ACGME cert. - What does that even mean?

[clarence]

Can anyone tell me what the significance is of a pain or spine fellowship being ACGME accredited. Why does that matter and to whom? Thanks!

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[PMR 4 MSK]

ACGME certification means the program meets the criteria set forth by the ACGME for a comprehensive pain fellowship.

It matters to:

A) The program - more prestige, better bragging rights, likely to attract better candidates.
B) The candidates - for the same reasons
C) Hospitals - some will not grant privileges for pain procedures without it
D) Insurance companies - some will not pay for procedures done by doctors without it
E) The graduates of those programs for all the above reasons
F) The ACGME - because they make more money
G) The ABPM&R and ABAnesth - because they make more money

 

[fozzy40]

There was a great discussion thread on this topic on PhyzForum in the Musculoskeletal Forum if you are an AAPM&R member.

 

[clarence]

Thanks for the response! I am a little surprised - can you comment:

So insurance companies and hospitals really deny to pay or give privileges without having completed an ACGME accredited fellowship, even if you did a nonACGME fellowship and sat for the pain boards? They deny a board-certified pain doc on these grounds?!? (You can still sit for pain boards coming from a nonACGME fellowship right?)

I am an AAPM&R member but haven't been on the forum. I'll look into that, thanks!

 

[Ludicolo]

Thanks for the response! I am a little surprised - can you comment:

So insurance companies and hospitals really deny to pay or give privileges without having completed an ACGME accredited fellowship, even if you did a nonACGME fellowship and sat for the pain boards? They deny a board-certified pain doc on these grounds?!? (You can still sit for pain boards coming from a nonACGME fellowship right?)

I am an AAPM&R member but haven't been on the forum. I'll look into that, thanks!

You cannot sit for pain boards unless you complete an ACGME accredited pain fellowship. The days of grandfathering are over.

 

[FitDoc]

You cannot sit for pain boards unless you complete an ACGME accredited pain fellowship. The days of grandfathering are over.

What about other boards, such as ABIPP, or ABPM? Will the ABPMR recognize these board certifications? The wording on the ABPM site is unclear, but leans toward the idea that one could complete a nonaccredited fellowship, but an ACGME residency, and still sit for the board exam.

???

 

[webtek]

So for pain its pretty clear...if do an ACGME fellowship you can be boarded in pain and have all that goes along with board certification. How about PM&R accredited sports programs that include interventional spine procedures in their curriculum. How would that work out in the future? Would you still be able to do these procedures such as epidurals, trans-foraminals and rfa? With so many new sports accredited fellowships starting up in recent years how will this impact future residents and fellows? I appreciate your comments, since I have not seen this issue discussed previously.

 

[PMR 4 MSK]

What about other boards, such as ABIPP, or ABPM? Will the ABPMR recognize these board certifications? The wording on the ABPM site is unclear, but leans toward the idea that one could complete a nonaccredited fellowship, but an ACGME residency, and still sit for the board exam.

???

No, those are not ABMS recognized, so they don't count. I believe only a handful of states recognize them.

 

[axm397]

ABMS = American Board of Medical Specialties - parent organization for ABPMR, ABA (Anesthesia), etc.

For pain - ABA administers pain boards to those who completed ACGME accredited pain fellowships, ABPMR confers subspecialty board certification in pain.

For sports - same as above but I think it's ABFM (family medicine) - ACGME accredited sports fellowship grads take exam, ABPMR confers subspecialty board certification in sports.

All non-accredited fellowships - fellow can take non-ABMS "board" exams administered by various entities but depends on certain states if the state licensing boards consider them to be "equivalent" to ABMS board certification. Interesting fact: AANEM is NOT a ABMS recognized board, so taking the AANEM boards does not make you "board certified" in the eyes of ABMS - BUT - that exam is respected by most electromyographers and considered very challenging and difficult.

Credentialing - the process of getting "credentialed" - allows you to get onto insurance plans such as Medicare and other insurance plans.

A lot of times, credentialing will require that you have certain "privileges" at hospitals. (I have privileges to admit and perform procedures at hospitals although I never really use those privileges - but I had to get those privileges to get on certain insurance contracts)

"privileging" at hospitals - usually controlled by a "board" or some kind of "committee". This is where it gets political. If a physician wants to block competition, he/she can find any excuse (board certification, fellowship, etc.) to block you from getting privileges. Different hospitals have different criteria for privileging and a lot of it depends on your relationship or your group's relationship with the local hospitals.

"privileging" at surgery centers - same as above but usually less stringent because they want you to buy in and do procedures at their facilities so they can make $$.

In terms of $$: for procedures, there are professional fees and facility fees. there are 3 places where you can do procedures. In-office, hospitals, and ambulatory surgery centers (ASC). For in-office, the pro fee and facility fee are usually bundled - for example (not real numbers) $300 for an epidural. for ASCs and hospitals, there is a pro fee and a facility fee. The total is usually higher than the bundled in-office fee BUT overhead is usually higher. Example - $100 pro fee, $450 facility fee. In this example, if you are part owner of an ASC, you will usually keep most of the pro fee and you may see some of the facility fee profits. if you do it in the hospital, usually they keep the facility fee, you keep the pro fee.

Hope this clarifies.

 

[Mattchiavelli]

So basically the advantage of ACGME accredited fellowships is you know you can sit for boards and you're good to go anywhere in the country... and if your fellowship isn't ACGME.... you have to learn a lot more complicated acronyms

 

[FitDoc]

That's a great summary of what should be known by applicants...though the "political" part really bites. It's called GREED.

 

[clarence]

Wow, that was really helpful! Thank you everyone. Axm especially.

