P015: ANESTHESIA FELLOWSHIP IN THE POST-COVID ERA: NATIONAL TRENDS AND FINANCIAL IMPLICATIONS
Kiana Foster, BS1; Kendall M Jenkins, MD2; Cynthia Garvan, PhD2; Nikolaus Gravenstein, MD2; Emuejevoke Chuba, MD2
1FIU Herbert Wertheim College of Medicine ; 2University of Florida
The recent COVID-19 pandemic significantly disrupted the anesthesiology workforce, leading to a reduction in clinical capacity, increased burnout, and interruptions in graduate medical education (1,2,3). These disruptions may have long term implications on the participation and interest in anesthesiology of subspecialty training, possibly leading to downstream effects on patient care. Increased financial compensation for primary residency specialty as well as declining specialty reimbursement have been posited as reasons for decreased anesthesiology fellowship enrollment (4).
This study analyzed data from the ACGME and NRMP databases from 2014 to 2024, focusing on trends in demographics and anesthesiology fellowship applications across anesthesia residency programs and anesthesia subspecialty programs in the pre-COVID-19 era (2014 - 2019) compared to the post-COVID-19 era (2019 - 2024). Salary and financial compensation data were collected from AAMC. Overall trends were analyzed while specific data was kept confidential in line with privacy guidelines stipulated. The linear relationship between median salary and year was evaluated for anesthesiologists in three fields (general anesthesia, pediatrics, and pain).
There were 43,240 general anesthesiologists, 3,310 pain anesthesiologists, and 7,227 pediatric anesthesiologists. Median salary (“y” variable) was modeled for each field (general anesthesia, pediatrics, and pain) by year (“x” variable). Pediatric anesthesiology had twice the decline in the ASA units over a ten-year period. Critical care and pediatric anesthesiology both had an increase in the number of relative value units (RVUs) over time (Fig. 1). Comparing salaries, general anesthesiologists had a 1.5x increase in median salaries since 2015. Although pain and pediatric anesthesiologists have increased over time, the growth rate was insignificant (Fig. 2).
The tempered rise in enrollment in anesthesiology subspecialty programs such as critical care medicine and pain and the decrease in enrollment for pediatrics indicates possible future workforce shortages potentially leading to complications in patient care. This discrepancy in fellowship enrollment could be explained in part by increased financial compensation for general anesthesiologists compared to subspecialities such as pain and pediatrics.
1. Abouleish AE, Pomerantz P, Peterson MD, Cannesson M, Akeju O, Miller TR, Rathmell JP, Cole DJ. Closing the Chasm: Understanding and Addressing the Anesthesia Workforce Supply and Demand Imbalance. Anesthesiology. 2024 Aug 1;141(2):238-249. doi: 10.1097/ALN.0000000000005052. PMID: 38884582.
2. Afonso AM, Cadwell JB, Staffa SJ, Zurakowski D, Vinson AE. Burnout Rate and Risk Factors among Anesthesiologists in the United States. Anesthesiology. 2021 May 1;134(5):683-696. doi: 10.1097/ALN.0000000000003722. PMID: 33667293; PMCID: PMC9430843.
3. Research Education INnovation in Surgery (REINS) initiative COVID-19 group, Yiasemidou M, Tomlinson J, Chetter I, Biyani CS. Impact of the SARS-CoV-2 (COVID-19) crisis on surgical training: global survey and a proposed framework for recovery. BJS Open. 2021 Mar;5(2):zraa051. DOI: 10.1093/bjsopen/zraa051. PMID: 33855364; PMCID: PMC8047098.
4. Jueng J, Pritzlaff SG, Mehta N, Gulati A, Schatman ME, Wahezi SE, Day M, Durbhakula S, Pak DJ. Analyzing Trends in the Pain Fellowship Match - A Survey of Program Directors. J Pain Res. 2025 May 7;18:2335-2341. doi: 10.2147/JPR.S496104. PMID: 40356685; PMCID: PMC12067977.