Specialty Training
CRNA Fellowships & Specialty Training
Post-graduation fellowships are optional but increasingly valued — especially for CRNAs who want to work in cardiac, pediatric, pain management, or trauma settings. Here's what's available, what it pays, and whether it's worth the investment.
Are fellowships required? No. You can practice in any anesthesia subspecialty without a fellowship — your DNP/DNAP and NCE certification qualify you for all anesthesia care. Fellowships are for CRNAs who want dedicated training and a competitive edge in subspecialty positions. They typically come with a salary (lower than staff CRNA pay) and are 3-12 months long.
Cardiac Anesthesia
Open-heart surgery, cardiopulmonary bypass management, TEE, complex hemodynamic monitoring. The most established CRNA fellowship pathway.
Skills Developed
- Cardiopulmonary bypass
- Transesophageal echo (TEE)
- Swan-Ganz catheter management
- Ventricular assist devices
- Complex hemodynamic management
Known Programs
- Mayo Clinic (Rochester, MN)
- Duke University (Durham, NC)
- Emory University (Atlanta, GA)
- Cleveland Clinic (Cleveland, OH)
- Texas Heart Institute (Houston, TX)
Who Should Consider This
CRNAs who want to work in cardiac OR settings. Some positions require or strongly prefer cardiac fellowship training. Highly valued at academic medical centers.
Pediatric Anesthesia
Neonatal and pediatric anesthesia including congenital cardiac, craniofacial, and specialized airway management for infants and children.
Skills Developed
- Pediatric airway management
- Congenital heart anesthesia
- Regional techniques in children
- Neonatal pharmacology
- Pediatric pain management
Known Programs
- Children's Hospital of Philadelphia (PA)
- Boston Children's Hospital (MA)
- Cincinnati Children's (OH)
- Nationwide Children's (Columbus, OH)
- Texas Children's (Houston, TX)
Who Should Consider This
CRNAs interested in dedicated children's hospital positions. These roles often require or prefer fellowship training. Rewarding but emotionally demanding.
Obstetric Anesthesia
Labor epidurals, spinal anesthesia for C-sections, high-risk OB management, and maternal hemorrhage protocols.
Skills Developed
- Labor epidural placement and management
- Spinal anesthesia for cesarean
- High-risk maternal conditions
- Massive hemorrhage protocols
- Neonatal resuscitation
Known Programs
- Less formalized than cardiac/peds — many hospitals offer focused OB rotations
- Some academic centers offer 3-6 month OB fellowships
- Contact hospitals with high-volume L&D units directly
Who Should Consider This
CRNAs who want to specialize in labor and delivery settings. OB is a subspecialty where comfort with the patient population and practice patterns matters more than credentials.
Regional Anesthesia & Pain Management
Ultrasound-guided nerve blocks, neuraxial techniques, chronic pain interventions, and ERAS (Enhanced Recovery After Surgery) protocols.
Skills Developed
- Ultrasound-guided peripheral nerve blocks
- Neuraxial techniques
- Chronic pain interventional procedures
- ERAS protocol development
- Pain clinic management
Known Programs
- Duke University (Durham, NC)
- Virginia Commonwealth University (Richmond, VA)
- Walter Reed National Military Medical Center (Bethesda, MD)
- Several VA hospitals offer pain fellowships
Who Should Consider This
CRNAs interested in pain management clinics or surgical settings emphasizing regional techniques. Pain management CRNAs can practice independently in many states and often have the highest salaries.
Trauma / Critical Care Anesthesia
Level I trauma center anesthesia, massive transfusion, damage control resuscitation, battlefield anesthesia (military), and emergency airway management.
Skills Developed
- Rapid sequence induction in trauma
- Massive transfusion protocols
- Damage control resuscitation
- Hemodynamically unstable patients
- Austere/field anesthesia (military)
Known Programs
- US Army Graduate Program (Fort Sam Houston, TX)
- R Adams Cowley Shock Trauma (Baltimore, MD)
- Several Level I trauma centers offer informal fellowships
Who Should Consider This
CRNAs who thrive in high-acuity, fast-paced environments. Military CRNAs often pursue this pathway. Valuable for Level I trauma center employment.
COA-Accredited Fellowship Programs
As of December 2025, COA accredits 7 post-graduate CRNA fellowships — split between Pediatric Anesthesia and Pain Management. Cardiac, OB, critical care, and regional fellowships exist as institutional programs but are not currently held to the COA standard. The directory below is sourced directly from the COA accredited-fellowships PDF and includes program-director contacts.
Nemours Children's Hospital
Pediatric AnesthesiaNemours Children's Hospital Pediatric Nurse Anesthesia Fellowship
University of South Florida
Pain ManagementUniversity of South Florida Advanced Pain Management Fellowship
Ann & Robert H. Lurie Children's Hospital of Chicago
Pediatric AnesthesiaAnn & Robert H. Lurie Children's Hospital of Chicago Pediatric CRNA Fellowship
Boston Children's Hospital
Pediatric AnesthesiaBoston Children's Hospital Pediatric Nurse Anesthesia Fellowship
Children's Hospital of Michigan
Pediatric AnesthesiaChildren's Hospital of Michigan Fellowship Program in Pediatric Nurse Anesthesia
Middle Tennessee School of Anesthesia
Pain Management (Acute Surgical)Middle Tennessee School of Anesthesia Acute Surgical Pain Management Fellowship
Texas Christian University
Pain ManagementTexas Christian University Post-Graduate Advanced Pain Management Fellowship
Is a Fellowship Worth It Financially?
Fellowship salary is typically $80K-$120K for 6-12 months — significantly less than a staff CRNA position. The salary impact post-fellowship is $10K-$40K/year depending on specialty. For cardiac and pain management, the ROI is typically positive within 1-2 years. For others, the value is more about career satisfaction and access to specific positions than pure financial return.
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