I completed Furman's fellowship in 2005 after having practiced general PM&R in private practice for 12 years. So I have a somewhat different perspective than most replies to this forum.
When you become an attending, who do you think does your work? For 12 years I dictated my own attorneys letters, did my own disability evaluations, coded my own charges, etc. I took a buy-out from my practice to be able to avail myself one of the few ACGME accredited PM&R Pain Fellowships in the region.
PERSPECTIVE: Scut will follow you when you become an attending. I remember back when I was a resident and I thought that when I become an attending everything would be done for me. If you want, you can create that arrangement for yourself, however, you will be surrounded by minions of employees all with salaries and benefits that you will be paying with your collections. You can hire 5 people to support you, do your scut, etc, and build a palace of an office, but expect to work 6-7 days a week to support their overhead. The reality is that there is a balance. IMPORTANT BROMIDE: It is not what you collect, it is what you take home.
Even after 12 years of practice, I learned an enormous amount about management of spine and pain issues in Furman's fellowship. For a resident coming into the fellowship, you will also learn some aspects about billing - which is not bad, because billing and coding will be your life when you become an attending... more clearly stated, that is how you pay the bills. They don't teach you that in your residency.
SUPERVISION: When you get out and start doing your own procedures as a new attending, do you expect your fellowship director to be hovering over you? I strongly believe, having been through this, that it is important to get a perspective of doing these procedures on your own, with the fellowship director present to address a problem or confirm needle placement or contrast flow if you have a question. There are lots of moving parts to a fellowship that need to be kept oiled to continue operating - that is the directors job also. If the fellowship director was not present in the procedure room, it is not he was "making money off of me."
Furman's fellowship offers many opportunities to publish, participate in research, coauthor book chapters in which a fellow may participate.
If you do not plan on building a practice (ie. do not want to go out and build a practice, do not desire to market - no, it is not a dirty word - yourself to other physicians, have no desire to understand how to be efficient and productive) you should look for a purely academic fellowship. If you want to understand how private practice works from the inside, observe how to be deposed by attorneys, learn how to be efficient in your practice, have opportunities to participate in research, etc, then a fellowship such as Furman's would be a good place to start.
From the real world... over and out.
