Regional Anesthesia Fellowship

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Dr. Spartan

Dr. Spartan

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What are the best fellowship programs for Regional Anesthesia?
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Right off the top of my head University of Usethesearchfunction ranks highly
 
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Duke, Pitt, Wake Forest, Virginia Mason was pretty good at one point.

Also, consider why you are doing a regional fellowship? Are you looking for a "Gap Year" while a significant other finishes education? Why not do Chronic Pain--which would be a much wider and marketable skill set than doing a regional fellowship doing the same blocks that you are probably already proficient in?
 
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vector2 said:
Right off the top of my head University of Usethesearchfunction ranks highly
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Getting a little salty, Vec?

I didn’t do a fellowship, but one thing that can’t be the overlooked is watching a colleague that is good at regional in your attending job. I felt like my training was pretty good in regional. I’m fortunate that I’m in a group that does a lot of regional and I help and watch them do procedures if if I’m not busy.

Always be willing to help and see how others do things. You’ll be surprised what new techniques you’ll adopt.
 
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D P356 said:
Getting a little salty, Vec?

I didn’t do a fellowship, but one thing that can’t be the overlooked is watching a colleague that is good at regional in your attending job. I felt like my training was pretty good in regional. I’m fortunate that I’m in a group that does a lot of regional and I help and watch them do procedures if if I’m not busy.

Always be willing to help and see how others do things. You’ll be surprised what new techniques you’ll adopt.
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There's like 10 threads about it and it's always the same names that pop up, stanford, virginia Mason, Pitt, Duke, hss, wake etc etc. It would be more fruitful for the OP and for everyone else for him to do even the most basic research on his own and then ask something specific about a specific program(s).
 
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HSS, Virginia Mason, Duke, UCSD, Stanford, Dartmouth, Pitt

Decide if you want ACGME or non-ACGME

Non-ACGME = double the pay, same training, ability to do extended time international or off-site

At this point, ACGME is not truly beneficial but once there is a large overall accrediting body then it will be. ACGME right now is just how programs can justify paying you $75k instead of $200k. Many ACMGE programs have you sit and do the case as well so that means ~3 blocks a day, not sure why anyone would do that fellowship since it doesn't provide any more than residency.
 
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I’ll give you some hints. What city do you want to end up in? What kind of cases do you like? Do you want to do thoracic epidurals and open belly’s? Do you want to do catheters? Do you want to do as many blocks as possible? Supervise? Sit your own cases? academics? Just want to join a busy ortho practice? What’s more important career wise money, location, case mix, hours, being done with the patient once they leave the pacu? Does your ideal practice exist where you want to live? Do they need someone regionally trained? Would they hire you without the fellowship?
 
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Dr. Spartan said:
What are the best fellowship programs for Regional Anesthesia?
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Here is some advice that most will disagree with, maybe even scoff at, But it is solid advice and you should think about it for a while.

You should do a chronic pain fellowship. Find one that is heavy on procedures and uses a lot of ultrasounds. I believe that at the end of that year, you will be just as competent, or very close to, well trained regionalist. But you will also have a skill set they will likely never develop with regards to procedures. In addition you will get very comfortable dealing with patients with complex pain issues both acute, And acute on chronic.


I feel like you will have great marketing advantage if you wanted to go to a place that was asking for a Regionally trained physician
 
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We have a fellowship trained regional guy in our group. He does lots of extremity blocks etc in our group just like every other anesthesiologist in the practice.... and he doesn’t make anymore money than the rest of the generalists. Agree that if you have interest do Pain
 
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epidural man said:
Here is some advice that most will disagree with, maybe even scoff at, But it is solid advice and you should think about it for a while.

You should do a chronic pain fellowship. Find one that is heavy on procedures and uses a lot of ultrasounds. I believe that at the end of that year, you will be just as competent, or very close to, well trained regionalist. But you will also have a skill set they will likely never develop with regards to procedures. In addition you will get very comfortable dealing with patients with complex pain issues both acute, And acute on chronic.


