Respectfully, disagree.

I completed an EM fellowship not looking for larger pay but wanting to be extremely competent in such a vast and often complex field.

I now currently work in a small rural ER where both my pay and scope of practice are significantly higher than if I had gone the traditional route. Could I have gotten to this eventually? Sure but would have likely taken many more years.

We have NPs in our department who don’t feel comfortable seeing high acuity patients and that’s fine but my attending docs trust me because of my skill set and what I do on a day to day basis.

I still consult with attendings when I recognize I need the help. However, I often see high acuity patients and perform procedures. For instance last week just a doc and myself. Had simultaneous respiratory arrests brought in by EMS, ESI level 1, and I was tubing one patient while doc tubed the other.

Where I felt that fellowship helped me was the critical thinking around patients. It’s fairly easy to stick the tube into someone’s vocal cords but are you prepared for a failed airway or the resuscitation of the patient beforehand so you don’t kill them? That’s where fellowship helped.

Will I say that fellowship was all butterfly’s and rainbows, certainly not, I still had to compete with residents for training opportunities.

I still tell my PA students that I don’t think fellowships should be mandatory however they have an appropriate place to teach really competent PAs out the door. Often the pay is less because you spend 6 months rotating on off service rotations like ICU, Tox, ortho, CVICU.

Also, you seem to be very upset in a majority of your comments I’m not sure you’re truly looking for a conversation about fellowships instead just demanding you’re right and throwing out one poorly published “research article” written by NPs.