I’m genuinely curious what you think I should do? Are you suggesting I not work? I’ve said multiple times in this thread these are the only jobs available in the area.
Piggybacking off of what SSdoc said, I'd be going to every entity that could possibly employ a pain doctor and your area to find out if they'd like to start a discussion. Just because a group doesn't have an advertisement up doesn't mean they wouldn't consider bringing in the right person with strong local ties.
From watching friends search for jobs, I can tell you that a common type of job is starting a pain division for some entity, such as a hospital system or a neurosurgery/ortho group. If you're an anesthesiologist, sometimes a group without pain will want you to start with a mixed practice, then transition to more pain as that practice builds up.
You could also start your own pain practice. Find some per diem work in your primary speciality. Save up some cash. Then build slowly.
Finally, I'd do some soul searching about your geographic restriction. Are there jobs with a longer commute you haven't been considering? Are there jobs where you could stay in a hotel for a few weeknights, then get back to your preferred location for long weekends? Is there another place you'd be willing to live for a year while looking for other jobs? Are you making assumptions about what the other humans in your life want and you need to open up a discussion?
Just to play devil's advocate here, per this thread below:
Current fellow here. 9 months in and starting to doubt myself on whether or not I know how to perform bread and butter procedures proficiently. Will struggle with the occasional LESI and even some lumbar medial branch blocks. Attendings don’t really give me a chance to correct myself and I...
forums.studentdoctor.net
If the OP works in his primary specialty after fellowship, won't he suffer extreme procedural skill atrophy, potentially wasting his fellowship?
The thread you linked is about someone who doesn't feel comfortable with bread and butter procedures upon completion of fellowship, which is not normal. I predict someone could go years without "extreme procedural skill atrophy" after a pain fellowship, but I don't have anecdotal evidence to back it up.
I do know that people go years without practicing anesthesiology, then quickly get back into the groove. I know which one I'd be more worried about returning to after a break.