Family Graduate----advice

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wasatch

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I need advice---

I am very interested in Pain Management as a career. I originally applied for an anesthesiology residency last year hoping to get into a pain fellowship. At the time I knew that anesthesiology had most of the fellowships under their department. I was not completely in love with anesthesiology though, I figured it would be the best stepping stone to Pain. Unfortunatly, I was not selected for a spot in anesthesia. I opted to go for family as it has always interested me.

I still want to go into pain management though! I understand there are some major orginizational issues that need to be ironed out. The issues of accreditation and so on. Now that family graduates are eligible to apply...I am being realistic and know that my application won't be as competitive as an anesthesiologist or PM&R, etc.

How can I become more competitive? I don't want to reapply for anesthesiology again...as that is not really what I want...and I don't want to waste my time and others opportunities for this field, just to get to Pain. PMR will allow me to use my first years as an intern year and they have their own pain fellowships....and some of the anesthesiology depts are more open to PM&R....I actually enjoy the work of physiatry as well.

Should I risk it and stay with family and try and apply then or should I be more aggressive and look into PM&R? :confused:

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I think you will need to apply for a PM&R spot. Family is not a very good or realistic stepping stone into pain. Pain spots are getting more difficult each year, especially the better ones. If you didn't do so well in med school (as I would guess is the case since you didn't get a gas spot) you will really need to step it up in residency.
 
I came across a family medicine "spine" fellowship in SLC. I think it may even be associated with the U of UT. They were doing primarily lumbar interventions, including RF, per word of mouth.

Just saw your member name so maybe you already know about this?

Family medicine having their own "spine" fellowships does raise alot of interesting issues.
 
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I was not able to find the fellowship in the family med department at the U of U. Maybe it was under a different department or another hospital?
 
Randomly met someone during a job interview last year who said their husband was doing this "fellowship". Im sorry but do not have any other details.
 
I don't think that fellowship exists. There is a sports and spine fellowship at the University of Utah through the PM&R department directed by Stuart Willick. It's a great fellowship and the fellows are educated in some circumstances by family physicians. Dan Petron is a family medicine attending who is very involved with the orthopedic department and does some spinal intervention as well. I spent some time out there and never met a family med fellow. Other residents from Utah may have better info.
 
I emailed the PD at Univ of Nebraska anesthesiology dept to find out if Family graduates could apply to the program. I got an email back that said no. I thought this year family graduates could apply....am I wrong in this?

Anyone know of programs that are considering family graduates?

Thanks
 
The new Guidelines state that the fellowship training is to be multidisciplinary (Anesthesia, PM&R, Psyche, Neuro) and that anyone with a base ABMS board certification can become ABMS subspecialty certified.

Is does not, however, dictate the application/selection process for any program.
 
Oh really, then it is a useless change.

Due to the fact that 90% of the fellowships are ran through anesthesiology departments. They will continue to be biased to their own anesthesiology graduates. Yippee. :thumbdown:
 
The anesthesiology fellowships should be biased for anesthesiology fellows. If I was interested in cardiothoracic anesthesia and wanted to do a cardiology fellowship to sharpen my TEE skills do you think that they would give me the time of day??? Some cardiology fellowship do not even want to let cardiac anesthesia fellows rotate through their department........
 
If you really want to do pain, take the initiative and do an anesthesiology residency. Neuro, PM&R, and anesthesiology are the only fields that should be sending people to pain fellowships, regardless of ACGME rules.

In your not so humble opinion.

If I went the anesthesiology route, why would one want to do another year to learn pain procedures? I have done a rotation in anesthesia and pain. Pain does not come close to the complexity of anesthesia care. Seems rather ******ed to me.

In my opinion pain could not stand alone as a separate residency either. It just is not that difficult of a field to make it largely an anesthesiology fellowship. Which explains why psychiatry was previously allowed entry to the field. Hence the change in rules to begin allowing everybody in....I feel bad for all those that worked hard in other difficult residencies, but it just makes a lot of sense. I am sure the change has irked many people.
 
Despite the rule change I would be surprised to see numbers really change for many years. It will continue to be mostly anesthesia, with a few pmr and neuro, very few psych, and even less of anyone else.
 
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