I feel like you will have great marketing advantage if you wanted to go to a place that was asking for a Regionally trained physician
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its often not the same slice of residents applying to regional that are applying to chronic pain, chronic pain may not be a very doable option for everyone
 
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Hoya11 said:
its often not the same slice of residents applying to regional that are applying to chronic pain, chronic pain may not be a very doable option for everyone
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that rotation reminded me why i chose anesthesia...progress notes and seeing patients :vomit:
 
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epidural man said:
Here is some advice that most will disagree with, maybe even scoff at, But it is solid advice and you should think about it for a while.

You should do a chronic pain fellowship. Find one that is heavy on procedures and uses a lot of ultrasounds. I believe that at the end of that year, you will be just as competent, or very close to, well trained regionalist. But you will also have a skill set they will likely never develop with regards to procedures. In addition you will get very comfortable dealing with patients with complex pain issues both acute, And acute on chronic.


I feel like you will have great marketing advantage if you wanted to go to a place that was asking for a Regionally trained physician
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Do you have a chronic pain fellowship program in mind?
 
NICMAN said:
Duke, Pitt, Wake Forest, Virginia Mason was pretty good at one point.

Also, consider why you are doing a regional fellowship? Are you looking for a "Gap Year" while a significant other finishes education? Why not do Chronic Pain--which would be a much wider and marketable skill set than doing a regional fellowship doing the same blocks that you are probably already proficient in?
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Because I like Regional Anesthesia and I don't like chronic pain sounds a good answer?
 
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USCTrojan11 said:
HSS, Virginia Mason, Duke, UCSD, Stanford, Dartmouth, Pitt

Decide if you want ACGME or non-ACGME

Non-ACGME = double the pay, same training, ability to do extended time international or off-site

At this point, ACGME is not truly beneficial but once there is a large overall accrediting body then it will be. ACGME right now is just how programs can justify paying you $75k instead of $200k. Many ACMGE programs have you sit and do the case as well so that means ~3 blocks a day, not sure why anyone would do that fellowship since it doesn't provide any more than residency.
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Totally agree. I chose a non-ACGME fellowship program from that group and very happy I did. Some of my co-residents went ACGME and have been really disappointed in their fellowship year. Being a PGY5 making that crappy salary with no option for attending moonlighting or working the OR seems to make for a very depressing year. There are non-ACGME programs with much higher volume and way better experiences overall.
 
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Dr. Spartan said:
Because I like Regional Anesthesia and I don't like chronic pain sounds a good answer?
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Missing the whole point. It’s one year, we have all decided that an extra one year of training is universally terrible, no matter what the specialty.

I second chronic pain, it is marketable if you want to do GA and regional anesthesia, and in some cases more marketable if you do an APS service since half the consults are medical management for chronic pain patients that have surgery. You gain new skills for the extra year, fluoro guided procedures, sympathies blocks, implant s**t in the OR, and do more MSK ultrasound and injections. And you have a fall back and an extra board certification that actually means something. Just my opinion as a pain fellow.
 
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Yoj also might find that you like chronic pain. The progress notes are not like internal medicine notes, very focused, more of a consult than an actually medicine note.
 
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I’ve done a bunch of lateral femoral cutaneous, common perineal, tibial, suprascapular, axillary, radial nerve, median nerve, ilioinguinal and olio hypogastric blocks, all sorts of bursa and tendon and deep muscle injections under ultrasound. Definitely makes you better. Of course you learn all the spine fluoro procedures and advanced stuff as well.

I am actually curious, for the people that did regional fellowships, what new blocks are you actually learning?
 
dipriMAN said:
Missing the whole point. It’s one year, we have all decided that an extra one year of training is universally terrible, no matter what the specialty.

