pain medicine fellowship

[WHOIZME]

how important is it to attend a residency program where they have a pain fellowship? Would this increase the chances of me getting into a pain program not just into that program but other pain fellowship programs? Or it doesnt really matter?

Thanks, this will help with ranking.

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[walli]

Rank the places where you think you will get the best residency training. When you finish residency you can apply for a pain fellowship if you are still interested in pain. You probably will want to go elsewhere since you will have already rotated with the pain specialists at your home institution during your 2nd and 3rd year and will want to learn other pain management techniques and philosophies.

 

[amyl]

this is good advice.... dont worry about fellowship specifically. go to a good, well respected program that will make you competitive for fellowships and the job market in general. i know you think you know what you want but things change.... when i started med school i had it all figured out and anesthesia was the last thing i thought i'd do. starting residency i was sure i would want to do a certain fellowship and i have changed my mind. make sure to go to a place that keeps your options open....

 

[ILM5]

this is good advice.... dont worry about fellowship specifically. go to a good, well respected program that will make you competitive for fellowships and the job market in general. i know you think you know what you want but things change.... when i started med school i had it all figured out and anesthesia was the last thing i thought i'd do. starting residency i was sure i would want to do a certain fellowship and i have changed my mind. make sure to go to a place that keeps your options open....

I agree with all the posters, go to the best program, the fellowship may not be there in 3-4 years due to departmental politics as I have seen at my med school.

 

[ultm8frisbee]

how important is it to attend a residency program where they have a pain fellowship? Would this increase the chances of me getting into a pain program not just into that program but other pain fellowship programs? Or it doesnt really matter?

Thanks, this will help with ranking.

I think it is important to go to a program with a strong pain fellowship, if thats what you're thinking. Strong pain fellowships have strong pain faculty, that can write you letters of rec when it comes time again to interview for fellowships. At the minimum, go to a program that provides good pain exposure during residency, so you can at least decide if you enjoy it or not. Strong internal candidates also have a leg up for their home instituion come fellowship time as well....

 

[narcusprince]

this is good advice.... dont worry about fellowship specifically. go to a good, well respected program that will make you competitive for fellowships and the job market in general. i know you think you know what you want but things change.... when i started med school i had it all figured out and anesthesia was the last thing i thought i'd do. starting residency i was sure i would want to do a certain fellowship and i have changed my mind. make sure to go to a place that keeps your options open....

I accept your hypothesis that things change when entering residency . As for fellowships, I am currently rotating with our pain guys here at CCF. I can tell you without a doubt they do the most pain procedures in the country. RFA's, intrathecal pumps, CNS stimulators, PNS stimulators, if you have got a nerve these guys CAN block it. Also, I think our fellowship is the largest in the country at around 10 fellows each year.

 

[lord_jeebus]

I agree that it is beneficial to select a program with a strong pain fellowship. Pain is the most competitive of anesthesia fellowships; I know of people who failed to get a spot anywhere. When I spoke to pain faculty at various programs when I applied for residency (my application made it very clear that I was committed to pain, so most places had pain faculty interview me), at all but one program I was told that priority was given to the local residents.

I ranked residencies mostly based on my perception of the strength of the pain program, and I have no regrets. Most strong pain programs are affiliated with strong anesthesia programs. As a CA-2, the faculty at my local pain fellowship have already assured me that a spot is mine if I want it, and having an excellent fallback program (which I am likely to stick around for, even if I am offered a fellowship at every other program) is huge. We don't interview many applicants, and I would not have been guaranteed of even an interview here if I had done residency elsewhere.

Being able to do pain research is also a plus - if your department did not have such resources, you could not pursue this. Similarly, getting letters from well-known pain faculty would be difficult if your program does not have such faculty internally.

 

[lord_jeebus]

I accept your hypothesis that things change when entering residency . As for fellowships, I am currently rotating with our pain guys here at CCF. I can tell you without a doubt they do the most pain procedures in the country. RFA's, intrathecal pumps, CNS stimulators, PNS stimulators, if you have got a nerve these guys CAN block it. Also, I think our fellowship is the largest in the country at around 10 fellows each year.

Are you guys doing much kyphoplasty/vertebroplasty and intradiscal procedures? With so many fellows, does anyone get much OR time? There are a lot of programs that claim to do more procedures than anyone else, and I'm trying to narrow down my list of pain apps.

 

[maahyd]

I don't know if you should make a decision to rank a school based on the pain program for the various reasons stated above. However, it is certainly true that if you go to a place with a strong pain program that you have better chances for you to get a pain fellowship in the future. We have a huge guy in pain at my school and because of him we have alot of guys go to unbelievable places for pain. In addition we take 75-100% of our 4 pain spots from our own school. Good luck with ranking although its too late cuz its 9:30 and the deadline to rank was 30 mins ago.

 

[ssmallz]

I would certainly look at programs w/a strong pain fellowship for the reasons the above posters mentioned. You can get good anesthesia training anywhere and most places are very good. My program doesn't have any fellows and while we do place people at many fellowships around the country, it certainly helps to have a home program to fall back on and people in the know to writing letters.

One more small point that no one mentioned. Moving sucks, and moving for 1 year sucks even more. This may not mean much to you but if your program doesn't have a fellowship you will be forced to move to another area of the country. If you're in a densely populated area of the country like NYC w/multiple fellowship programs to choose from this may not be a big deal but if your in a state where the fellowships are spread out, you might have to pick up and move for a year. This can be very complicated if you have a SO or children. On top of that, if you don't want to stay in the community where you do your fellowship you will have to move again. While this may not be a huge consideration in planning your residency it is certainly something you should think about

 

[flipcyde]

Quick question, when do people send their application for pain fellowships? I've heard March but others have said that programs don't start reviewing applications until June. Anyone have any insight? My program doesn't have a pain fellowship so no help here. Thanks!

 

[lord_jeebus]

Quick question, when do people send their application for pain fellowships? I've heard March but others have said that programs don't start reviewing applications until June. Anyone have any insight? My program doesn't have a pain fellowship so no help here. Thanks!

Some programs accept applications year-round on a rolling basis, with multiple start dates. Most seem to accept them starting March or April, although interviews seem to start 2-3 months after that. My local program will accept applications starting April 1 and plans to start interviews in May.

 

[narcusprince]

Are you guys doing much kyphoplasty/vertebroplasty and intradiscal procedures? With so many fellows, does anyone get much OR time? There are a lot of programs that claim to do more procedures than anyone else, and I'm trying to narrow down my list of pain apps.

Jeebs I checked with our pain guys. We do plenty of intradiscal procedures kyphoplastys and vertebroplastys.

 

[lord_jeebus]

Jeebs I checked with our pain guys. We do plenty of intradiscal procedures kyphoplastys and vertebroplastys.

thanks

 

[caprisun]

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[lord_jeebus]

You can find pain jobs in major urban areas, but the opportunity cost is HUGE

 

[citixen]

but the opportunity cost is HUGE

what do you mean?

 

[geogil]

what do you mean?

Opportunity cost is an economic term that refers to the price one has to pay in order to do something. This cost can be financial, one of inconvenience, time spent doing something undesirable, etc..

The opportunity costs of doing a pain fellowship are multiple:
Financial: you have to sacrifice a year of attending salary to do another year of training (which would have been the first year of your attending gig). This may be money which can be recuperated from the increased earnings offered by a pain fellowship training, depending on the job you get.

Convenience: you might have to move across the country for a year. This is not insignificant if you have school aged children or a spouse whose employement you must consider.

Geographic: you might have to live in an undesirable location in order to get the training you want.

Ultimately though, the opportunity cost can only be determined by the potential applicant.