medicine and pain

[wood]

Is it true that other residency grads such as IM will soon be allowed to obtain pain fellowships?? Also is it harder for pmr grads to obtain pain spots from anesthesia based programs??

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[PainDr]

1. no
2. yes

 

[ParaVert]

One of the fellows for 2007-2008 at MGH is internal medicine. What happens in Boston will likely spread.

Is it true that other residency grads such as IM will soon be allowed to obtain pain fellowships?? Also is it harder for pmr grads to obtain pain spots from anesthesia based programs??

 

[paz5559]

One of the fellows for 2007-2008 at MGH is internal medicine. What happens in Boston will likely spread.

Can they sit for the ABA pain boards? or is that a non-ACGME accredited position?

 

[HolyMoly]

So PM&R grads, if they want to do pain medicine, only have truly legit shots at the 11 pain fellowships for PM&R grads? How difficult are those to obtain? What about after that, in practice...are they discriminated against?

 

[drusso]

So PM&R grads, if they want to do pain medicine, only have truly legit shots at the 11 pain fellowships for PM&R grads? How difficult are those to obtain? What about after that, in practice...are they discriminated against?

No, PM&R grads can apply to anesthesia pain fellowships and Anesthesia grads can apply to PM&R pain fellowships. Neurologists and psychiatrists can apply to both. The ABMS fellowships (ACGME-approved) are sponsored by Anesthesia, PM&R, and Neuro.

I'm a PM&R grad doing an anesthesia-based fellowship.

 

[Disciple]

So PM&R grads, if they want to do pain medicine, only have truly legit shots at the 11 pain fellowships for PM&R grads? How difficult are those to obtain? What about after that, in practice...are they discriminated against?

Depending on the interdepartmental relations at the hospital that your PM&R residency is at, you may actually have an easier time entering an Anesthesia pain fellowship at your home institution than a PM&R pain fellowship at an outside institution (due to limited spots for those 11 programs), and 90+ Anesthesia programs.

In the metro area I'm currently in there are several large private practice pain groups and many smaller ones. Many have both Anesthesia and PM&R docs. Interventional Physiatrists are also attractive to Orthopaedic Spine and Neurosurgery groups.

 

[drrinoo]

One of the fellows for 2007-2008 at MGH is internal medicine. What happens in Boston will likely spread.

When did (s)he apply?

I heard in late 2005/early 2006 that ACGME pain fellowships were no longer available to IM grads...prior to this period IM grads were allowed in.

It is truly a travesty that internists or family physicians cannot pursue pain fellowship training.

 

[lobelsteve]

It is truly a travesty that internists or family physicians cannot pursue pain fellowship training.

I do not see at as a travesty as much as it is a career choice. I have the technical skills to perform a lap chole, but I did not sign up to be a surgeon.

 

[Spine Specialist]

I have the technical skills to perform a lap chole, but I did not sign up to be a surgeon.

I remember you saying before that you do not have the skills to fix a light bulb. I am very glad you're getting confident lately. Physiatrists are the 'ultimate spine mechanics'. We are gonna fix spine pain in future without surgery.( Forget the 1% who need surgery anyway)

 

[Kwijibo]

but it wouldnt be safe for you to.

Either way, we have an internal medicine trained fellow in our program currently(interventional pain management-Cleveland Clinic), and our spine center has an attending who was internal medicine trained pain fellowship trained pain MD as well. I believe he did his at Beth Isreal in NYC.
So it is possible but hard to get a spot. You could probably do one of these pain fellowships that are less interventional and just take the weekend courses as well if you really wanted it.

 

[paz5559]

When did (s)he apply?

I heard in late 2005/early 2006 that ACGME pain fellowships were no longer available to IM grads...prior to this period IM grads were allowed in.

It is truly a travesty that internists or family physicians cannot pursue pain fellowship training.

Pain Medicine Examination Application Requirements (taken from the ABPM&R website)

All candidates for subspecialization in Pain Medicine must:

* provide documentation of a medical degree by submitting a copy of a diploma or certificate;
* maintain general certification by an ABMS Member Board other than the ABA or the ABPN;
* provide a copy of a current, valid and unrestricted license to practice medicine or osteopathy in a United States licensing jurisdiction or Puerto Rico, or licensure in Canada;
* fulfill the educational requirement for subspecialization in Pain Medicine; and satisfy the Pain Medicine examination requirement for Pain Medicine subspecialization.

