Pain fellowship match results

[nerve zapper]

Unfilled positions: 61 out of 393 (15.5%)
Unfilled programs: 35 out of 115 (30.4%)

Unmatched applicants: 27 out of 359 (7.5%)

What happened this year? Is it that a strong general anesthesia job market lured gas applicants away from pain? Or is there more to the story

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[au bon pain]

PM&R market is also super strong.

 

[TheNolano]

As a current pain fellow from anesthesia background, the insane anesthesia market is legitimately making me question my choices.

I do like pain. I like the science, the tech, the cool future of neuromod, and the fluoro anatomy. I am at a great and supportive fellowship.

But man. I could sign multiple contracts today to do general anesthesia out west at reasonable sized towns doing MD only with a lot of vacation. Had an offer for $550 starting for MD only at a level 2 trauma center with 12 weeks off.

I think pain will make me happy, but I have not found any jobs in pain that come close to the jobs in anesthesia. Sure pain doesn’t have night or weekend call, but no one I know gets close to 12 weeks of vacation. My wife would definitely rather I work a bit more when on for way more weeks off. And at least at this point, anesthesia feels way easier than pain.

So I dunno. I’m still a brand new fellow and hope it gets easier. At least I get to moonlight every weekend for an easy $300/hr at a small local hospital where I mostly watch Netflix on the weekend.

But I’d give more than 30% odds that I just do anesthesia after this year. And that kinda sucks and makes me wonder what I’m doing.

 

[RoloTomassi]

Good for you gas folks but why is the anesthesia market strong? I feel like not long ago, there was talk of CRNAs and AAs devaluing the field and hospitals contracting with PE owned groups to save money?

 

[Status Sciaticus]

As a current pain fellow from anesthesia background, the insane anesthesia market is legitimately making me question my choices.

I do like pain. I like the science, the tech, the cool future of neuromod, and the fluoro anatomy. I am at a great and supportive fellowship.

But man. I could sign multiple contracts today to do general anesthesia out west at reasonable sized towns doing MD only with a lot of vacation. Had an offer for $550 starting for MD only at a level 2 trauma center with 12 weeks off.

I think pain will make me happy, but I have not found any jobs in pain that come close to the jobs in anesthesia. Sure pain doesn’t have night or weekend call, but no one I know gets close to 12 weeks of vacation. My wife would definitely rather I work a bit more when on for way more weeks off. And at least at this point, anesthesia feels way easier than pain.

So I dunno. I’m still a brand new fellow and hope it gets easier. At least I get to moonlight every weekend for an easy $300/hr at a small local hospital where I mostly watch Netflix on the weekend.

But I’d give more than 30% odds that I just do anesthesia after this year. And that kinda sucks and makes me wonder what I’m doing.

+1. Also current fellow considering doing anesthesia/pain combo or straight locums to accumulate some cash.
I dont think any pain job can really match the vacation week that anesthesia has. Unless its HOPD and just aiming to hit the median RVU numbers.

 

[Agast]

Good for you gas folks but why is the anesthesia market strong? I feel like not long ago, there was talk of CRNAs and AAs devaluing the field and hospitals contracting with PE owned groups to save money?

I think a lot of people retired thinking “Eff this” during covid, plus cashed out with private equity = relative shortage

 

[pastafan]

Everything is cyclical. I remember the years when anesthesiology graduates were desperately seeking jobs. Call will always suck and decades of sleep deprivation also suck the life out of you. First, choose what will make you happy. Perhaps you can milk the current situation by doing part-time gas until the tide turns.

 

[Dr.Jekyll75]

Also have had second thoughts but knew deep now. Will likely finish … if anything you get an extra title… and you can use it for chair and teaching faculty positions or even consulting

 

[TrailRun]

Also have had second thoughts but knew deep now. Will likely finish … if anything you get an extra title… and you can use it for chair and teaching faculty positions or even consulting

Can you mention what makes you not like it? I'm an EM applicant who didn't match this year (geographically limited), thinking about reapplying

 

[GoBeers]

anesthesia money is hot right now; but no amount of money will have me back working call, weekends, nights , holidays, 630am start times.
i think i'm the only father at all of my kids' soccer, tennis, gymnastics practice in a sea of moms lol.

 

[adamkiewicz]

I was on the fence going into Pain for lifestyle but I chose to do anesthesia. I found a lifestyle job without any calls or weekends. Last year I made slightly less than a million and this year I'll be over a million. I get to have dinner with my kids and sleep in my bed every night. I'm doing this as an employee. I don't have any extra stress from running a business.

 

[Status Sciaticus]

I was on the fence going into Pain for lifestyle but I chose to do anesthesia. I found a lifestyle job without any calls or weekends. Last year I made slightly less than a million and this year I'll be over a million. I get to have dinner with my kids and sleep in my bed every night. I'm doing this as an employee. I don't have any extra stress from running a business.

