likeaboss

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So everyone knows about peds, cardiac, pain, crit care, etc as fellowships you can do after anesthesiology residency, but what about other non-anesthesia related fellowships?

I have heard of people doing palliative medicine, sleep medicine, blood banking (not sure what this fellowship is called).

Any others you guys can think of? I feel like there are probably a lot more options out there...

Thanks!!
 

Doctor4Life1769

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Spinach Dip

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I know a couple current residents who are leaning towards sleep medicine.


Wounds. And with America getting fatter and more diabetic, they probably are pretty busy. Also a big population they take care of are para/quadreplegics who get lots of wounds.
Interesting route, but how many are accepted into hyperbarics each year? I would suspect its a small number.
 
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FFP

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I think the most logical non-anesthesia fellowship for anesthesiologists is palliative care. It's like chronic non-interventional pain, but without the crazies.
 
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likeaboss

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Medical informatics also sounds interesting but non-clinical...

Sleep medicine sounds cool too. Does anyone know anesthesiologists who do part time sleep clinic and part time OR anesthesia?
 
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narcusprince

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Sleep medicine would be a good gig. Just eval sleeps studys for cpap machines. Diagnosis of parasomnias would be low yield for reimbursement. Why would you do this if your billing yield would be higher in the OR? This is an academic fellowship with little yield to an academic department. Lose lose situation unless your willing to sacrifice the greens......
 
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likeaboss

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Sleep medicine would be a good gig. Just eval sleeps studys for cpap machines. Diagnosis of parasomnias would be low yield for reimbursement. Why would you do this if your billing yield would be higher in the OR? This is an academic fellowship with little yield to an academic department. Lose lose situation unless your willing to sacrifice the greens......
I like clinic... I like the pace of it, and the being able to think and formulate a plan before executing it. I also love the the excitement of the OR through, so ideally I would like to do both if that is feasible....
 

SaltyDog

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Sleep medicine would be a good gig. Just eval sleeps studys for cpap machines. Diagnosis of parasomnias would be low yield for reimbursement. Why would you do this if your billing yield would be higher in the OR? This is an academic fellowship with little yield to an academic department. Lose lose situation unless your willing to sacrifice the greens......
If you opened your own sleep center/lab I would imagine it could be pretty profitable. Gotta be less overhead than opening your own pain clinic??
 

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Interesting route, but how many are accepted into hyperbarics each year? I would suspect its a small number.
My residency program had 2-3 hyperbaric fellows per year; however, they were usually FM or EM residents from the military, not anesthesia. Either that or heavy researchers. Lots of military applications for dive medicine/high altitude medicine.

Most of the day-to-day stuff was chronic wound therapy, with the occasional carbon monoxide poisoning thrown in during the winter. Plus fielding phone consults from divers around the world and the occasional one flown in from the coast for treatment. Then research stuff on the side.
 

bashwell

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Sorry for the mercenary like question.... But what's the salary like for hyperbaric or sleep? Possible to equal general anesthesia?
 

caligas

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Sorry for the mercenary like question.... But what's the salary like for hyperbaric or sleep? Possible to equal general anesthesia?
Usually those are combined with another practice such as sleep/pulmonary etc. not much data on salary for a 100% sleep practice. Its Hard to do much better than what you can make as a partner in a good anesthesia practice.
 
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repititionition

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Hyperbarics is going through a transition much like anesthesia more broadly. Over the last 5 years, large HBOT companies have bought up incredible numbers of what were formerly independent practices.

HBOT was a goldmine 10-20 years ago. Now you need a very specific opportunity where there is a) volume to support 2+ chambers and b) no competition in the area. I'll save you the looking. There aren't many places like that left.
 

nycitygas

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The money isn't in sleep anymore. Too much competition and decreased reimbursement.
 
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likeaboss

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So the same changes are happening in like every field
 

gasoflife

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So everyone knows about peds, cardiac, pain, crit care, etc as fellowships you can do after anesthesiology residency, but what about other non-anesthesia related fellowships?

I have heard of people doing palliative medicine, sleep medicine, blood banking (not sure what this fellowship is called).

Any others you guys can think of? I feel like there are probably a lot more options out there...

Thanks!!
Look into perioperative medicine fellowships. They are proliferating and most are run by the big centers so you get that name as well.
 
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likeaboss

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Interesting. Are these essentially perioperative surgical home fellowships?
 

caligas

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Look into perioperative medicine fellowships. They are proliferating and most are run by the big centers so you get that name as well.
What will that teach that one doesn't learn in a solid 4 year anesthesiology residency?
 

2win

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What will that teach that one doesn't learn in a solid 4 year anesthesiology residency?
You are absolutely right!
But who cares anymore ...they care about a stupid piece of paper...
2win
BTW - the concept of the home BS has no EBM base - just another failed attempt by the ASA ...
 

pgg

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What will that teach that one doesn't learn in a solid 4 year anesthesiology residency?
Most residents don't get to "run things" beyond basic scheduling, and often only when on call or on weekends ... ie, slow times.

I learned 100x more about OR management my first year out of residency than I did as a resident. As a resident, I just wasn't dealing with all the **** and wrenches thrown into the logistics of the department. There's more to it than answering pages and fitting add-ons into an available OR.

I can see how some formal instruction and a curriculum could be beneficial. Much the same way that "anyone" can run a business, but the people with business degrees have a leg up.


That said, other than the formal credential (paper certificate), a year of working in a non-drone capacity should get anyone well on the way to competence here ... a year as a FELLOW is a hell of an opportunity cost to bear for something that's OJT for most of us.

The fellowship might be good if you're aiming for a career as a traveling efficiency consultant instead of a practicing anesthesiologist. Those guys can scam big fees out of suckers and dysfunctional institutions.
 
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