Are Anesthesia Fellowships worth it?

[MarsRover]

I am nearing time to start thinking about anesthesia fellowships, and some of my staff ask me about them etc. I honestly have to say a good many seem just like a scam to get you to work another year not being paid attending salary. As in Peri-op ultrasound, airway, "clinical anesthesia", acute pain, peri-operative... these all seem like things a 5yr FRCPC anesthesiologist should just be able to do. Heck even neuro, thoracic, transplant seem questionable unless you are in a bigger site and plan to do mainly just those cases. I can get behind Peds and Cardiac. Just not sure I see why a fellowship is the "norm" to work in a bigger center. Seems like an unnecessary hurdle.. without much real benefit. Lots of the fellowship produce staff that seem equivalent to the staff that are doing those cases without the fellowship? Am I missing something obvious here? 

[blah1234]

Credential creep is all it is in my opinion. Not sure if it really drives any material outcomes unless you do something niche. You still learn as staff and I feel the learning sticks as you're the one making the final call with the burden of MRP. This fellowship/grad degree nonsense is pretty much free labor for academics and older people pulling the ladder up behind them.

[MarsRover]

This is essentially my thought, in some cases it makes sense. I don't think we get enough peds in core residency to do peds fully. Cardiac similar. Obstetrics I feel on the fence about. The rest seems dumb to me. Unless you are working in a really big center having the vascular, neuro, thoracics, regional, or peri-op ultrasound fellowship is unlikely to change anything. A no fellowship staff focused on continued learning in all areas is likely best. Though the peri-op/clinical anesthesia fellowships that are literally just described as a year fellowship to do higher risk cases to gain exposure is hardly even trying to hide the scam. 

 

Of course some fellowships are better.. say thoracics/transplant/peds for gen surg. Chronic pain/critical care for anesthesia. I guess someone neuro fellowship trained could help give experience to the other staff.. but the reality is they will be just saying what preferences their staff had during fellowship.. which presumably the non-fellowship 20yr in staff doing neuro cases also has. If you wanted to know what best in neuro now just read about it not ask someone who got a neuro fellowship 5-6 years ago.. 

[shikimate]

One of my classmate is doing chronic pain fellowship in USA right now. He mentions renumeration is good in chronic pain, but otherwise he wouldn't have gone for it. I know 3-4 other anesthesia grad that are all working without fellowship, some in smaller centers, some in big cities.

[jb24]

I would just work at a community hospital and make bank as an FRCPC 5 year anesthesiologist. Why bother with fellowship if you don't need it?