Regional Anesthesia Fellowship: Essential Guide 2025
Understanding Regional Anesthesia Fellowship Programs
A regional anesthesia fellowship is a one-year subspecialty training program for anesthesiologists who want to master nerve blocks, pain management, and advanced procedural skills. Here’s what you need to know:
Key Program Features:
- Duration: 12 months (most programs)
- Focus: 70% clinical training, 20% research/education
- Volume: Fellows perform 1,000+ blocks annually
- Requirements: Completed anesthesiology residency
- Application: 12-18 months in advance via SF Match or ERAS
Main Training Areas:
- Ultrasound-guided nerve blocks
- Upper/lower extremity blocks
- Truncal and neuraxial techniques
- Acute pain service management
- Research projects and teaching
These fellowships prepare anesthesiologists to become experts in regional anesthesia and acute pain medicine. The training focuses heavily on ultrasound guidance and modern pain management techniques that reduce opioid dependence.
Most programs offer 2-6 positions per year at major academic medical centers. Fellows gain experience in high-volume block rooms, performing thousands of procedures while learning to manage complex pain cases.
As Dr. Niveditha Karuppiah from India shared about her fellowship experience: “This fellowship gave me a multi-layered experience both clinically and academically. The varied patient population between the three hospitals made sure the exposure to the different blocks and cases was vast and complete.”
I’m Dr. Erika Peterson, and I bring experience in neuromodulation and chronic pain management, having trained in functional neurosurgery with a fellowship in deep brain stimulation. My work with regional anesthesia fellowship programs helps bridge the gap between traditional pain management and advanced neuromodulation techniques. This background allows me to provide unique insights into how regional anesthesia training connects to broader pain management careers.
A regional anesthesia fellowship is a specialized postgraduate training program designed for physicians who have completed their anesthesiology residency. Its primary objective is to cultivate highly skilled experts in the field of regional anesthesia and acute pain medicine. This involves mastering advanced techniques for nerve blocks, understanding the nuances of acute pain management, and often, contributing to research and education in the specialty.
The ultimate goal of this focused training is to equip fellows with the knowledge and practical abilities to minimize opioid use in perioperative settings, improve patient recovery, and improve overall patient outcomes. It’s about providing precision pain relief, which is a cornerstone of modern patient care. We believe this specialized training is vital for advancing the cutting-edge advancements in the neuromodulation field, as precise regional pain control often complements or sets the stage for advanced neuromodulation therapies.
The Fellowship Experience: Core Competencies and Training Structure
If you’re considering a regional anesthesia fellowship, you’ll be looking at an intensive but incredibly rewarding year of training. Most programs follow a similar structure that balances hands-on clinical experience with academic growth.
The typical duration is one year – twelve months of focused learning that will transform you from a general anesthesiologist into a regional anesthesia expert. This timeframe is consistent across top programs, whether you’re looking at McGill University, Toronto Western Hospital, or Mayo Clinic.
Here’s what makes these programs so effective: they’re built around a 70% clinical focus. That means you’ll spend most of your time working directly with patients, perfecting your technique, and building confidence through repetition. The remaining 20% goes toward research and education – ensuring you’re not just a skilled practitioner, but also a thoughtful contributor to the field.
Most fellowships follow the CanMEDS framework, which sounds fancy but really just means they want you to excel in all aspects of being a physician. You’ll develop skills as a medical expert, communicator, leader, and scholar. It’s about becoming well-rounded, not just technically proficient.
Now, let’s talk about the commitment. You’ll have a service commitment of about 100 days per year at many programs. Call duties vary significantly – some programs like Mayo Clinic offer no call duty at all (lucky you!), while others like Toronto Western have you on call about 1 in 10 nights. The University of Michigan includes one overnight call per month in the main OR.
These commitments aren’t just busy work – they’re designed to give you diverse clinical exposure and help you develop the independent decision-making skills you’ll need as an attending. For a broader look at pain management approaches you’ll encounter, check out our comprehensive guide on Treatments.
Gaining Clinical and Procedural Mastery
This is where the magic happens. The clinical experience in a regional anesthesia fellowship is unlike anything you’ve encountered in residency – it’s intense, focused, and incredibly rewarding.
