What do you all think about this

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Lostin_space

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Hey good pain folk,

So I completed a pain rotation recently. Attending gave me excellent feedback, told me how I had done really well during the rotation, said so repeatedly, how I did x, y and z procedures with no problem, etc. At the same time, and without me saying anything, he told me I should consider Sports/spine but not pain Medicine. I was shocked and kind of hurt about this. I was surprised to hear from this person that if I had done so well and he felt I was doing the procedures so well he would say this. I also found it really odd that he would recommend me doing Sports/and in particular spine! Don't spine trained fellowship docs do a lot of what pain docs do? Further this person talked about the uncertain of how I would do with cervical procedures (I have never done one by the way) and this attending does not do them either. I found it very odd to be told that I should not do pain because this person doesn't know how I would do on one specific set of procedures that I have never do and that they don't do. In addition looking at spine fellowships, it seems most if not all of them do cervical procedures ? I was also offered a letter for spine but not for pain.
Thoughts on this?
I was hurt but at the same time confused. I have no idea what to make of this.
 
One person's opinion. Who knows the motivation. Don't Dwell on it


Sent from my iPhone using SDN mobile app
 
What is it about pain management that you really enjoy? Be as specific as you can.
 
NJPAIN said:
One person's opinion. Who knows the motivation. Don't Dwell on it


Sent from my iPhone using SDN mobile app
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Agreed, but it sucks that this person is only offering a spine letter not a pain letter. I wanted to apply for pain.
 
101N said:
What is it about pain management that you really enjoy? Be as specific as you can.
Click to expand...

I enjoy procedures - I initially was going to do IR, and was/am excellent at precise, detailed, small scale procedures. I enjoy being able to visualize what Im doing, working with my hands, being able to be efficient and help patients deal with their pain. I obviously like imaging in general, and find tremendous satisfaction in giving patients a non surgical option to manage their pain. I not only like spinal procedures but also peripheral procedures. I enjoy treating things like spasticity as well, and find tremendous satisfaction in helping patients with improving their outcomes - whether it is being able to get back to their daily activity because of lack of pain, or being able to open their hands because now they have less spasticity, etc.
 
you are better off with spine. 90% of pain is spine anyway. think of it as pain without CRPS. 🙂
 
Lostin_space said:
Hey good pain folk,

So I completed a pain rotation recently. Attending gave me excellent feedback, told me how I had done really well during the rotation, said so repeatedly, how I did x, y and z procedures with no problem, etc. At the same time, and without me saying anything, he told me I should consider Sports/spine but not pain Medicine. I was shocked and kind of hurt about this. I was surprised to hear from this person that if I had done so well and he felt I was doing the procedures so well he would say this. I also found it really odd that he would recommend me doing Sports/and in particular spine! Don't spine trained fellowship docs do a lot of what pain docs do? Further this person talked about the uncertain of how I would do with cervical procedures (I have never done one by the way) and this attending does not do them either. I found it very odd to be told that I should not do pain because this person doesn't know how I would do on one specific set of procedures that I have never do and that they don't do. In addition looking at spine fellowships, it seems most if not all of them do cervical procedures ? I was also offered a letter for spine but not for pain.
Thoughts on this?
I was hurt but at the same time confused. I have no idea what to make of this.
Click to expand...

You will be more comprehensively trained and sit on a higher echelon than most of your peers by completing an ACGME-accredited Pain Medicine fellowship.
 
Lostin_space said:
I enjoy procedures - I initially was going to do IR, and was/am excellent at precise, detailed, small scale procedures. I enjoy being able to visualize what Im doing, working with my hands, being able to be efficient and help patients deal with their pain. I obviously like imaging in general, and find tremendous satisfaction in giving patients a non surgical option to manage their pain. I not only like spinal procedures but also peripheral procedures. I enjoy treating things like spasticity as well, and find tremendous satisfaction in helping patients with improving their outcomes - whether it is being able to get back to their daily activity because of lack of pain, or being able to open their hands because now they have less spasticity, etc.
Click to expand...

Ok, then what NJ said. Remember, like a lot of other fields, this is largely an 'old boy' network.
Hang tough.
 
willabeast said:
you are better off with spine. 90% of pain is spine anyway. think of it as pain without CRPS. 🙂
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that's what I thought to some extent, which is why I thought the comment was so odd. I mean spine docs do a ton of cervical procedures, do they not? why would this person suggest that I go into spine because they don't know how well i would do with cervical procedures, when spine docs do a ton of them. its like saying - not sure how well you'd do with surgery, so i would suggest you do plastics. seems odd.
 