 

[clarence]

You cannot sit for pain boards unless you complete an ACGME accredited pain fellowship. The days of grandfathering are over.

So I emailed the ABPM (American Board of Pain Medicine) just this question and recieved the response below. Am I missing something? Please comment because this is a big deal for me to know.

"Thank you for contacting the American Board of Pain Medicine, (ABPM). In response to your inquiry, an ACGME residency is required. An ACGME fellowship is not required, but can be applicable toward practice experience. However, if an applicant completed an ACGME residency other than the primary five (anesthesia, PM&R, neurology, psych, neurosurgery), and that residency did not adequately cover pain medicine, the ACGME fellowship would be necessary to meet the educational requirements. None of these requirements are changing for 2012.

If you have further questions or concerns, please feel free to contact our office at 847-375-4726 or [email protected] and a member services representative will be happy to assist you.

Best Regards,
Jennifer Bose
Member Services"

This is my original message to ABPM:
"To whom it may concern,

I am a third year resident in physical medicine and rehabilitation currently researching fellowship opportunities in pain medicine. One of my goals is to be board certified in pain medicine. If I complete a pain medicine fellowship that is NOT ACGME accredited, am I still eligible to sit for the pain boards? I read through the 2011 bulletin of information and it does NOT seem to indicate that an applicant is required to complete an ACGME accredited pain fellowship (if the other requirements are met including completion of ACGME accredited residency training in one of the 5 specialties). However, I have been told by colleagues and peers that an applicant IS required to have completed and ACGME accredited fellowship. Is that misinformation? Is there a plan to make this a requirement in the near future?"

 

[Ludicolo]

So I emailed the ABPM (American Board of Pain Medicine) just this question and recieved the response below. Am I missing something? Please comment because this is a big deal for me to know.

"Thank you for contacting the American Board of Pain Medicine, (ABPM). In response to your inquiry, an ACGME residency is required. An ACGME fellowship is not required, but can be applicable toward practice experience. However, if an applicant completed an ACGME residency other than the primary five (anesthesia, PM&R, neurology, psych, neurosurgery), and that residency did not adequately cover pain medicine, the ACGME fellowship would be necessary to meet the educational requirements. None of these requirements are changing for 2012.

If you have further questions or concerns, please feel free to contact our office at 847-375-4726 or [email protected] and a member services representative will be happy to assist you.

Best Regards,
Jennifer Bose
Member Services"

This is my original message to ABPM:
"To whom it may concern,

I am a third year resident in physical medicine and rehabilitation currently researching fellowship opportunities in pain medicine. One of my goals is to be board certified in pain medicine. If I complete a pain medicine fellowship that is NOT ACGME accredited, am I still eligible to sit for the pain boards? I read through the 2011 bulletin of information and it does NOT seem to indicate that an applicant is required to complete an ACGME accredited pain fellowship (if the other requirements are met including completion of ACGME accredited residency training in one of the 5 specialties). However, I have been told by colleagues and peers that an applicant IS required to have completed and ACGME accredited fellowship. Is that misinformation? Is there a plan to make this a requirement in the near future?"

The ABPM is not recognized by the ABMS. What I was referring to was the subspecialty pain board certification given through the ABA and also conferred by the ABPMR (both of which ARE recognized by the ABMS). For better or for worse, the ABMS is considered the "gold standard" for board certification.

For more info from ABPMR (start on page 18):
https://www.abpmr.org/boi/Cert_BOI.pdf#nameddest=pain

 

[PMR 4 MSK]

So I emailed the ABPM (American Board of Pain Medicine) just this question and recieved the response below. Am I missing something? Please comment because this is a big deal for me to know.

APBMed is a LGOW (Looks Good on Wall) organization. They do have a pretty good annual meeting. As Ludicolo said, it is not recognized by ABMS, and is open to any Doctor of Medicine or Osteopathy. Even if you have a certificate from the ABPMed, in many states, you cannot advertise yourself as "Board Certified in Pain Management." You need ABMS sub-specialty Pain Board through AAPM&R, ABA, etc.

Go to http://www.abms.org/ for more details.

 

[melancholy]

Their emailed response appears consistent with their bulletin for requirements to take their board exam.

The bottom line is you'll be able to sit for boards, but what path you take will determine which boards you can sit for.

So I emailed the ABPM (American Board of Pain Medicine) just this question and recieved the response below. Am I missing something? Please comment because this is a big deal for me to know.

"Thank you for contacting the American Board of Pain Medicine, (ABPM). In response to your inquiry, an ACGME residency is required. An ACGME fellowship is not required, but can be applicable toward practice experience. However, if an applicant completed an ACGME residency other than the primary five (anesthesia, PM&R, neurology, psych, neurosurgery), and that residency did not adequately cover pain medicine, the ACGME fellowship would be necessary to meet the educational requirements. None of these requirements are changing for 2012.

If you have further questions or concerns, please feel free to contact our office at 847-375-4726 or [email protected] and a member services representative will be happy to assist you.

Best Regards,
Jennifer Bose
Member Services"

This is my original message to ABPM:
"To whom it may concern,

I am a third year resident in physical medicine and rehabilitation currently researching fellowship opportunities in pain medicine. One of my goals is to be board certified in pain medicine. If I complete a pain medicine fellowship that is NOT ACGME accredited, am I still eligible to sit for the pain boards? I read through the 2011 bulletin of information and it does NOT seem to indicate that an applicant is required to complete an ACGME accredited pain fellowship (if the other requirements are met including completion of ACGME accredited residency training in one of the 5 specialties). However, I have been told by colleagues and peers that an applicant IS required to have completed and ACGME accredited fellowship. Is that misinformation? Is there a plan to make this a requirement in the near future?"