Ultrasound guidance is the foundation of modern regional anesthesia, and you’ll become an expert at it. Programs from Stanford to Sunnybrook emphasize mastering ultrasound-guided techniques. You’ll learn to visualize nerves clearly, watch your needle placement in real-time, and see exactly where your local anesthetic spreads. Some programs, like Frank H. Netter MD School of Medicine, use ultrasound exclusively for all peripheral blocks. While ultrasound is king, programs like Toronto Western also teach nerve stimulation techniques to give you a complete skill set.
The high-volume experience you’ll get is staggering. At Mayo Clinic Jacksonville, each fellow personally performs about 1,000 blocks during their year and supervises around 500 more. Toronto Western and Sunnybrook together perform around 3,000 procedures annually. Wake Forest reports approximately 3,500 peripheral, 2,000 neuraxial, 700 continuous peripheral, and 1,000 truncal blocks yearly. Schulich’s facilities can handle over 8,000 blocks annually.
These numbers aren’t just impressive statistics – they represent your path to mastery. You’ll become proficient in upper and lower extremity blocks, master truncal blocks like TAP and PECS blocks, and gain expertise in neuraxial techniques including thoracic epidurals and spinal anesthetics. Continuous catheter techniques for prolonged pain relief will become second nature.
The connection between precise regional pain control and advanced therapies like Peripheral Nerve Stimulation (PNS) becomes clear during this training. You’ll see how these foundational skills complement cutting-edge neuromodulation approaches.
You’ll also learn the business side of things. Programs like Schulich teach block room administration – how to run an efficient service and even establish new regional anesthesia programs. This combination of clinical excellence and organizational skills prepares you for leadership roles down the road.
The Academic Side: Research and Education
A regional anesthesia fellowship isn’t just about becoming a procedural expert – it’s about contributing to the future of pain medicine. Most programs dedicate around 20% of your time to research and educational activities. Mayo Clinic even provides a dedicated non-clinical day each week to support your academic work.
You’ll be expected to complete an academic project requirement during your year. McGill expects at least one clinical research project. Toronto Western encourages fellows to initiate one project and participate in another. Sunnybrook aims for each fellow to produce at least one peer-reviewed publication. Mayo Clinic’s goal is to get every fellow published in an indexed journal.
The research you do matters. Schulich fellows regularly present their findings at major conferences like CAS, ASRA, and ASA. This isn’t just resume-building – you’re genuinely advancing the field and positioning yourself as a future leader.
Journal clubs are a regular feature at programs like Schulich, University of Michigan, and Stanford. You’ll critically analyze current literature, debate findings, and stay current with emerging techniques. It’s intellectual stimulation that keeps you sharp.
Teaching is another crucial component. You’ll work with residents and medical students, sharing your growing expertise and solidifying your own understanding. Stanford fellows even teach ultrasound and cadaver workshops. There’s truth to the saying “see one, do one, teach one” – teaching others deepens your own mastery.
For exploring more fellowship opportunities, the ASRA Fellowship Directory is an invaluable resource. And to continue learning throughout your career, our Anesthesiology CME Courses offer cutting-edge insights into the latest developments in pain management and neuromodulation.
Navigating the Application Process for a Regional Anesthesia Fellowship
Applying for a regional anesthesia fellowship is like planning a complex surgical procedure – timing, preparation, and attention to detail make all the difference. The competition is real, but with the right approach, you can steer this process successfully.
First things first: you’ll need to have completed an ACGME-accredited anesthesiology residency program. This is non-negotiable across virtually all programs. Think of it as your ticket to the show. Beyond this foundation, most programs require you to hold a valid medical license in the state or province where you’ll be training.
For international medical graduates, the path involves a few extra steps. You’ll typically need to demonstrate English proficiency through tests like TOEFL (often requiring a minimum score of 93 overall with 24 in speaking) or IELTS (usually requiring a minimum of 7 in each category). Some programs also require recognition of your medical degree and residency training, plus a pre-entry assessment period.