101N said:
Ok, then what NJ said. Remember, like a lot of other fields, this is largely an 'old boy' network.
Hang tough.
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Yeah I realize this. But this person - again when I have not expressed any interest - specifically suggested based on how well i did and my procedural acumen to do spine - but not pain. I will regardless apply to pain but just trying to understand why they would say/do that.
 
Lostin_space said:
that's what I thought to some extent, which is why I thought the comment was so odd. I mean spine docs do a ton of cervical procedures, do they not? why would this person suggest that I go into spine because they don't know how well i would do with cervical procedures, when spine docs do a ton of them. its like saying - not sure how well you'd do with surgery, so i would suggest you do plastics. seems odd.
Click to expand...

Anyone can learn where to put a needle. That's just "injectionology." If you want to learn about multi-modal pain management (including where NOT to put needles and WHO not to put them in), then do a university-affiliated ACGME-accredited fellowship.
 
drusso said:
You will be more comprehensively trained and sit on a higher echelon than most of your peers by completing an ACGME-accredited Pain Medicine fellowship.
Click to expand...

So you are saying it's better to complete a pain fellowship right?
That's what I thought, which is why i dont understand this person's intentions.
 
drusso said:
Anyone can learn where to put a needle. That's just "injectionology." If you want to learn about multi-modal pain management (including where NOT to put needles and WHO not to put them in), then do a university-affiliated ACGME-accredited fellowship.
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yes that was my goal. but this person was saying NOT to do that because they did not know how well i'd do with cervical spine procedures - again even though i have never done one yet.
 
Lostin_space said:
Hey good pain folk,

So I completed a pain rotation recently. Attending gave me excellent feedback, told me how I had done really well during the rotation, said so repeatedly, how I did x, y and z procedures with no problem, etc. At the same time, and without me saying anything, he told me I should consider Sports/spine but not pain Medicine. I was shocked and kind of hurt about this. I was surprised to hear from this person that if I had done so well and he felt I was doing the procedures so well he would say this. I also found it really odd that he would recommend me doing Sports/and in particular spine! Don't spine trained fellowship docs do a lot of what pain docs do? Further this person talked about the uncertain of how I would do with cervical procedures (I have never done one by the way) and this attending does not do them either. I found it very odd to be told that I should not do pain because this person doesn't know how I would do on one specific set of procedures that I have never do and that they don't do. In addition looking at spine fellowships, it seems most if not all of them do cervical procedures ? I was also offered a letter for spine but not for pain.
Thoughts on this?
I was hurt but at the same time confused. I have no idea what to make of this.
Click to expand...
You need to realize how many crazy ass docs there are out there. It's a lot. So don't take it personally.
 
hyperalgesia said:
Why not just ask him why he said what he did? No one knows but him.
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Because he gets easily upset about most things, and I don't want to rock the boat. I'm just curious what others thought. As in my opinion most spine docs do just as many if not more cervical procedures than pain docs. And I found it odd that someone would be able to make a judgment like that without even seeing someone else perform certain procedures.
 
To be honest...

What I think is, based only on the limited comments you have made, is that you are too procedurally oriented to be happy long term doing comprehensive pain.

Your comments suggest that the tip of the needle gives you more satisfaction than a more holistic whole body approach that may involve no injection whatsoever and people get "better".

ergo, Spine, where the focus is on the procedure......


Sent from my iPhone using SDN mobile
 
He sees residents and fellows as part of his job. He may have some insight as to who would do well or not. He may also be a dick and not like you. Ask him why he said it
 
Many "sports pain fellows" are limited in their arsenal and cannot provide comprehensive care. We see it everyday in the field. If you want to go solo or small physician group you need a true pain fellowship with OR and advanced procedures. If you want to avoid cervical procedure and focus on tendons , work with a ortho group and refer ones deficiencies to colleagues or outside groups. Go for a pain fellowship if you have the "stamina"....you seem motivated, that's good
 
sports and pain is not a synergistic combination and should be distinctly separate specialties. I cannot fathom any sideline sports doc wanting to see a pain population. This all came about because certain interventional spine fellowships got temporary ACGME accreditation as sports fellowships. Most have lost their accreditation because they are not sports fellowships.
 
