You just got to find a program that has an opening and wants you or has just lost a pain fellow and needs to fill the spot. Get a list of pain programs and send them all your CV with a cover letter explaining your situation. You could get back on schedule by earning a few buck working locums or work as an attending at you current location until July.
i briefly asked a couple pain fellows this before, my sense is it's harder...but you also see some people get "luckier" than if they applied only for July...it seems we hear more often about where people get in and much less about where they do not get offered spots/get denied interviews
My impression was that fellowships are a little looser than residencies in regards to number caps, etc. I kinda thought that if you were willing to do a little clinical instruction and work for the institution some days doing gen. anes. for the low salary then you could be accomodated with a spot for training certification. Not true?
fellowships (atleast those certified by the acgme) are restricted to a certain number. the program must "apply" to be able to have another fellow spot similar to residency.
i am currently doing a pain fellowship off cycle. i interviewed for a normal July start but was offered a Jan start. it was really where i wanted to be so i took it. it is a planned off cycle fellowship but i think there are some that suddenly lose a fellow or some programs that "don't fill" although i think that's pretty rare right now