Is it important to do a fellowship in PMR?

[kingofhearts]

Hello, I am a 2nd year PM&R resident. I was thinking of doing pain or musculoskeletal fellowship. But my seniors feel that after PMR residency, you get enough training to do procedures in outpatient setting. So as per them, there is no need to do a fellowship.
I just want to know what are the advantages of doing a fellowship after PM&R residency in MSK or pain? Does doing fellowship really make a difference??

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[axm397]

Hello, I am a 2nd year PM&R resident. I was thinking of doing pain or musculoskeletal fellowship. But my seniors feel that after PMR residency, you get enough training to do procedures in outpatient setting. So as per them, there is no need to do a fellowship.
I just want to know what are the advantages of doing a fellowship after PM&R residency in MSK or pain? Does doing fellowship really make a difference??

It depends on which procedures and how well you get trained at your residency in MSK. If you're doing shoulder, hip, knee, and maybe even lumbar injections only, then you probably don't need a fellowship, provided you got enough education in residency. If you want to do more high risk procedures or specialize in a certain aspect of pain, then fellowship may be the way to go. I know we only have 2-3 4th years going into fellowships. Many of the seniors have gotten private practice jobs doing outpatient MSK.

 

[drusso]

It also depends how where you're going to practice and how you're going to market yourself. If you're going to be in a predominantly urban area with lots of specialists and sub-specialists around, then a fellowship is the way to go. Ditto if you're going to be joining multi-specialty surgical practice. If you're more interested in a more ordinary community private practice setting or are considering a location of the USA unsaturated by physiatrists (eg the Southeast) then you can likely skip a fellowship provided that you have adequate numbers of procedures to get you privileges at the local community hospital or surgical center.

 

[Disciple]

Hello, I am a 2nd year PM&R resident. I was thinking of doing pain or musculoskeletal fellowship. But my seniors feel that after PMR residency, you get enough training to do procedures in outpatient setting. So as per them, there is no need to do a fellowship.
I just want to know what are the advantages of doing a fellowship after PM&R residency in MSK or pain? Does doing fellowship really make a difference??

It's my opinion, but I don't see huge advantages to doing an MSK fellowship except to possibly increase your chances for certain academic MSK positions.

For some residents, it may be a necessity if their core MSK or sports training was weak.

The advantages of doing a "pain" fellowship are to gain exposure to comprehensive pain medicine, to learn higher risk procedures (cervicals, implantables, discography, intradiscal procedures) if so desired and to obtain pain board eligibility (if the possibility of credentialing/reimbursement difficulties) is an issue with you.

At the current time, some employers want fellowship trained interventionalists, some don't care as long as you've officially logged enough procedures under supervision. Some may want interventionalists with comprehensive procedural skills, others may require only basic lumbar stuff.