Jigsaw said:
He sees residents and fellows as part of his job. He may have some insight as to who would do well or not. He may also be a dick and not like you. Ask him why he said it
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He does not work with fellows. He does not do any cervical procedures, any RFAs. I have never done any cervical procedure either. I don't see why he would praise my interventional skills but say i should do sports/spine vs pain.
 
Lostin_space said:
He does not work with fellows. He does not do any cervical procedures, any RFAs. I have never done any cervical procedure either. I don't see why he would praise my interventional skills but say i should do sports/spine vs pain.
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From your other post:
Lostin_space said:
So currently doing a pain rotation. While I enjoy certain aspects of pain and certain procedures, and while I have another pain rotation lined up for a bit later on in the year, I find it that I am not enjoying certain procedures such as cervical blocks/RFAs, lumbar blocks/RFAs, ESI's, etc. I am also a bit intimidated by the fact that it's mostly a male dominated field, I feel frequently I'm not in the "in" crowd with the dudes and it's difficult to develop more interpersonal relationships with attendings and what not, especially with no female mentors in the field. I also feel that I am graded more harshly than my male residents in part because I'm a girl and not in the in crowd.
I'm re-thinking this whole pain thing. Does anyone have suggestions as to ways to get training in procedures that don't involve spine stuff, but that involve MSK stuff? I would like more exposure if possible before being able to make a final decision on whether I should apply or not.
Any ideas? Thanks!
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I'm confused. Have you done cervical procedures or not?
 
Lostin_space said:
He does not work with fellows. He does not do any cervical procedures, any RFAs. I have never done any cervical procedure either. I don't see why he would praise my interventional skills but say i should do sports/spine vs pain.
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OK, I don't mean to sound harsh, but at this point, you don't actually have interventional skills. When I was a first month fellow after countless labor epidurals in anesthesia, I had no skills. Immediately following fellowship, most have minimal skills compared to a few years into practice. It has nothing to do with skills. This person may or may not even remember their recommendation to you. There are a ton of aloof goofball pain docs out there. Don't take it personally. R-E-L-A-X.
 
Yo GabbaPentin said:
OK, I don't mean to sound harsh, but at this point, you don't actually have interventional skills. When I was a first month fellow after countless labor epidurals in anesthesia, I had no skills. Immediately following fellowship, most have minimal skills compared to a few years into practice. It has nothing to do with skills. This person may or may not even remember their recommendation to you. There are a ton of aloof goofball pain docs out there. Don't take it personally. R-E-L-A-X.
Click to expand...

upload_2016-11-1_17-38-31.png
 
Yo GabbaPentin said:
OK, I don't mean to sound harsh, but at this point, you don't actually have interventional skills. When I was a first month fellow after countless labor epidurals in anesthesia, I had no skills. Immediately following fellowship, most have minimal skills compared to a few years into practice. It has nothing to do with skills. This person may or may not even remember their recommendation to you. There are a ton of aloof goofball pain docs out there. Don't take it personally. R-E-L-A-X.
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Ok actually that's a very very good point and I'll definitely give you that. I don't have "skills" I think that what this person was saying is that I have shown good proficiency in all the procedures I have done so far, and he's noticed that I'm above average in them. To your point as well, and as one other of the pain attendings I previously worked with said, he reiterated your statement above and was talking about how it took like him 2-3 years after fellowship to truly master some procedures.

Which is exactly why I feel it's so tremedously odd that this person would say no you can't do those procedures when I have not even done 1! If I have shown proficiency in all these other procedures why could I not learn that type of procedure? It's not like most residents without a pain fellowship can do them, and certainly I'm sure many fellows need to continue working on them in order to master them.
 
Lostin_space said:
Ok actually that's a very very good point and I'll definitely give you that. I don't have "skills" I think that what this person was saying is that I have shown good proficiency in all the procedures I have done so far, and he's noticed that I'm above average in them. To your point as well, and as one other of the pain attendings I previously worked with said, he reiterated your statement above and was talking about how it took like him 2-3 years after fellowship to truly master some procedures.

Which is exactly why I feel it's so tremedously odd that this person would say no you can't do those procedures when I have not even done 1! If I have shown proficiency in all these other procedures why could I not learn that type of procedure? It's not like most residents without a pain fellowship can do them, and certainly I'm sure many fellows need to continue working on them in order to master them.
Click to expand...

