Private practice vs. fellowship

[Gas]

I'm a CA-2 and I'm starting to think about private practice vs. fellowship. It may be a bit early, but I was interested to hear some opinions about those senior to me as to what the pros and cons are.

Pros of private practice are obviously better reimbursement and more freedom, but I heard that as the job market tightens up, fellowships may become more valuable because you are less expendable. The market is hot right now, but if it goes down, groups may want anesthesiologists with a particular niche.

It's tempting to just start working, buy a nice car, and not worry about gas prices. By the way, this forum rocks!

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[militarymd]

......but I heard that as the job market tightens up, fellowships may become more valuable because you are less expendable. The market is hot right now, but if it goes down, groups may want anesthesiologists with a particular niche.

Expendability is determined more by the kind of person you are more than the type of training you went through.

I work with someone who is currently fellowship trained, and let me tell you what......he is at the top of my "expendable" list.

 

[supahfresh]

some CA-3 was telling me that the number of residency spots are not increasing and thus the gap b/t supply and demand should continue. in other words, this should keep the market good. what do you guys think?

 

[Dr. J?]

What's the gap now?

 

[Noyac]

There are a lot of reasons to do a fellowship but worrying about being expendable is not one of them. Not even close. Anesthesia is one of those specialties that doesn't require fellowships to practice all aspects of the field. When a group is deciding whether or not to keep someone or downsize or whatever, there are some things that they will consider and one of those may be a fellowship but it is not on the top of the list. They are more concerned with compatability within the group and performance, period. My group downsized and the first to go were 2 of the most entrenched members (>15yrs with the group). These 2 did not carry their load and we got complaints from surgeons and nursing about them from time to time. Fellowships are fine when they are done for the right reason (need time to find the right job, want to stay in academics, really enjoy certain types of anesth., etc.). But they will not secure a spot for you if you are not a performer and they will not make up for deficiencies. Don't get me wrong, I think fellowships are great and I thought about it when coming out of residency but I was comfortable with all forms of anesth, even pain, therefore I didn't see the need and I am glad I went the way I did.

 

[jetproppilot]

There are a lot of reasons to do a fellowship but worrying about being expendable is not one of them. Not even close. Anesthesia is one of those specialties that doesn't require fellowships to practice all aspects of the field. When a group is deciding whether or not to keep someone or downsize or whatever, there are some things that they will consider and one of those may be a fellowship but it is not on the top of the list. They are more concerned with compatability within the group and performance, period. My group downsized and the first to go were 2 of the most entrenched members (>15yrs with the group). These 2 did not carry their load and we got complaints from surgeons and nursing about them from time to time. Fellowships are fine when they are done for the right reason (need time to find the right job, want to stay in academics, really enjoy certain types of anesth., etc.). But they will not secure a spot for you if you are not a performer and they will not make up for deficiencies. Don't get me wrong, I think fellowships are great and I thought about it when coming out of residency but I was comfortable with all forms of anesth, even pain, therefore I didn't see the need and I am glad I went the way I did.

Nice post. Well said.