I second chronic pain, it is marketable if you want to do GA and regional anesthesia, and in some cases more marketable if you do an APS service since half the consults are medical management for chronic pain patients that have surgery. You gain new skills for the extra year, fluoro guided procedures, sympathies blocks, implant s**t in the OR, and do more MSK ultrasound and injections. And you have a fall back and an extra board certification that actually means something. Just my opinion as a pain fellow.
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Lol. Doing a pain fellowship for the benefit of running an inpatient acute pain service for medication management has to be the single worst justification for a fellowship I’ve ever heard.
 
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SnapperRocks said:
Lol. Doing a pain fellowship for the benefit of running an inpatient acute pain service for medication management has to be the single worst justification for a fellowship I’ve ever heard.
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Why? I would 100% rather be rounding in an APS service than covering ORs.
 
SnapperRocks said:
Lol. Doing a pain fellowship for the benefit of running an inpatient acute pain service for medication management has to be the single worst justification for a fellowship I’ve ever heard.
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Plus, isn’t that the point of doing regional, so you can be an APS person?
 
dipriMAN said:
Why? I would 100% rather be rounding in an APS service than covering ORs.
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rounding on an APS service sounds horrible. I’d much rather be covering ORs. I also hated clinic. A year of doing a chronic pain fellowship sounded like hell to me and in my area the job market for general anesthesia is much much better. Many more jobs and higher pay
 
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Rounding on pain patients is the highlight? Jeez. The whole point is to dump the local and never look back!
 
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So I guess the question I have is what kind of job does a regional fellowship get people? If your not going for some sort of APS thing, then your doing OR cases, and why do the fellowship to begin with?
 
dipriMAN said:
So I guess the question I have is what kind of job does a regional fellowship get people? If your not going for some sort of APS thing, then your doing OR cases, and why do the fellowship to begin with?
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Presumably joining the block team in an academic setting. I do know of a couple private practices that have hired regional trained folks too, though I’m not sure if they would have gotten hired and ended up doing the same thing without the extra year (not so different than the super lucrative OB jobs which have been discussed on the board recently... Certainly not the norm, and not a great justification for the average bear to spend a year in fellowship, but it can definitely open the doors in the right setting)
 
Just as an FYI for those considering UCSD for regional fellowship. Would highly recommend against it. Two of us dropped out this year mid-fellowship. It's a dumpster fire of a fellowship program. Fellows are the workhorses and do everything with zero protected time for education. You just run around every day doing a lot of blocks. It's brutal and no one cares about you. Rumor is they have blackballed some graduating fellows from getting good jobs locally in PP.
 
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The best answer is go to a program that does tons of regional and has zero fellows to compete with. Then, no need for any fellowship at all.
 
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Still don't understand what the need for a regional fellowship is... Most people do bread and butter blocks that any competent program should have taught, and others can be easily YouTubed and done with a bit of practice. Unless your program has no blocks, then it makes no sense to waste a year of earning
 
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Regfellow said:
Just as an FYI for those considering UCSD for regional fellowship. Would highly recommend against it. Two of us dropped out this year mid-fellowship. It's a dumpster fire of a fellowship program. Fellows are the workhorses and do everything with zero protected time for education. You just run around every day doing a lot of blocks. It's brutal and no one cares about you. Rumor is they have blackballed some graduating fellows from getting good jobs locally in PP.
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It is pretty difficult to get “blackballed” in the area at the moment. If you’re below average and not a sex offender, you can get a job nowadays. I did hear one of their more talented faculty quit and commutes to Visalia for work.
 
Regfellow said:
Just as an FYI for those considering UCSD for regional fellowship. Would highly recommend against it. Two of us dropped out this year mid-fellowship. It's a dumpster fire of a fellowship program. Fellows are the workhorses and do everything with zero protected time for education. You just run around every day doing a lot of blocks. It's brutal and no one cares about you. Rumor is they have blackballed some graduating fellows from getting good jobs locally in PP.
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The best way to learn blocks is doing them.
 