So, you are overthinking things, I mean this in a nice way. Go, here and take this test:
http://www.outofservice.com/bigfive/
Review your scores - like I have mine - and consider how your personality traits
influence how you are perceived in real life. The good news is that traits are maleable🙂
 
Lostin_space said:
Ok actually that's a very very good point and I'll definitely give you that. I don't have "skills" I think that what this person was saying is that I have shown good proficiency in all the procedures I have done so far, and he's noticed that I'm above average in them. To your point as well, and as one other of the pain attendings I previously worked with said, he reiterated your statement above and was talking about how it took like him 2-3 years after fellowship to truly master some procedures.

Which is exactly why I feel it's so tremedously odd that this person would say no you can't do those procedures when I have not even done 1! If I have shown proficiency in all these other procedures why could I not learn that type of procedure? It's not like most residents without a pain fellowship can do them, and certainly I'm sure many fellows need to continue working on them in order to master them.
Click to expand...
There are some things in life that we will never have answers to. Why do women go to the bathroom in pairs? How did Trump/Clinton get the nomination? Why is it that when we talk to God it is called praying, but when God talks to us we get involuntarily admitted to psych ward? Why do oddball docs make odd comments? The sooner you move past these unanswerable questions, the sooner you can move on and stick some needles in necks.
 
Yo GabbaPentin said:
There are some things in life that we will never have answers to. Why do women go to the bathroom in pairs? How did Trump/Clinton get the nomination? Why is it that when we talk to God it is called praying, but when God talks to us we get involuntarily admitted to psych ward? Why do oddball docs make odd comments? The sooner you move past these unanswerable questions, the sooner you can move on and stick some needles in necks.
Click to expand...

Haha, you truly made me chuckle. Thank you for that.
 
Sorry to be the stick in the mud here but in two other threads you complained that several of your other attendings didn't support your bid for pain fellowships and now another different attending is saying you shouldn't do cervical procedures or do a pain fellowship, but stick to sports or sports/spine, basically saying you shouldnt do complicated, risky procedures.

Sorry but if multiple attendings do not support your desire for a pain fellowship, you need to face the cold hard truth, that you're not as good as you think you are, and these attendings question your clinical skills.

No one wants to hear that in today's "everyone gets a trophy" world, but you need to face the fact that you truly may not be cut out for pain medicine.
 
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bedrock said:
Sorry to be the stick in the mud here but in two other threads you complained that several of your other attendings didn't support your bid for pain fellowships and now another different attending is saying you shouldn't do cervical procedures or do a pain fellowship, but stick to sports or sports/spine, basically saying you shouldnt do complicated, risky procedures.

Sorry but if multiple attendings do not support your desire for a pain fellowship, you need to face the cold hard truth, that you're not as good as you think you are, and these attendings question your clinical skills.

No one wants to hear that in today's "everyone gets a trophy" world, but you need to face the fact that you truly may not be cut out for pain medicine.
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Umm perhaps you did not read the thread. This attending complimented heavily on how WELL I did. I have complained about lack of research opportunities in general previously, which is a major issue in my program not just for me but most of my fellow residents. And it makes no sense to say you do everything you've gotten a chance to do very well, but don't know how you'd do on something we've never allowed you to do.
Do you think that makes sense? And again - SPINE in particular as he suggested does a TON of cervical procedures. FYI - I was going to do IR btw and had already been given an IR fellowship because I was so good at it which is similar skill set as pain.
How am I not cut out for pain medicine again? Based on the fact that I did so well on the rotation? I see. Because that's what he's saying. And as many on this board have said and other attendings have told me, it will require tons of practice even as an attending to be able to master these skills. So I'm not sure what you are talking about.
Most people can learn to place a needle - saying otherwise makes no sense. What I think is at play here is that I am a woman, and no woman from my program has ever matched to an ACGME pain fellowship before. Even the other female person in my program interested in pain was told to pursue spine as well (and guess what she's doing - applying for spine) as he did not give her a pain but rather a spine letter.
 
Yo GabbaPentin said:
There are some things in life that we will never have answers to. Why do women go to the bathroom in pairs? How did Trump/Clinton get the nomination? Why is it that when we talk to God it is called praying, but when God talks to us we get involuntarily admitted to psych ward? Why do oddball docs make odd comments? The sooner you move past these unanswerable questions, the sooner you can move on and stick some needles in necks.
Click to expand...