A million as an employed anesthesiologist? Sounds suspect...

 

[GoBeers]

I was on the fence going into Pain for lifestyle but I chose to do anesthesia. I found a lifestyle job without any calls or weekends. Last year I made slightly less than a million and this year I'll be over a million. I get to have dinner with my kids and sleep in my bed every night. I'm doing this as an employee. I don't have any extra stress from running a business.

7 figures with no nights, call, weekend??

Care to share what group this is? Maybe I'll go back to anesthesia lol

 

[GlowInTheDark]

Because the field has been clamped down on more and more the last few years and the astute have realized it’ll be toast in 10 years if your shoes aren’t pointy enough.

The sky! It’s coming down!

 

[sevo00]

I was on the fence going into Pain for lifestyle but I chose to do anesthesia. I found a lifestyle job without any calls or weekends. Last year I made slightly less than a million and this year I'll be over a million. I get to have dinner with my kids and sleep in my bed every night. I'm doing this as an employee. I don't have any extra stress from running a business.

I don’t believe this. The only people I know making 7 figures doing anesthesia are the ones taking a lot of call

 

[SpineandWine]

Best thing for pain then would be to reduce amount of fellowship like they do with Dermatology - increase demand

 

[NVO]

Best thing for pain then would be to reduce amount of fellowship like they do with Dermatology - increase demand

They instead added ~20 more spots this year vs last year. HCA pain fellowships opening up and academic programs with way too many spots

 

[sevo00]

Best thing for pain then would be to reduce amount of fellowship like they do with Dermatology - increase demand

its already only 1 year long. how much more can you reduce it?

 

[swamprat]

its already only 1 year long. how much more can you reduce it?

I think poster meant the # spots not the duration.

 

[oreosandsake]

Data presented at one of the meetings.

Average age of anesthesiologists much higher. Post COVID they retired

Lot of fields swing back and forth. Psych was dead then became very lucrative. Family med on upswing in pay too
ER was hot 10-15 years ago, now can’t fill and ERs run by NPs

 

[bedrock]

Data presented at one of the meetings.

Average age of anesthesiologists much higher. Post COVID they retired

Lot of fields swing back and forth. Psych was dead then became very lucrative. Family med on upswing in pay too
ER was hot 10-15 years ago, now can’t fill and ERs run by NPs

Agree on the supply demand of the fields you mentioned.

But do you think that psych became lucrative because of high demand or become they figured out how to do cash psych practices?

Though I’m PMR, I think there is a lot of value in hedging your bets by doing anesthesiology and pain. They can bounce back and forth. Not easy but it provides a great deal of carerr flexibility

 

[bedrock]

Funny about ER too. My lady had never seen the show ER and so we’ve been watching it frequently on Hulu lately.

The show was still big while I was in medical school and I strongly considered ER as a specialty.

Now it is still fun to watch and my girlfriend really enjoys the show, but OMG I’m glad I’m not now working all night shifts in my late 40s and dealing the craziness and unreasonable demands of our current population in this country.

I’d never consider ER if I was in med school now.

 

[oreosandsake]

Agree on the supply demand of the fields you mentioned.

But do you think that psych became lucrative because of high demand or become they figured out how to do cash psych practices?

Though I’m PMR, I think there is a lot of value in hedging your bets by doing anesthesiology and pain. They can bounce back and forth. Not easy but it provides a great deal of carerr flexibility

Low reimbursement drives down interest creates supply
Problem then it shifts the other way. Also cultural shift of diagnosing everything as a medical problem… and yes, shirt to cash psych
There was a time when every gunner wanted to be a surgeon and ROAD like specialties were for bottom tier students. If you look at NRMP pmr has nearly 2 applicants for every spot. Every spot was filled in the match. In that sense, it’s up there with ortho and other sought after specialties. Scores and other markers might not be the same. not to shift too far away from OP

Also as gas pays so well vs pain now will see more spots going to non anesthesia due to opportunity cost and ROI shifts

 

[oreosandsake]

Funny about ER too. My lady had never seen the show ER and so we’ve been watching it frequently on Hulu lately.

The show was still big while I was in medical school and I strongly considered ER as a specialty.

Now it is still fun to watch and my girlfriend really enjoys the show, but OMG I’m glad I’m not now working all night shifts in my late 40s and dealing the craziness and unreasonable demands of our current population in this country.

I’d never consider ER if I was in med school now.

Yeah I was contemplating that for a hot second too. Though I knew from undergrad I wanted to do pmr and likely pain/sports spine etc. had a great ER rotation at a county L1 Trauma center etc. enjoyed the action for the month. Didn’t see it long term as a career besides the benefit flexibility which is also what killed the specialty

So glad I didn’t do that.