Pay Discrepancies in Anesthesia Fellowships?

[klmdgmc]

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I know there have been posts scattered throughout the forums, but many of them are a few years old.

I'm especially curious about the southwest and west coast:

-Which fellowships tend to pay more (if they even pay more than general)? Typical floor and ceilings for the fellowships? (I'm not talking about that 99th percentile unicorn practice)

-Which fellowships are more marketable?

-Are fellowships imperative for being hired?

-If you do a fellowship, are you more or less pigeon-holed as the "designated specialist" in the practice (and therefore can't do other cases)?

$ isn't the end all be all, but I was just curious. I can see myself doing different fellowships in the future but just wanted to get a better idea of the job market and demands outside of Gasworks. Thank yall for all of your input!

 

[AdmiralChz]

This isn't a very useful question - I wouldn't go chasing money as a primary reason to do a fellowship. I'd be pretty miserable doing chronic pain (hats off to those who love it!) even with an exorbitant salary. Anesthesiology typically is an "hours worked" specialty in terms of salary - the more you work, the more you earn and vice-versa.

Looking at your posting history you were asking about SOAP last year - have you even graduated medical school yet? These questions indicate you don't have a firm grasp on the field, which

But, I guess to answer your questions just for discussions sake...

-Which fellowships tend to pay more (if they even pay more than general)? Typical floor and ceilings for the fellowships? (I'm not talking about that 99th percentile unicorn practice)

Chronic pain and cardiac typically pays more including in academics, I don't have figures available but it isn't a gigantic incremental difference (very different from the difference between IM and say Cards or GI). Pediatrics tends to pay more, but sometimes not. Again, talking about ceiling isn't productive since one can make a lot more by busting his or her butt working 6 days a week 100+ hours than the person working only 4 days 40 hours. Exact same thing for floor earnings.

-Which fellowships are more marketable?

All are pretty marketable, but I get a TON of chronic pain as well as palliative care postings. If you go to a reasonably-respected fellowship for pain/cardiac/peds/ccm you shouldn't have trouble getting a job unless it's a hyper-competitive market. If that's the case, I'd recommend trying to train (residency/fellowship) near the area you want to end up so you can link up with local contacts.

-Are fellowships imperative for being hired?

Only for jobs that require a fellowship? Plenty of generalist jobs out there. Strange question.

-If you do a fellowship, are you more or less pigeon-holed as the "designated specialist" in the practice (and therefore can't do other cases)?

Only if you choose to be, ideally you'd have this discussion with the group before joining on.

 

[pgg]

Fellowships all pay about the same in the grand scheme of things.

Some of the non-ACGME ones that are really part-time attending / part-time fellow positions will have substantially higher salaries.

Some fellowships permit some moonlighting, but that sounds exhausting to me.

Plus or minus 5% on your paycheck for your fellow year is probably the least important thing to consider.

 

[AdmiralChz]

Fellowships all pay about the same in the grand scheme of things.

Some of the non-ACGME ones that are really part-time attending / part-time fellow positions will have substantially higher salaries.

Some fellowships permit some moonlighting, but that sounds exhausting to me.

Plus or minus 5% on your paycheck for your fellow year is probably the least important thing to consider.

Ah, I guessed the OP was asking about job prospects afterwards. I didn't consider he/she was asking about the fellowship year itself. Another sorta strange question.

In general (there are several exceptions), ACGME fellowships don't allow for part-time attending work which makes the salary only one incremental PGY above a CA-3. Some programs have internal moonlighting, most explicitly do not allow external moonlighting but I know some do locums work anyway at their own risk.

The ACGME fellowships include CCM, Pain, Cardiac and Peds. Doing a fellowship that doesn't have accreditation (they are out there) likely won't let you sit for the end of year board exam, so I wouldn't recommend that.

 

[MirrorTodd]

Ah, I guessed the OP was asking about job prospects afterwards. I didn't consider he/she was asking about the fellowship year itself. Another sorta strange question.

In general (there are several exceptions), ACGME fellowships don't allow for part-time attending work which makes the salary only one incremental PGY above a CA-3. Some programs have internal moonlighting, most explicitly do not allow external moonlighting but I know some do locums work anyway at their own risk.

The ACGME fellowships include CCM, Pain, Cardiac and Peds. Doing a fellowship that doesn't have accreditation (they are out there) likely won't let you sit for the end of year board exam, so I wouldn't recommend that.

There are no ACGME regional fellowships?

 

[pgg]

Ah, I guessed the OP was asking about job prospects afterwards.

Maybe he was and I misunderstood. Now that I reread the OP, I think you're right.

 

[pocafx]

Is doing heavy cardiac in CA-3 and then joining a practice doing all cardiac still possbile?

 

[Psai]

Is doing heavy cardiac in CA-3 and then joining a practice doing all cardiac still possbile?

It's possible to do heavy cardiac, not sure about all cardiac.

 

[AdmiralChz]

Is doing heavy cardiac in CA-3 and then joining a practice doing all cardiac still possbile?

10 years ago the answer was “absolutely” now the answer is “probably not” - but it largely depends on the complexity of the cases and group dynamics.

If one wants to do a good amount of cardiac in their practice, I would encourage him or her to just complete a fellowship. I did a heavy amount in my CA-3 year but I can’t overstate the importance of the additional training seeing lots of pathology and hands-on TEE training has had this year. It’s completely changed my practice and my approach to cardiac patients, especially since I went to a different institution and saw other ways of delivering care. A new grad would almost certainly require a lot of hand holding, especially with echo skills for complex cases, that groups may or may not want to deal with.