{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T07:25:00Z","timestamp":1787642700246,"version":"build-2736575974"},"reference-count":14,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Anesthesiology continues to attract growing interest among medical school graduates, yet its subspecialty fellowships remain chronically underfilled. Pediatric anesthesiology illustrates the pattern clearly, with unfilled fellowship positions rising more than fivefold between 2017 and 2023. Compensation is often cited as a driver but does not appear to fully explain the trend.<\/jats:p>\n <\/jats:sec>\n \n Aims<\/jats:title>\n This Perspective examines when subspecialty interest actually develops and argues that the traditional assumption that it forms during residency may already be too late.<\/jats:p>\n <\/jats:sec>\n \n Findings<\/jats:title>\n National Academies data indicate that a substantial share of pediatric subspecialists chose their field at the start of medical school, well before meaningful clinical exposure. A national survey of anesthesiology residents found that many enter their fellowship decision year without a subspecialty direction, and that adequate exposure during pediatric rotations was among the strongest predictors of fellowship pursuit, though such exposure varies widely by program. National efforts, including the Society for Pediatric Anesthesia's SPAERS committee and the Minds on Peds platform launching in early 2027, aim to standardize exposure earlier in training, in part through social media outreach to preclinical students. Fellowship fill rates have improved over this period of expanded outreach, although direct evidence linking social media exposure to subspecialty interest is still lacking.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Residency\u2010level interventions alone are unlikely to resolve the fellowship pipeline problem. The field should extend and standardize subspecialty exposure into the medical school years and build a deliberate, authentic presence on the platforms where trainees already learn.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/pan.70297","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T07:17:13Z","timestamp":1787642233000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Meeting Trainees Where They Are: Rethinking Fellowship Pipeline Development in Anesthesiology"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0159-8975","authenticated-orcid":false,"given":"Philip","family":"Carullo","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9834-233X","authenticated-orcid":false,"given":"Sabina","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care and Pain Medicine McGovern Medical School Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4111-8034","authenticated-orcid":false,"given":"Ariana","family":"Abdollahnejad","sequence":"additional","affiliation":[{"name":"Kansas City University College of Osteopathic Medicine Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9492-8196","authenticated-orcid":false,"given":"Erin","family":"Conner","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Oregon Health & Science University School of Medicine Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4626-4605","authenticated-orcid":false,"given":"Mitchell","family":"Phillips","sequence":"additional","affiliation":[{"name":"Department of Anesthesia Nemours Children's Hospital Florida Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2152-3627","authenticated-orcid":false,"given":"Kevin","family":"Spellman","sequence":"additional","affiliation":[{"name":"Anesthesiology & Pain Medicine Nationwide Children's Hospital Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4066-2354","authenticated-orcid":false,"given":"Allison","family":"Thoeny","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of Arizona College of Medicine Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5249-6851","authenticated-orcid":false,"given":"Tammy","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Stanford University School of Medicine Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3676-9001","authenticated-orcid":false,"given":"Rebecca","family":"Nause\u2010Osthoff","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of Michigan School of Medicine Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"Advance Data Tables: 2026 Main Residency Match","author":"National Resident Matching Program","year":"2026"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.14844"},{"key":"e_1_2_6_4_1","first-page":"2893","article-title":"Analyzing Trends in the Pain Fellowship Match: A Survey of Program Directors","volume":"17","author":"Wyles S. E.","year":"2024","journal-title":"Journal of Pain Research"},{"key":"e_1_2_6_5_1","volume-title":"Influences on the Career Path of a Pediatric Subspecialty Physician","author":"National Academies of Sciences, Engineering, and Medicine","year":"2023"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.15049"},{"key":"e_1_2_6_7_1","unstructured":"Society for Pediatric Anesthesia SPAERS: SPA Engagement with Residents and Students https:\/\/pedsanesthesia.org\/spaers\/."},{"key":"e_1_2_6_8_1","unstructured":"SF Match Pediatric Anesthesiology Fellowship Match Statistics sfmatch.org."},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.14336"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.14226"},{"key":"e_1_2_6_11_1","first-page":"7944","article-title":"How Social Media Encourages Medical Students to Pursue a Career in Neurosurgery: A Comprehensive Comparison of Twitter, LinkedIn, and Facebook","volume":"87","author":"Chaurasia B.","year":"2024","journal-title":"World Neurosurgery"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.15694\/mep.2020.000203.1"},{"issue":"1","key":"e_1_2_6_13_1","article-title":"The Impact of Social Media on Anesthesia Resident Recruitment","volume":"21","author":"Renew J. R.","year":"2019","journal-title":"Journal of Education in Perioperative Medicine"},{"issue":"10","key":"e_1_2_6_14_1","first-page":"673","article-title":"The Role of Social Networking Web Sites in Influencing Residency Decisions","volume":"112","author":"Schweitzer J.","year":"2012","journal-title":"Journal of the American Osteopathic Association"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.2196\/59417"}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pan.70297","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pan.70297","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pan.70297","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T07:17:15Z","timestamp":1787642235000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pan.70297"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,25]]},"references-count":14,"alternative-id":["10.1002\/pan.70297"],"URL":"https:\/\/doi.org\/10.1002\/pan.70297","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"value":"1155-5645","type":"print"},{"value":"1460-9592","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,25]]},"assertion":[{"value":"2026-07-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"pan.70297"}}