I am also curious about why ESU_MD put "fellowships" and "fellow" in quotes. Does this imply that MIS is not a fellowship discipline that is on a par with something like plastics or surg onc that is a distinct surgical discipline?
Certainly not on par with a plastics fellowship anywhere, and probably not surg onc, although the latter depends on where you trained.
I suspect his comment is essentially the realization that most MIS fellows are simply doing the same cases the residents are. As a matter of fact, before my residency had both an MIS and a Bariatrics fellow, guess who did all the MIS cases? The residents!!! We still did them afterwards but you have to wonder whether or not you need such a fellowship.
But market forces are powerful - I probably didn't need a Breast fellowship to do Breast but it vastly increases my marketability and practices may find that an MIS fellowship trained surgeon is marketable. Whether that's true a few years from now as the insurance cuts on Bari care comes down the pike, remains to be seen.
So yeah, I think in many programs, the residents feel pretty darn comfortable with MIS procedures and wouldn't need a fellowship. There are probably some advanced cases (colons, spleens, adrenals, etc.) that you would get more of in a fellowship, but if your fellowship is all bariatrics, nissens, and appys/choles, I'd have to ask what is the benefit beyond marketing?
