My questions as I start my third year are- Should I do a fellowship? And if so, which field? My opinion is that a fellowship will help me from the standpoint of job-security in the future with a potentially competitive job-market looming in the near future. Also more importantly, I would like to add to my repertoire with some specialized knowledge to complete my jedi training. Pediatrics?? No way..Even though I like Peds I would go nuts working for a year with people with such intense personalities. OB? Naaa...I know there are complicated OB patients but ultimately, it doesn't seem inviting to me. Regional is an option but I can use the third year of my program to do all the electives in regional to get a better grasp of blocks, and it's also something I can continue to develop on my own when I'm out. So basically I'm trying to decide between Cardiac and Pain. My question with Pain is that my attendings have told me that at some point I will have to give up the O.R., and do strictly pain alone. I know one thing- I don't like my pager going off on the weekends or when I'm away from work. Is this how a life in Pain Management will be? Also, is it like a lot of medicine sub-specialties in that I will have to stick around at one place in order to build up a referral basis? How often will I be doing procedures? From a pay standpoint, is it far more lucrative than having a Cardio-thoracic background? I've seen job postings with pretty good salaries for people trained in this field. I read the previous posts on billing points, medicare/medicaid payouts. I just feel like there's a lot of contradicting info out there. As far as pain goes- how does the field stand right now and in the future? Is there a greater demand from Groups, looking to hire pain-trained people vs. Cardiac/peds/Ob trained people? It seems like there are so many people going into pain, I don't want to have a herd mentality, but I don't want to miss the boat either. Any seniors/veterans of the real world- please share your thoughts and break it down for me.