Pain fellowship vs. General

[seaofred]

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Hey guys,
I am going to be a CA3 here in July and I am having a hard time deciding whether to do a pain fellowship or hit the job market for general. I was hoping some of you that are out there practicing or doing fellowships could give some of the reasons on why you choose general or pain management.

Do you find pain management less stressful than a day in the OR?

Are most pain practices set up as "procedural based"?

How are the surgeon/MDA interactions in private practice?


Thanks.

 

[joshmir]

Good post- also something I would love to hear commented on.

As someone who is considering going into pain, I reflect often on the fact taht most of the anesthesia residents who *could* get into good pain fellowships choose *not* to do so...the same cannot be said of PM&R residents. Or internal med residents with GI and cards.

Can any residents shed any light on this? I hear the academic pain world is very different from the private practice pain world. I also know many residnts went into anesthesia because of the shorter, high yield patient contact, and working with chronic pain patients is the antithesis of that...

I would love it if the original poster could "think out loud" for us, tell us what he considers to be the pros and cons her percieves while making this decision...

thanks!

 

[seaofred]

Thanks for the reply. My thoughts on going into anesthesia were the same as many others on this board. The pros that I perceived were: short patient contact, the ability to help critically ill patients, cool drugs with immediate results, leaving at the end of the day and turning my pager off. I have learned the cons during my residency: having to work with surgeons who have no clue what you do but are quick to criticize (not all surgeons but there is always a few around every hospital), the stressful situations when a patient isn't doing well.

My biggest question is what life is like out in private practice, both in pain and general. I find myself attracted to pain to avoid some of the stress that comes with doing general but after talking to several attendings about this they have reassured me that it gets easier and easier. On the other hand, chronic pain patients can be difficult to deal with and I can't see myself sitting in a clinic every day.

Also, the job market seems much better in general vs. pain right now (my perception). The fellows that are just finishing their pain fellowship at my program got jobs but they had to be more selective of where they went and the packages didn't seem that great for the extra year.

I'd like to hear from some people out there practicing.

 

[Tollway]

Sounds like you answered your own question Seaofred.

 

[seaofred]

Na. Those are my perceptions that I have about private practice. I would like to know from people out there practicing in pain or general what the real world is like?

 

[HowUdoin]

Seaofred,

I just finished a rotation with an osteopathic pain medicine specialist in Plano (north Dallas) and can give you some info on his practice. He has been in practice with his sister (allopathic pain medicine physician) for the past 15 years. He sees about 50-60 pts in clinic each day, tues and thurs 9am-5pm, does 20-30 procedures each day, mon-wed-fri 730am-5pm. He had weekends free and split call with his sis, but we never got called in the entire month I was there. He is very successful and has treated numerous physicians and their family members. He even declined an offer to be a physician for the Dallas Stars because he would have to travel too much. Chronic pain pts took up about 25% of his practice, 60-70% of his patients did well after treatments, and the rest would need more treatments or did not get any relief at all. About 80% of his pts were greater than 40 years old. By the way, he makes anywhere from 700-800k a yr which almost made me change my mind on going into pediatrics. Hope this helps you a little bit. Good luck in your decision.

Matt 11:28-30

 

[Drakensoul]

... By the way, he makes anywhere from 700-800k a yr ....

.......Mother of god.
😱 😱 😱 😱