Possibilities to do pain medicine

[IMpainmedicine]

I started off in a specialty that is eligible to do a pain fellowship/sit for the boards but for various reasons switched to Internal Medicine after a year. Essentially I love procedures and was attracted to the idea of interventional cardiology at the time. Unfortunately years 2 and 3 showed me some pretty miserable aspects of the interventional cardiologist lifestyle which made me reconsider. I tried rotating in other IM subspecialities with procedures and wasn't too enthusiastic. Since then, I've had some exposure to a pain clinic and absolutely loved it. I was surprised to find how many great procedures they performed and found myself enjoying the patient population and overall lifestyle (surprise surprise).

My problem now is that IM does not cosponsor the Pain boards. They were actually invited and declined last year. I would really like to do a fellowship and am just looking at options. There are nonACGME I could apply to but fear that my options would be too limited after training. Are there any ACGME approved fellowships that would consider an IM grad and I would just be hopeful (and promote) that ABIM will eventually cosponsor the Pain boards?

The third and less desirable option would be to go back and finish 2 more years of my original residency that I started before switching to IM. Afterwards I would apply for a ACGME pain fellowship.

Thanks for any help/insight you guys can provide.

---

Members don't see this ad.

 

[Leo Aquarius]

Yes, there are a few approved fellowships that consider applicants outside of the traditional 4 specialties. I'm not in a position to say with certainty which ones they are. Search the reviews on pain fellowships on here and you'll come across a few. You can also read the websites of each program but that would take a lot of time, and many of the websites are a few years old.

ABIM is not politically motivated to sponsor the Pain boards.

 

[IMpainmedicine]

Thanks so much Leo! That's inspiring. I was getting very discouraged for that route since I reached out to at least a dozen programs and none accepted applicants outside of those designated specialties. If anyone is aware of these please feel free to send a message.

 

[Leo Aquarius]

Thanks so much Leo! That's inspiring. I was getting very discouraged for that route since I reached out to at least a dozen programs and none accepted applicants outside of those designated specialties. If anyone is aware of these please feel free to send a message.

Your welcome! Keep reaching out. I'm pulling for you.

 

[oreosandsake]

Cleveland clinic graduated and then hired an internist a few years ago. He is boarded through the abpmr

 

[hyperalgesia]

Are there any ACGME approved fellowships that would consider an IM grad and I would just be hopeful (and promote) that ABIM will eventually cosponsor the Pain boards?

Any fellowship can accept an IM grad and many will probably appreciate the diversity. Call around, be flexible, try again, things change constantly. After you are fellowship trained, you can probably get sponsored. I know of 2 people off the top of my head; one is rheum and the other is FM, who were able to take the boards under ABPMR. But anyway, the most important thing is that you are fellowship trained in pain. Especially ACGME fellowship trained. If you have that, you're pretty much at the highest level. The boards are like the cherry on top of a cake.

 

[freddydpt]

While there were many programs willing to accept other specialties in the past, the political climate has changed significantly. Most programs want to know you will become board certified afterwards. As an IM doc applying, you will no longer be eligible to sit for the boards under the ABA examination system (you can thank the ABIM for that). If you were currently in fellowship, you could have applied to be eligible through the ABPM&R or ABPN. With that said, there are many states that accept the ABPM as an "official" board certification. This may be a viable route for you in the future. With that said, research some of the non-accredited programs via former fellows/currently practicing physicians. You'll find they do the same things. The only limitations you'll have is getting privileges at a hospital, however, most pain medicine is outpatient clinic or ASC based. Continue to advocate to the ABIM and good luck!

By the way, the other residencies eligible for the Pain Medicine CAQ are Family Medicine, Emergency Medicine and Radiology. Could your first year of that previous residency count toward some of the credits of FM or EM?

 

[emd123]

I'd be really interested to hear the motivation as to why ABIM shot down the chance to cosponsor another sub-specialty, especially considering there already quite a few internists that have done ACGME Pain fellowships, and gotten Pain certified through ABPMR. Why would they want to shut that pathway down for future candidates? Trouble filling fellowship spots in their other sub specialties?

 

[IMpainmedicine]

I spoke to them on the phone and the answer they gave me was that there "was not enough interest" to warrant their involvement.

 

[freddydpt]

I spoke to them on the phone and the answer they gave me was that there "was not enough interest" to warrant their involvement.

I find that fascinating. And by fascinating, I mean likely completely false.

 

[101N]

I was surprised to find how many great procedures they performed and found myself enjoying the patient population and overall lifestyle (surprise surprise).

This is changing. Procedures are way over performed in this specialty and policy makers are taking note. Don't come here for that reason.

 

[IMpainmedicine]

So unfortunately I didn't get any invites for ACGME-approved fellowships this past cycle. I'm debating just going the nonACGME route vs reapplying next cycle. For the non ACGME fellowship route, are there any "pain boards" that I would be eligible to sit for? I contacted ABPM and they said I would not be eligible with them.

 

[Aether2000]

May not be such a bad thing since you will be competing with non-fellowship trained PAs, NPs, CRNAs, and radiology technicians that are all doing unsupervised pain medicine. If you operate out of your own office, the only issue will be insurance panels. A few require fellowship training for physicians, but of course not for nurses or PAs

 

[IMpainmedicine]

May not be such a bad thing since you will be competing with non-fellowship trained PAs, NPs, CRNAs, and radiology technicians that are all doing unsupervised pain medicine. If you operate out of your own office, the only issue will be insurance panels. A few require fellowship training for physicians, but of course not for nurses or PAs

I knew they could operate independently in some states, but I wasn't aware some insurance companies would cover their services but not someone with a nonACGME fellowship. So depressing.