MAY 9, 2025
Originally published by our sister publication Anesthesiology News
With the population growing older, it is crucial for medical specialties—such as anesthesia and pain medicine—to prevent staffing issues as best as possible. Unfortunately, a new study shows that fellowship applications to these specialties decreased over the past five years, raising concerns about the future of patient care (Pain Pract 2025;25[1]:e13441).
In an interview with Anesthesiology News, Scott G. Pritzlaff,
Originally published by our sister publication Anesthesiology News
With the population growing older, it is crucial for medical specialties—such as anesthesia and pain medicine—to prevent staffing issues as best as possible. Unfortunately, a new study shows that fellowship applications to these specialties decreased over the past five years, raising concerns about the future of patient care (Pain Pract 2025;25[1]:e13441).
In an interview with Anesthesiology News, Scott G. Pritzlaff, MD, an associate professor of anesthesiology and the director of the Pain Medicine Fellowship program at UC Davis School of Medicine, in Sacramento, said there are several reasons for this recent decline, but the most likely explanation is that many potential applicants are choosing to start their careers right away instead of committing to an additional year of training, which would forgo a year’s salary.
“Our paper that looked at the rates of applicants between 2019 and 2023 saw this pretty steep and precipitous drop-off in the amount of anesthesia residents applying to pain medicine,” said Pritzlaff, the study’s first author. “Was that driven by COVID? No, it’s driven by money. It’s the financial requirement of anesthesiology that residents are getting really high offers for salaries, and they don’t want to do an extra year of training.”
In the study, the investigators examined data from the Electronic Residency Application Service and the National Resident Matching Program from 2019 to 2023. The team focused specifically on trends in fellowship applications to pain medicine programs. They also analyzed preliminary 2024 match cycle data.
The results showed a decrease in anesthesiology residents applying to pain medicine fellowships during the study period, with applications falling from 251 in 2019 to 193 in 2023. This represents a 45% decline, with the largest decrease among anesthesiology applicants compared with other specialties.
In 2023, there was a significant number of unfilled programs during the match cycle, with 35 out of 115 programs not filling all their positions. Preliminary data from the 2024 match cycle indicate that this trend is likely continuing.
While there are many factors contributing to the decrease, Pritzlaff said the biggest issue might be a marketing problem. He noted a common misconception about pain medicine, with many believing that doctors in the field are strictly prescribing opioids and not performing other interventional procedures.
“I think it’s a concern,” he said. “I’ve made it very clear that I think we have an identity problem really getting out that idea of people understanding.”
Pritzlaff also noted that the decrease in applicants might be cyclical. “The reality is that anesthesia demand, which is a major driver of the decrease in applicants, is tied to market forces,” he said. “Once there is a point of saturation in the number of anesthesia providers, we may see the number of pain medicine applicants return to previous levels as salaries stabilize or even drop.”
By Kenny Walter
Pritzlaff reported no relevant financial disclosures.