"Accept the mystery."

 
Lostin_space said:
Hey good pain folk,

So I completed a pain rotation recently. Attending gave me excellent feedback, told me how I had done really well during the rotation, said so repeatedly, how I did x, y and z procedures with no problem, etc. At the same time, and without me saying anything, he told me I should consider Sports/spine but not pain Medicine. I was shocked and kind of hurt about this. I was surprised to hear from this person that if I had done so well and he felt I was doing the procedures so well he would say this. I also found it really odd that he would recommend me doing Sports/and in particular spine! Don't spine trained fellowship docs do a lot of what pain docs do? Further this person talked about the uncertain of how I would do with cervical procedures (I have never done one by the way) and this attending does not do them either. I found it very odd to be told that I should not do pain because this person doesn't know how I would do on one specific set of procedures that I have never do and that they don't do. In addition looking at spine fellowships, it seems most if not all of them do cervical procedures ? I was also offered a letter for spine but not for pain.
Thoughts on this?
I was hurt but at the same time confused. I have no idea what to make of this.
Click to expand...

I agree it is confusing with mixed messages you are getting and that the attending is willing to specifically write a recommendation for one type of fellowship but not another. Even though it is painful, I do think it may be helpful to non-confrontationally inquire as to the reasons. Perhaps ask why the specific recommendation and what "strengths" he/she felt you had that were more geared towards one area than another.

cervical procedures you will get wherever you go in spine or pain fellowships. as long as you don't go to a subpar program, you will hopefully learn what you need to with proficiency to stay out of trouble.

I do wonder what your particular goals are and what you envision yourself doing in the future. do you like musculoskeletal issues or do you want to only focus on the spine and nothing else?

I think in this climate, as some have mentioned, having an ACGME accredited pain fellowship is probably a good basis to then pursue whatever you want afterwards. If you have additional interests in sports/MSK that is icing on the cake as you'll be more well rounded and interested in continuing education to better help your patients.
 
Lostin_space said:
Umm perhaps you did not read the thread. This attending complimented heavily on how WELL I did. I have complained about lack of research opportunities in general previously, which is a major issue in my program not just for me but most of my fellow residents. And it makes no sense to say you do everything you've gotten a chance to do very well, but don't know how you'd do on something we've never allowed you to do.
Do you think that makes sense? And again - SPINE in particular as he suggested does a TON of cervical procedures. FYI - I was going to do IR btw and had already been given an IR fellowship because I was so good at it which is similar skill set as pain.
How am I not cut out for pain medicine again? Based on the fact that I did so well on the rotation? I see. Because that's what he's saying. And as many on this board have said and other attendings have told me, it will require tons of practice even as an attending to be able to master these skills. So I'm not sure what you are talking about.
Most people can learn to place a needle - saying otherwise makes no sense. What I think is at play here is that I am a woman, and no woman from my program has ever matched to an ACGME pain fellowship before. Even the other female person in my program interested in pain was told to pursue spine as well (and guess what she's doing - applying for spine) as he did not give her a pain but rather a spine letter.
Click to expand...

I read the thread, you however have trouble reading between the lines which is also likely why you don't mesh with your other pain attendings..

If this attending compliments your skills, yet at the same time tells you shouldn't pursue technical, risky procedures such as in pain medicine, it's because he's cushioning the blow. He's trying to find a way to say you're not that good, without crushing you.
 
bedrock said:
I read the thread, you however have trouble reading between the lines which is also likely why you don't mesh with your other pain attendings..

If this attending compliments your skills, yet at the same time tells you shouldn't pursue technical, risky procedures such as in pain medicine, it's because he's cushioning the blow. He's trying to find a way to say you're not that good, without crushing you.
Click to expand...
True, but it's only one persons opinion. Most of us would never let one attending shape our aspirations. Most academics are passive aggressive jealous beings anyway...find more mentors
 
Stim4me said:
True, but it's only one persons opinion. Most of us would never let one attending shape our aspirations. Most academics are passive aggressive jealous beings anyway...find more mentors
Click to expand...

agree that if only one attending says this I would ignore it however, if all or most of the faculty members don't believe in my goal, I would take a hard look at myself and my talents and whether I'm truly capable of it instead of blaming everyone else in the universe for my personal failings. (look at the other threads from the OP, that SSdoc posted)
 
bedrock said:
agree that if only one attending says this I would ignore it however, if all or most of the faculty members don't believe in my goal, I would take a hard look at myself and my talents and whether I'm truly capable of it instead of blaming everyone else in the universe for my personal failings. (look at the other threads from the OP, that SSdoc posted)
Click to expand...

