The program here also usually takes at least one physiatry resident annually. Lately there has been so much internal interest that the program has had a lot of quality applicants from within. My theory on the future of availability of pain fellowships is that as the number of programs contracts (due to the inability/unwillingness to meet the new ACGME requirements) positions will become more scarce and competitive. In this new environment, anesthesia applicants will certainly have the inside track. Truly excellent physiatry applicants will also have some opportunities although many might return to non-accredited PASSOR-type fellowships. Neurology and pyschiatry residents will face a much tougher road primarily due to lack of exposure to the fellowships. Certainly the fellowships that have historically considered non-anesthesia applicants will continue to do so, but I feel that the new requirements actually will make it more difficult for everyone but anesthesia. With regards to IM, FP, etc. I am not sure what program will truly consider these applicants and honestly I am not certain they should be considered particularly at the expense of good anesthesia or physiatry applicants.
The advice previously posted on this thread is very accurate. Good LORs, Some research (abstracts, publications), leadership (chief, national organizations), solid in-training/SAE scores, reasonable USMLE scores, reputation of your training institution are all factors that various programs consider. Rotating within your home institition's pain program is of utmost importance as it might land you a position or generate a very strong letter on your behalf. In the end optimizing this combination of factors might be a key to obtaining a fellowship position.