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Regfellow said:
Just as an FYI for those considering UCSD for regional fellowship. Would highly recommend against it. Two of us dropped out this year mid-fellowship. It's a dumpster fire of a fellowship program. Fellows are the workhorses and do everything with zero protected time for education. You just run around every day doing a lot of blocks. It's brutal and no one cares about you. Rumor is they have blackballed some graduating fellows from getting good jobs locally in PP.
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That sounds like what fellowship should be -- lots of blocks. What educational time do you need? I did regional, but my residency didn't do many blocks 10-12 years ago. I interviewed at UCSD, I want impressed back then. I did fellowship at a non-ACGME program, and I think it, sadly, became ACGME recently.
 
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Ashers said:
That sounds like what fellowship should be -- lots of blocks. What educational time do you need? I did regional, but my residency didn't do many blocks 10-12 years ago. I interviewed at UCSD, I want impressed back then. I did fellowship at a non-ACGME program, and I think it, sadly, became ACGME recently.
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Why would a regional fellowship need to be ACGME certified? There is no extra board certification?
 
dipriMAN said:
Why would a regional fellowship need to be ACGME certified? There is no extra board certification?
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I can't answer that. But from what I heard applicants didn't want to come because they weren't ACGME accredited. It loses a lot of the benefits and gains a bunch of hassles. That's how i see it.
 
Most of my cohort in residency (2018)decided on non-acgme for the extra cash . I think the acgme accreditation might play a role in the future but fully fleshed out yet.
 
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The only value that I can see from a regional fellowship is getting a job in a location where you have no connections and using the fellowship in that location to make those connections to land a job offer. A board certified anesthesiologist should be able to figure out how to teach themselves or be mentored in regional. No need to be spoon fed. Cardiac, peds, pain and critical care diverge enough from the mainstream that doing a fellowship makes sense for those interested in expertise in those areas.
 
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Hello there! Can somebody throw some light on the quality of university of iowa regional anesthesia fellowship program?
 
Don’t do a regional fellowship. Complete waste of income and time. Your residency should teach you the everything you need. Watch videos on the rest.
 
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MSU spartan said:
Don’t do a regional fellowship. Complete waste of income and time. Your residency should teach you the everything you need. Watch videos on the rest.
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I’d like to point out that a significant proportion of academic regional anesthesia faculty did exactly as described in this post.
 
deleted1123066 said:
Just as an FYI for those considering UCSD for regional fellowship. Would highly recommend against it. Two of us dropped out this year mid-fellowship. It's a dumpster fire of a fellowship program. Fellows are the workhorses and do everything with zero protected time for education. You just run around every day doing a lot of blocks. It's brutal and no one cares about you. Rumor is they have blackballed some graduating fellows from getting good jobs locally in PP.
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Outside observer opinion - this is really sad

UCSD pulled the ultimate bait and switch

Everyone went through staffing issues. However, the UCSD academic staff couldn't/no longer wanted to cover OB. Naturally that meant the fellows do it under the guise of "epidurals and spinals are regional anesthesia". They were voluntold to do so, paid at "attending" rate that was closer to "pre-tending" rate - like less than AAs and CRNAs make hourly. The fellowship was sold as half attending, half fellow - "you can make as much as you want".

Very little to no instruction during the year of fellowship, more of a "just go do it". Research meant you had to include the chair (Rodney) as author on papers that he didn't even know about - even before you started fellowship, done at a different institution.

The year ended up being a disaster - multiple people dropped out, even with less than a couple months to go. The director got replaced.

Don't do a regional fellowship, this is one of the "good" programs too
 
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Gern Blansten said:
and that is the smartest way to do it, IMHO.
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One of the regional big wigs at Stanford who started the UCSD fellowship program actually did a peds fellowship, not a regional fellowship. No question that he is smart ;)
 
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