Again - I never said I wanted to do a fellowship. He told me how well I had done and how good my skills were. It seems you just want to be passive aggressive and state whatever you want. He did not have to say anything. He could have passed - you passed the rotation. I got his eval - states that I am far above average in diagnostic/knowledge skills and have excellent interventional skills. Also states that I have exceptional patient care and bedside manner. Will make an extraordinary physician. Would highly recommend for a spine fellowship.
You can't know how good or bad you'd be at something without even having the chance to do it first. You just seem to want to be nasty for some reason. I'll leave it at that.
 
Lostin_space said:
Again - I never said I wanted to do a fellowship. He told me how well I had done and how good my skills were. It seems you just want to be passive aggressive and state whatever you want. He did not have to say anything. He could have passed - you passed the rotation. I got his eval - states that I am far above average in diagnostic/knowledge skills and have excellent interventional skills. Also states that I have exceptional patient care and bedside manner. Will make an extraordinary physician. Would highly recommend for a spine fellowship.
.
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If that is what he wrote, you are reading far too much in to what he wrote. He's going to give you rec for spine fellowship. Take it. He prob wants to save pain spots for anesthesia or PMR residents.

Let it go. Go in to spine.



Sent from my iPhone using SDN mobile
 
Ducttape said:
If that is what he wrote, you are reading far too much in to what he wrote. He's going to give you rec for spine fellowship. Take it. He prob wants to save pain spots for anesthesia or PMR residents.

Let it go. Go in to spine.

I'm not sure what you mean I'm reading too much into what he wrote. That is part of it, there more stuff. I AM a PMR resident. I am not going to go into Spine. That's offensive I would suggest I should go into Spine.

I clearly am excellent, so you suggesting something like that makes no sense. Even by this person's standards, who happens to be one of the harshest people out there.
I did not work this hard to go into something I don't feel like going into.

Why don't you suggest the men residents go into spine?

I guess I should take good feedback as poor feedback, that it means nothing, and maybe I should do nothing as I have been told before. But I guess when others are told something good - they should take it as fact?

I should do what my high school counselor told me I guess - be a stay at home mom and make tacos. I guess I really wasted my time going to college and med school. What a waste!
Click to expand...
 
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"I clearly am excellent, so you suggesting something like that makes no sense. Even by this person's standards, who happens to be one of the harshest people out there.
I did not work this hard to go into something I don't feel like going into."

Would not want this person in my department.
 
"I should do what my high school counselor told me I guess - be a stay at home mom and make tacos. I guess I really wasted my time going to college and med school. What a waste!"

OK, wait... did you say tacos? This may have changed everything. Are we talking beef, chicken or steak? If you are good with steak tacos, then you should definitely stay home. Average taco makers go the spine route.
 
Ok. You have got to calm down here OP. This is like the 5th thread between the Pain and PM&R sections that you have spouted off on people discriminating against you due to gender, you thinking that for some weird reason you're attendings don't think you're fit for pain or that you're attendings aren't handing you research on a platter. I am a guy and I had to create my own research project too. It was a lot of work and I had to take my own initiative to do it, but if you give someone a possible publication that they won't have to do all the work on, they will likely be more than willing to help since that is part of how they get their promotions. Nobody on here knows anything about how good or bad of a resident you are and can't really tell you what kind of fellowship you should apply for. Pain is highly competitive, so there are good residents every year that don't get spots. I think you should apply for the fellowships you want to do and see what happens. There is nothing bad about checking out spine fellowships and if you don't like any of them, just wait for the pain match and let the cards fall where they may. By the way, in case you haven't read this from other people on here, about 85%-90% of the patients I see as a pain fellow are spine patients, so if you hate spine so much, I don't get why you would want to do pain in the first place. The spine/sports folks have it bit easier as they don't have to deal with a lot of the issues that come with medication management, inpatient consults and being a pseudo-psychologist at times. That stuff doesn't bother me as much, but for others it is terrible. Yes I get to do some other cool procedures and see other stuff like cancer pain, facial pain, CRPS, etc that most spine/sport fellows don't see, but that really is the minority of what I do at my fellowship at least. You have mentioned in the past that you did not like bread and butter spine procedures, so if that is something that your attendings caught on to, it could also be why they kind of wrote you off or just didn't like you. Again the bread and butter stuff is the vast majority of what I and many other of us do, which is why it is called bread and butter. I am not putting in stims and pumps all or day or doing complex regional blocks as those are less common. I understand this fellowship thing is stressful, but as lobelsteve pointed out from your last post you clearly may have an issue controlling that stress. If that comes out during residency on rotations, it could be a killer as I sure as hell would not want to deal with that kind of attitude if I go the academic route next year. You need to just keep working hard, stay in the good graces of your PD/Dept head and get as good of letters as you can. Just because somebody recommends you do spine over pain, doesn't mean you can't apply for pain. As you and others pointed out, he doesn't really do pain anyways, so I don't really get why would you want a Pain letter from him in the first place. You need one from somebody that is actually doing pain and preferably is at a accredited fellowship program. Good luck.
 