Here’s where many applicants stumble: the application timeline. You need to start this process 12-18 months in advance of when you want to begin your fellowship. Yes, you read that right – some programs require applications a full 18 months ahead of time. This isn’t a process you can rush through during your final year of residency.
Key Application Services and Required Documents for a Regional Anesthesia Fellowship
Most regional anesthesia fellowship applications flow through two main channels: SF Match and ERAS®. SF Match tends to be the go-to platform for regional anesthesia and pain medicine fellowships, and you can access it at SF Match. ERAS® is another major pathway – you can Apply here via ERAS®. Some programs also accept direct applications, particularly for non-ACGME positions or international candidates.
Your application package needs to tell your story compellingly. The Curriculum Vitae (CV) should showcase your clinical experience, research involvement, and any regional anesthesia exposure you’ve had during residency. Don’t just list experiences – highlight achievements and growth.
Your personal statement is where you get to shine. This isn’t the place for generic statements about “wanting to help people.” Instead, share what drew you specifically to regional anesthesia. Maybe it was watching a patient walk pain-free after a nerve block, or perhaps you’re fascinated by the precision of ultrasound-guided techniques.
Letters of recommendation carry significant weight in this competitive field. You’ll typically need three strong letters, including one from your residency program director. Choose recommenders who can speak to your technical skills, work ethic, and potential for advanced training. Give them plenty of time and provide them with your CV and personal statement to help them write compelling letters.
Preparing for Interviews and Matching
The interview process is your chance to see if a program truly fits your goals. Some programs still conduct in-person visits, while others have moved to virtual formats. Either way, preparation is key. Research each program thoroughly – know their faculty, understand their research focus, and be ready to discuss why you’re interested in their specific approach to regional anesthesia training.
During interviews, programs are evaluating not just your knowledge, but how you’ll fit into their team. They want to see your enthusiasm for the field and your potential as a future leader in regional anesthesia. Ask thoughtful questions about faculty interaction, mentorship opportunities, and the program’s vision for training.
After interviews comes the ranking process. This is where strategy meets personal preference. Consider factors beyond just prestige: think about program selection criteria like clinical volume, research opportunities, faculty mentorship, and geographic location. The program that’s right for your colleague might not be right for you.
Match Day is the culmination of this entire journey. For many programs, this happens in June for fellowships starting the following year. It’s an exciting and nerve-wracking day that determines where you’ll spend this crucial year of subspecialty training.
Choosing the right regional anesthesia fellowship is deeply personal. The best program is the one that aligns with your learning style, career goals, and personal circumstances. Trust the process, stay organized, and don’t be afraid to reach out to current fellows or faculty with questions along the way.
A Look at Notable Regional Anesthesia Fellowship Programs
Choosing the right regional anesthesia fellowship can feel overwhelming with so many excellent programs available. Each institution brings its own strengths, teaching philosophy, and unique opportunities to the table. Let’s explore some of the standout programs that consistently attract top candidates.
The landscape of fellowship training varies significantly across institutions. Some programs focus heavily on research output, while others emphasize high-volume clinical experience. Understanding these differences helps you find the perfect match for your career goals.
| Institution | Location | Positions Per Year | Annual Blocks (approx.) | Unique Feature |
|---|---|---|---|---|
| Mayo Clinic | Jacksonville, Florida | 3 | 1,000 (performed) | No call duty; dedicated non-clinical day for academics. |
| Toronto Western Hospital | Toronto, Canada | 4 | 3,000 | 20% research/education; strong emphasis on ultrasound guidance. |
| Schulich School of Med & Dent | London, Canada | 2-4 | 8,000 | Strong focus on CanMEDS roles; block room administration training. |
| Stanford University | Palo Alto, California | Competitive | High volume | Global health electives; interdisciplinary POCUS/FATE course. |
Spotlights on Leading Institutions for a Regional Anesthesia Fellowship
Let’s take a closer look at what makes these programs special and why they consistently rank among the top choices for aspiring regional anesthesia specialists.
Mayo Clinic in Jacksonville offers something many fellows dream of: no call duties. Their Regional Anesthesiology and Acute Pain Medicine Fellowship (Florida) lets you focus entirely on mastering your craft without the interruption of emergency calls. Each fellow performs around 1,000 blocks personally while supervising residents through another 500 procedures.
