are important to you. And have a scoring system for each category and jot down the DESCRIPTION of what each score means. Then after you interview at a program, rate them on each category by looking through the descriptions that best match the program. At the end of the interview season, see how they ranked in terms of total score. If there is a category that is more important on the list (eg. GEOGRAPHY CATEGORY because I need to be close to family), then see how they ranked in terms of this category and compare it to your list of total score. See how the rankings looked compared to your 2nd most important category. This was a fun way metric for me to view programs from a more "objective" standpoint. And I was obsessed with evaluating programs and the Match so it was a good way to satisfy my neurotic tendencies.
For example:
CATEGORIES:
1. Interventional volume
2. Geography
3. Reputation
4. Fellow satisfaction
5. Staff/attendings
6. Schedule
7. My "gut feel"
8. Extra credit (for anything that was truly unique)
SCORING:
Reputation
1 - lower tier program
2 - regionally-recognized program (eg. best in the state)
3 - nationally-recognized program
4 - top programs in the country (eg. my uneducated relatives have heard of it)
Fellow satisfaction
1 - Fellows spoke poorly of the program and seemed unhappy/overworked
2 - Fellows were ambivalent
3 - Fellows enjoyed the program but had a few things that could be improved
4 - Fellows loved their program, wouldn't change a thing, would do it all over again if they had to