Yo GabbaPentin said:
"I should do what my high school counselor told me I guess - be a stay at home mom and make tacos. I guess I really wasted my time going to college and med school. What a waste!"

OK, wait... did you say tacos? This may have changed everything. Are we talking beef, chicken or steak? If you are good with steak tacos, then you should definitely stay home. Average taco makers go the spine route.
Click to expand...

Yes, he was of Hispanic descent, and I made tacos for one of those festive day things where we all brought food. When I told him I wanted to go to college and eventually med school, he said basically to stay home, raise a family and that I was great at making tacos. I made chicken and beef tacos for the food day.
 
RM38 said:
Ok. You have got to calm down here OP. This is like the 5th thread between the Pain and PM&R sections that you have spouted off on people discriminating against you due to gender, you thinking that for some weird reason you're attendings don't think you're fit for pain or that you're attendings aren't handing you research on a platter. I am a guy and I had to create my own research project too. It was a lot of work and I had to take my own initiative to do it, but if you give someone a possible publication that they won't have to do all the work on, they will likely be more than willing to help since that is part of how they get their promotions. Nobody on here knows anything about how good or bad of a resident you are and can't really tell you what kind of fellowship you should apply for. Pain is highly competitive, so there are good residents every year that don't get spots. I think you should apply for the fellowships you want to do and see what happens. There is nothing bad about checking out spine fellowships and if you don't like any of them, just wait for the pain match and let the cards fall where they may. By the way, in case you haven't read this from other people on here, about 85%-90% of the patients I see as a pain fellow are spine patients, so if you hate spine so much, I don't get why you would want to do pain in the first place. The spine/sports folks have it bit easier as they don't have to deal with a lot of the issues that come with medication management, inpatient consults and being a pseudo-psychologist at times. That stuff doesn't bother me as much, but for others it is terrible. Yes I get to do some other cool procedures and see other stuff like cancer pain, facial pain, CRPS, etc that most spine/sport fellows don't see, but that really is the minority of what I do at my fellowship at least. You have mentioned in the past that you did not like bread and butter spine procedures, so if that is something that your attendings caught on to, it could also be why they kind of wrote you off or just didn't like you. Again the bread and butter stuff is the vast majority of what I and many other of us do, which is why it is called bread and butter. I am not putting in stims and pumps all or day or doing complex regional blocks as those are less common. I understand this fellowship thing is stressful, but as lobelsteve pointed out from your last post you clearly may have an issue controlling that stress. If that comes out during residency on rotations, it could be a killer as I sure as hell would not want to deal with that kind of attitude if I go the academic route next year. You need to just keep working hard, stay in the good graces of your PD/Dept head and get as good of letters as you can. Just because somebody recommends you do spine over pain, doesn't mean you can't apply for pain. As you and others pointed out, he doesn't really do pain anyways, so I don't really get why would you want a Pain letter from him in the first place. You need one from somebody that is actually doing pain and preferably is at a accredited fellowship program. Good luck.
Click to expand...


Fine, I'll "calm down," and just stick with my non -ACGME pain fellowship that I already have. It's all my fault, I suck, I have done nothing well, and I don't deserve anything. I'm sorry I've wasted your time and everyone else's on this thread. I'll stop, be quiet and go make tacos. Sorry again.
 
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