What really sets Mayo apart is their dedicated non-clinical day each week. This protected time allows fellows to dive deep into research projects and academic pursuits. Since starting in 2008, the program has built a reputation for producing well-rounded specialists who excel in both clinical practice and scholarly work. With only three positions available each year, competition is fierce.
University of Toronto’s network of affiliated hospitals creates an incredible learning environment. Toronto Western Hospital and Sunnybrook Health Sciences Centre together perform over 3,000 procedures annually, giving fellows exposure to an impressive variety of cases. The Regional Anesthesia and Pain Management (SHSC) program stands out for its innovative POCUS focus.
What makes Toronto special is their commitment to research and education. Fellows spend about 20% of their time on academic activities, ensuring they graduate as thoughtful clinicians who can contribute to the field’s advancement. Sunnybrook’s POCUS fellowship was the first of its kind in Toronto, showing their commitment to staying at the cutting edge of technology.
Duke University has built something unique with their Regional Anesthesiology & Acute Pain Medicine Fellowship. Their strong research emphasis produces fellows who become leaders in academic medicine. The program’s social media presence through @Duke_Anesthesia shows how engaged they are with the broader anesthesia community.
Duke offers five positions at the PGY-5 salary level, making it one of the larger programs. Their structured educational approach ensures every fellow gets comprehensive training while contributing meaningful research to the field.
Stanford University takes a different approach with their Fellowship program. What makes them stand out is the incredible diversity of clinical sites. Fellows rotate through four different hospitals, including Stanford Hospital, Palo Alto VA, and Lucille Packard Children’s Hospital. This exposure to different patient populations creates well-rounded specialists.
Stanford’s global health electives are truly special. Imagine spending part of your fellowship in Rwanda, Tanzania, or Guyana, bringing your skills to underserved populations. These experiences often become career-defining moments for fellows. Their interdisciplinary POCUS/FATE course shows their commitment to cutting-edge ultrasound training.
The program also emphasizes teaching, with fellows leading ultrasound and cadaver workshops for residents. This “learning by teaching” approach helps solidify knowledge while building leadership skills.
Each of these programs represents excellence in regional anesthesia fellowship training, but they offer different paths to that excellence. Whether you’re drawn to Mayo’s research-focused environment, Toronto’s high-volume experience, Duke’s academic rigor, or Stanford’s global perspective, there’s likely a perfect fit for your career aspirations.
Frequently Asked Questions about the Regional Anesthesia Fellowship
Thinking about pursuing a regional anesthesia fellowship? You’re not alone in having questions about this exciting career path. Let’s explore the most common concerns that future fellows ask about.
What is the typical salary for a regional anesthesia fellow?
Fellowship compensation varies quite a bit depending on where you train and the type of institution you choose. Most regional anesthesia fellowship programs pay fellows at the PGY-5 level, recognizing your advanced training status after completing residency.
The salary range can be surprisingly wide. Some programs offer more modest compensation – Albany Medical Center, for example, provides around $68,759 annually. Meanwhile, Cedars-Sinai bumps that up to $74,775 plus a $10,000 housing stipend to help with California’s cost of living.
On the higher end, you’ll find programs like Charter Anesthesiology offering $200,000 plus a $3,500 education stipend, or Bone & Joint Institute at Hartford Hospital at $155,000. East Memphis Anesthesia Services falls somewhere in the middle with $120,000 plus CME funding.
Don’t forget about the extras that make fellowship life more manageable. Most programs include health insurance, four weeks of vacation time, and a budget for attending conferences. These benefits add real value to your overall compensation package.
The variation in pay often reflects differences in call responsibilities, clinical volume, and geographic location. Urban programs in expensive areas typically offer higher salaries or housing allowances to help offset living costs.
Are most regional anesthesia fellowship programs ACGME-accredited?
This is a crucial question that affects your future career options. Many top-tier regional anesthesia fellowship programs carry ACGME accreditation – think Mayo Clinic, Thomas Jefferson University, and Stanford University. This gold standard means the program meets strict national requirements for curriculum quality, faculty credentials, and educational resources.
