Do you essentially need to do a fellowship?

[SoulinNeed]

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I'm just a pre-med, but I've spent a lot of time volunteering in the OR, and I really like what Anesthesiologists do. I have a close friend who is currently doing his Anes residency, and he's telling me that I should prepare to do a fellowship, as well. He says that there are few jobs out there that pay out of the low 200K's for general anesthesiologists, and that I would need to do a pain/cardio fellowship. I wouldn't mind it. I'm just wondering what you guys think about this? In your experiences, is a fellowship becoming an unofficial requirement? Are you guys planning on doing one?

 

[urge]

No. Just need to be a decent anesthesiologist.

 

[Consigliere]

Unnecessary. When you finish residency 8-10 years from now, anesthesiology as a specialty will be in the shi_tter anyway.

 

[Gaseous Clay]

That's a very broad generalization and incorrect in my opinion. But if you're only in college, this is the last thing you should be worrying about. Plus if you happen to get into med school, you'll likely change your mind on what field you want to apply into.

 

[SoulinNeed]

Unnecessary. When you finish residency 8-10 years from now, anesthesiology as a specialty will be in the shi_tter anyway.

Why do you say that? Or is this because of CRNA's, etc?

 

[Consigliere]

Why do you say that? Or is this because of CRNA's, etc?

Obamacare.

 

[SoulinNeed]

Obamacare.

I've spent the last few days researching PPACA's effect on Physician and hospital reimbursement, and there's nothing that I can see that would show detrimental effect on Anesthesiologists vs any other specialty. Why would Obamacare make Anesthesiology any worse than any other specialty?

 

[shift_roro]

False.
It's only one year anyway.
The market may completely change by the time you finish college, med school, and residency...

 

[SoulinNeed]

Just to be clear, I've finished college, and I've been accepted into med school, lol.

 

[Postictal Raiden]

I am also a pre-med but I will offer my input.

The ACA is going to be a negative force on physicians' income, no question about it. However, this may not be as bad as some may portray, especially here on SDN. Under "Obamacare", physicians may need to work harder to maintain their current compensation. I genuinely believe that there is a limit to how low the government can reduce physician's salaries without the risk of losing the brightest minds in medicine. With the current cost of medical education (money and time), few will accept to work for less than 200K. I, for one, would prefer to relocate to Canada, Australia or even the Middle East.

Also, ACA will create an enormous shortage for physicians in pretty much every field of medicine. Midlevels will be given a broader scope of autonomy to meet the demand. Although many believe, and propagate their believe, that these midlevels (CRNA's, NP's, and PA's) are threat to physicians. I disagree. Yes, many midlevels have been pushing for full autonomy and equal pay, but that does not mean that they will compete with physicians for same jobs. Anesthesiologists are the kings of anesthesia and they are the main providers; CRNA's are only alternatives and will always remain this way.

Bottom line, I think doctors, especially anesthesiologists, are irreplaceable. They will continue to thrive regardless of politics. Midlevels will never pose a threat to competent physicians; they only overcrowd themselves.

 

[yesno]

I am also a pre-med but I will offer my input.

The ACA is going to be a negative force on physicians' income, no question about it. However, this may not be as bad as some may portray, especially here on SDN. Under "Obamacare", physicians may need to work harder to maintain their current compensation. I genuinely believe that there is a limit to how low the government can reduce physician's salaries without the risk of losing the brightest minds in medicine. With the current cost of medical education (money and time), few will accept to work for less than 200K. I, for one, would prefer to relocate to Canada, Australia or even the Middle East.

Also, ACA will create an enormous shortage for physicians in pretty much every field of medicine. Midlevels will be given a broader scope of autonomy to meet the demand. Although many believe, and propagate their believe, that these midlevels (CRNA's, NP's, and PA's) are threat to physicians. I disagree. Yes, many midlevels have been pushing for full autonomy and equal pay, but that does not mean that they will compete with physicians for same jobs. Anesthesiologists are the kings of anesthesia and they are the main providers; CRNA's are only alternatives and will always remain this way.

Bottom line, I think doctors, especially anesthesiologists, are irreplaceable. They will continue to thrive regardless of politics. Midlevels will never pose a threat to competent physicians; they only overcrowd themselves.

I think when they say that CRNA's are competing for drs' jobs they mean that if 1 anesthesiologist can supervise 4 crna's instead of doing only his own cases, then there is a surplus of anesthesiologists that graduated the same # of residencies. As for canada/australia, what makes you think they'll want you? They have far fewer positions and residency grads. If they took even 10% of american drs, their market would crash. I don't think middle east would have any incentive to pay you $300k if you were out of work in usa or made 1/2 as much.

 

[gasp]

I'm just a pre-med, but I've spent a lot of time volunteering in the OR, and I really like what Anesthesiologists do. I have a close friend who is currently doing his Anes residency, and he's telling me that I should prepare to do a fellowship, as well. He says that there are few jobs out there that pay out of the low 200K's for general anesthesiologists, and that I would need to do a pain/cardio fellowship. I wouldn't mind it. I'm just wondering what you guys think about this? In your experiences, is a fellowship becoming an unofficial requirement? Are you guys planning on doing one?

Absolutely not. It is a growing trend in teaching institutions to give the idea to the residents that you will basically not be able to get a job without doing a fellowship. There is very little truth to this if taken out of context. Obviously doing a fellowship is going to give you an edge over someone else with the exact same job qualifications. However, this usually only pertains to some teaching institutions because their program looks more prestigious in regard to academics/research when they have more fellowship trained staff. in the PP world and most teaching institutions, they are looking more for quality. You can have a peds fellowship trained staff who sucks and a regular non-fellowship trained anesthesiologist who is better with peds/hearts/..etc. Obviously it would benefit the group more to take the latter anesthesiologist over the former even though he/she is not fellowship trained.

 

[IlDestriero]

You don't need to do a fellowship to get a good job. However, of you want to get a job doing Pain, or some ICU time, or at a Children's hospital you need to do a fellowship, or have years of experience. I'm sure many, if not most, groups looking to hire a cardiac person will want to see fellowship training these days, or at least echo boards. That's probably difficult to do without a fellowship.
I don't see much use for a regional, ob, trauma, neuro, practice management, etc. fellowship outside of academia (and you still don't need one of these "fellowships") or a deficit in your training and a special interest.
I also don't think there's a conspiracy among the big academic centers to trick its residents into thinking that they need to do a fellowship to get a job. ~1/2 of their residents are going into practice every year without one.

 

[Sonny Crocket]

Do a fellowship if you have a special interest in something and feel that you did not get enough exposure during residency. I thought of doing regional but by the time I was done with residency, I was happy I dd not do a fellowship in regional because I did so many blocks during residency.

ICU, pedi, pain, cardiac are the most worthwhile. Just remember that whatever you do your fellowship in, you may very well be expected to do it every day or most days when you join a group. Think about that in relation to just being more marketable. Do you really want to be doing pain or hearts everyday?

 

[pjl]

We have turned down multiple fellowship trained people (cards and peds), and are most likely to hire a nonfellowship person in their place. A fellowship does not make you a likeable person, and there are many intangibles that go into a hiring.