Interventional Spine or Pain Medicine

[RandyMarsh4Prez]

I’m well aware there’s been a million threads on this topic already (you’ll still remind me); however, I’m curious about the changes that are about to happen since interventional spine looks to be making some changes.

The top interventional spine programs are now gaining “NASS Recognition” status and will be participating in a match in 2019. Since the match will come before the traditional match, you’ll have to make a choice between pain or spine then stick with it.

Removing all variables, if a NASS recognized spine fellowship trainee from a top academic medical center lined up with an ACGME trained applicant from a mid to low tier program and you could only hire one, who gets the job and why?

Not looking to start a turf battle. I’d just like to know what all needs to be considered (i.e., issues with insurances paying non-pain boarded physicians, marketing university training vs being pain boarded, unfamiliarity with NASS).

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[DOctorJay]

In my network if you aren’t ACGME fellowship trained you wouldn’t be looked at for an interventional position. Not saying it’s right but that is the way it is here.


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[nvrsumr]

NASS fellowship will prepare u to be a surgeon’s injection monkey and post op pain pill provider

 

[lobelsteve]

NASS fellowship will prepare u to be a surgeon’s injection monkey and post op pain pill provider

I know many of the docs running these fellowships and can state that for the folks I know that is not the case.

 

[nvrsumr]

The last thing the world needs is more unaccredited pain/spine felllowships.

Today NASS tomorrow ASSIP etc..

 

[sdnuser001]

I’m well aware there’s been a million threads on this topic already (you’ll still remind me); however, I’m curious about the changes that are about to happen since interventional spine looks to be making some changes.

The top interventional spine programs are now gaining “NASS Recognition” status and will be participating in a match in 2019. Since the match will come before the traditional match, you’ll have to make a choice between pain or spine then stick with it.

Removing all variables, if a NASS recognized spine fellowship trainee from a top academic medical center lined up with an ACGME trained applicant from a mid to low tier program and you could only hire one, who gets the job and why?

Not looking to start a turf battle. I’d just like to know what all needs to be considered (i.e., issues with insurances paying non-pain boarded physicians, marketing university training vs being pain boarded, unfamiliarity with NASS).

Where did you get info on this match? I am a PGY-2 and my understanding was that the ACGME match for 2021-2022 fellowship year opens up December of next year. Does the NASS match start before December? And why can't you just participate in both matches?

 

[nvrsumr]

NASS is 100% surgeon led society. I presented a poster as a resident. Got a free trip. Not a hater but an advocate for pmr.

Some of the pmr Nass representation are academic program directors of pmr sub departments that are within ortho. Stanford comes to mind.

Don’t be trained to be a cog.

 

[SSdoc33]

There's been a million threads on this topic already

 

[SSdoc33]

the truth lies somewhere between nvrsumr and lobelsteve's opinions.

not all places require "ACGME" accreditation

some of these so called "NASS" fellowships are clearly better than some ACGME pain ones, and may be more spine focused (less cancer pain, weird pain syndromes, etc)

 

[Prof Moriarty]

It's program by program. Top spine program will be better than mid-low-tier ACGME pain program. Top pain program will be better than mid-low-tier spine program. If your interest is truly image-guided interventional MSK medicine, then spine is generally the way to go. If your interest is truly comprehensive pain medicine including cancer pain, CRPS, post-op pain, etc, then pain medicine is generally the way to go. I dropped out of the pain match to accept spot at a NASS-oriented spine/MSK program, and was extremely well-prepared to hit the ground running upon completion. My training was the opposite of being a surgeon's injection monkey or pain pill provider. However, as DoctorJay pointed out, there are some systems that require ACGME-training. They actually do not care if your training and skills are superior. These are typically anesthesia-based programs holding onto their turf. If you know you want to work in one of these systems, you have to play their game. On the other hand, if you know you don't want to work there, then you are free to make the decision to go where you feel you can receive the best training. Personally, I felt it was important to interview at both, check out as many programs as possible, and then choose the best training *for me*.

 

[Disciple]

It's a trade-off.

The nuts and bolts of this are that if you want the overall greatest number of job prospects (some of which may involve chronic opioid management, harm reduction clinics, MAT--especially nowadays, or to give yourself the greatest odds of succeeding in running your own practice) do the pain fellowship.

If you want to be a musculoskeletal doctor that does image guided injections, and are leaning towards working in an Ortho or Neurosurg group, and have no intention of doing chronic opioid management/psychosocial case management, etc., do the spine fellowship.

After all these years, PMR still has not been able to merge the benefits of column A. and column B. Maybe they'll finally figure it out with their PM&R Bold initiative.

See this thread:

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