However, excellent non-accredited programs exist too. The University of Michigan’s Regional and Ambulatory Anesthesia Fellowship and Toronto Western Hospital’s program both explicitly state they’re not ACGME-accredited. These programs can still provide outstanding clinical training and valuable experience.
Why does accreditation matter? It can impact your eligibility for certain board certifications and may influence how future employers view your training. Some institutions prefer or require ACGME-accredited fellowship training for leadership positions.
Before you apply, always verify each program’s accreditation status on their official website or through the ASRA Fellowship Directory. Understanding this upfront helps you make informed decisions about which programs align with your long-term career goals.
What career paths are available after completing the fellowship?
Completing a regional anesthesia fellowship opens doors to diverse and rewarding career opportunities. Your specialized skills in nerve blocks and acute pain management make you highly sought after in today’s healthcare landscape.
Academic medicine attracts many fellowship graduates who love teaching and research. You’ll split your time between clinical practice, educating residents and medical students, and advancing the field through research projects. Mayo Clinic graduates, for instance, successfully practice in both academic and private settings nationwide.
Private practice offers another appealing path. You might join an established anesthesia group, work in ambulatory surgery centers, or even help develop independent pain clinics. Wake Forest specifically trains their fellows to establish regional anesthesia and acute pain management practices as core components of their future careers.
Leadership roles naturally follow this training. Many graduates become block room directors, ensuring safe and efficient regional anesthesia services throughout their hospitals. Others advance to Acute Pain Service director positions, overseeing comprehensive perioperative pain programs.
The Schulich program takes leadership training seriously, specifically preparing fellows to establish new Regional Anesthesiology and Acute Pain Medicine programs and provide visionary leadership in acute pain service management.
Your expertise in precise pain control often complements advanced neuromodulation therapies, creating opportunities in cutting-edge pain management. This specialized skill set connects beautifully with the broader field of interventional pain medicine and the various Conditions Treated through advanced techniques.
The beauty of this fellowship is its versatility – whether you’re drawn to academics, private practice, or hybrid models combining both, your training prepares you for impactful leadership roles in modern pain management.
Conclusion: Is a Regional Anesthesia Fellowship Right for You?
Deciding whether to pursue a regional anesthesia fellowship is one of those career-defining moments that deserves careful thought. Throughout this guide, we’ve walked through the intensive training, the impressive clinical volumes, and the academic rigor that defines these programs. Now comes the personal question: is this path right for you?
The career advancement opportunities are genuinely exciting. You’ll emerge as a specialist who can lead block rooms, direct acute pain services, or shape academic departments. The skill specialization you’ll gain – mastering ultrasound-guided techniques, performing thousands of nerve blocks, understanding complex pain pathways – makes you incredibly valuable in today’s healthcare landscape.
But perhaps most importantly, consider the impact on patient care you’ll have. Every block you perform could mean a patient needs fewer opioids, recovers faster, or experiences significantly less pain. That’s the kind of work that makes the long days and intensive training worthwhile.
The future of anesthesiology is moving toward precision medicine and multimodal pain management. Regional anesthesia sits right at the heart of this evolution. As healthcare continues to grapple with the opioid crisis, specialists who can provide effective, targeted pain relief become more essential than ever.
We understand that advanced pain management often connects with cutting-edge neuromodulation techniques. The precision you’ll develop in regional anesthesia can beautifully complement more advanced therapies, opening doors to exciting interdisciplinary approaches.
For deeper insights into this evolving field, explore our Blog where we share the latest developments in pain management and neuromodulation. Making an informed decision about your subspecialty training is crucial, and we hope this comprehensive overview has given you the clarity you need.
If you find yourself excited about delivering precise, patient-centered pain relief and eager to be part of medicine’s cutting edge, a regional anesthesia fellowship might just be your perfect next step. The field needs passionate, skilled physicians who can push boundaries while keeping patient care at the center of everything they do.
Explore more about advanced pain management techniques and find how regional anesthesia fits into the broader landscape of modern pain medicine. Your journey toward becoming a leader in pain management could start with that first fellowship application.