Pain Medicine candidates who hold general certification from an ABMS Member Board other than the ABPMR, the ABPN, or the ABA must provide documentation of permission from their original certifying Board to pursue subspecialty certification in Pain Medicine.

 

[Kwijibo]

what makes physiatrist the 'ultimate spine specialist'? What does a PMR doc do that makes them better than anyone else? The fact that you think you can do a better physical exam? The bottom line is that being a pain physician has 100 times more to do with understanding pathophysiology, anatomy, pharmacology, and most importantly understanding your patient. Being PMR, Anesthesia, Neurology, Medicine or whatever doesn't matter as much as you think. Every subspecialty has its own advantage coming into the field, but in the end it is what type of physician you are. You can train a 14 year old to do these injections and use algorithms. Diagnosing a condition, and knowing how and what to do to make your patients 'better' is truely an art that supercedes all else.

 

[paz5559]

what makes physiatrist the 'ultimate spine specialist'? What does a PMR doc do that makes them better than anyone else? The fact that you think you can do a better physical exam? The bottom line is that being a pain physician has 100 times more to do with understanding pathophysiology, anatomy, pharmacology, and most importantly understanding your patient. Being PMR, Anesthesia, Neurology, Medicine or whatever doesn't matter as much as you think. Every subspecialty has its own advantage coming into the field, but in the end it is what type of physician you are. You can train a 14 year old to do these injections and use algorithms. Diagnosing a condition, and knowing how and what to do to make your patients 'better' is truely an art that supercedes all else.

So by that logic, it would be fine for, oh, say, a pathologist to be eligible for a cardiothoracic fellowship, since being a cardiothoracic surgeon "has 100 times more to do with understanding pathophysiology, anatomy, pharmacology, and most importantly understanding your patient." After all, "Every subspecialty has its own advantage coming into the field, but in the end it is what type of physician you are. You can train a 14 year old to do surgery and use algorithms. Diagnosing a condition, and knowing how and what to do to make your patients 'better' is truely[sic] an art that supercedes all else", right?

I mean, if your residency doesn’t have to have anything to do with your fellowship in pain, why would it matter in ANY field? Gee, maybe the retina fellowships would consider me, or plastics, or interventional cardiology ... No, wait, they actually think residency in an area related to the fellowship might actually be a reasonable pre-requisite!

 

[Spine Specialist]

what makes physiatrist the 'ultimate spine specialist'? What does a PMR doc do that makes them better than anyone else? The fact that you think you can do a better physical exam? The bottom line is that being a pain physician has 100 times more to do with understanding pathophysiology, anatomy, pharmacology, and most importantly understanding your patient. Being PMR, Anesthesia, Neurology, Medicine or whatever doesn't matter as much as you think. Every subspecialty has its own advantage coming into the field, but in the end it is what type of physician you are. You can train a 14 year old to do these injections and use algorithms. Diagnosing a condition, and knowing how and what to do to make your patients 'better' is truely an art that supercedes all else.

Kwijibo-

Dont take my post seriously, dude. It was my mistake to generalize the speciality. It was a post written in a moment of emotional response after a drive in the ultimate drivin' machine. Can a doctor be an ultimate healing machine? ultimate spine specialist? absolutely. A doctor who has passion for his work/compassion for his patients/ tireless worker like a german engine/ who never errs/who aims for relentless pursuit of perfection in diagnostic & interventional skills. It is my goal to beat a car in performance.
I will leave the hard part of debating abt speciality to paz....

 

[Ligament]

The requirements change July 1, 2007. At that time, ANY ACGME specialty can enter an ACGME Pain Medicine fellowship. Look at the 2007 ACGME guidelines at ACGME.org, in particular the 2007 guidelines with the "tracked changes"

In addition, ACGME accredited pain fellowships must be at an institution with 2 of the 4 following RESIDENCY programs: PMR, Anesthesia, Pscyh, Neuro. I suspect this may kill some of the existing programs.

Hopefully I'm misinterpreting this info.