For residency you can look up stats like USMLE score and applicants to get a sense of how competitive they are. For fellowship it's hard to tell. One website I went to said they got 70 applications for 6 applicants.
How hard is it to get one of these accredited PM&R pain positions? What are the main deciding factors?
If you can't get one of those, how competitive are non-accredited spine programs?
"Competitiveness" is relative. Most accredited pain fellowships receive between 60-80 PM&R applicants per year - so the odds depends on the number of positions available and quality of other applicants. If the program also attracts anesthesia candidates, those numbers double. If you take out 1 or 2 spots for possible internal candidates, that changes the odds as well. From what I could see, fellowship directors look for several things from external candidates:
1. where you did your residency - if someone from your residency did fellowship there and did a good job, that helps. if you come from a "name" residency, that helps.
2. letters of recommenation - if there is a "name" pain guy/gal at your residency and he/she knows you well and writes you a stellar letter and calls the fellowship director on your behalf, that really helps. Alternatively, if you rotate with a "name" pain guy/gal and get a letter, that's good too - but obviously, a letter coming from someone who has known you for 3-4 years vs 1 month elective will have different strengths.
3. other stuff - board scores, where you went to med school, pain research, any research, leadership stuff, publications, etc.
4. Red/pink flags - poorly written personal statements, sloppy CV, late applications, mediocre or boring letters of recs, bad reputation at your residency which can make its way to fellowships via word of mouth (PM&R is small), treating secretaries poorly, arrogance/cockiness, and misrepresentation/exageration on CV.
These factors determine if you get an interview - and then when you come for the interview, they look for personality factors.
Some might argue to go to a mediocre residency with an accredited pain fellowship - that may be something to consider but know that per class, there probably will be more people applying to fellowship than spots available and should you not get that fellowship, your file will not be as impressive as someone coming from a higher quality residency. You also may not like the fellowship at your program and then you are stuck with a subpar application (comparatively) and few choices.
In terms of "competitiveness" of non-accredited spine fellowships - it depends on the name/reputation of the fellowship (ex. slipman, geraci, RIC, etc.) and location of the fellowship (nice places/big cities are usually more competitive) .
So no hard numbers but an overall feel. Average about 60-80 applicants --> about 2-6 interviewees per spot. (I think we interviewed about 12 for our 4 spots this year) Hope this helps.
That sucks. Only one on list that is hands-down anti.
