Non-accredited sports/spine vs. accredited sports

[TXPMR]

I did a search for recent discussions on this topic and didn't find much. If there has been a recent discussion, point me to the right place.

I'm in the middle of training and considering sports/spine, sports fellowship. As I understand there is no longer grandfathering in sitting for the PM&R sports boards for non-ACGME trained fellows as of 2013. So, obviously ACGME programs seem to be advantageous. But, also as I understand (i.e. from the sports match results just now coming out) that the sports match takes place after most of the non-accredited sports/spine offers have gone out. So, one could in a sense be putting all of their eggs in one basket for the ACGME fellowships without a fall back plan.

Ideally interested in being a sports fellowship trained physiatrist and not a primary care trained sports med doc. So ACGME PM&R sports programs are really attractive, albeit competitive. And I'm queasy about not being able to hone PM&R based skills (US, fluoro, EMGs etc.) in a PC fellowship.

I've also noticed that there are some otherwise big name programs for sports/spine that are non-accredited. So, my main question is if there is any universe in which going to a big name non-accredited program would be a good idea for someone who wants to be a fellowship trained sports med physiatrist or if I should be focused on going the ACGME accredited PM&R and PC route at all costs.

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[MedBronc23]

Just Putting this out there. Others may feel different. Unless you have not been fortunate enough to have much US EMG or spine interventions during residency...I don't see the advantage to doing a sports and spine fellowship. It doesn't count for subspecialty certification and payers may not eventually recognize reimbursement since not accredited. I guess if the s and s fellowship is with a group that you potentially want to stay with or in a desired geographic area it could make sense.

I personally just wanted my paper that said I did something that counted and could either say I was a board certified sports med doc or pain doc after 1 year.

Chose sports because it fit me better and being a team physician for a university hospital system or multi disciplinary sports group sounded most appealing. You can still do spine from a sports fellowship and you do not have to go to one of the PMR sports fellowships to continue EMG or spine injections. Utah and JPS are great examples of primary care sports fellowships that allow weekly flouro suite time, US, and EMG continuity plus primary care and nonoperative ortho sports stuff.

In fact some of the PM&R sports fellowships frown on doing spine as part of training, while others are heavy spine.

It's a tough choice because I feel like every sports fellowship has its own strengths and weaknesses just like residency and not one offers the same experience or exposure for PMR sports docs.

Just my 2cents. Happy to be PM&R and proud to be one of the fortunate to sit for sports boards in 2015.

 

[oreosandsake]

http://www.pmrjournal.org/article/S1934-1482(13)00370-5/fulltext

 

[Disciple]

I personally just wanted my paper that said I did something that counted and could either say I was a board certified sports med doc or pain doc after 1 year.

That's the issue here. If you're a musculoskeletal Physiatrist who performs interventional procedures, you shouldn't be forced into other specialties' classification systems because Physiatry chooses not to support your professional identity.

It's been a problem 10+ years running, and we (our specialty) seem to lack the fortitude to correct the situation. As a specialty, we don't take full advantage of the strengths and skills that we bring to the table.

Our identity crisis is outlined in the article in the above link.

Most of those who might agree with me, most of the original PASSORites, etc. have moved on, and the younger generation has migrated to ISIS and/or ASIPP.

Sad that we can't assert ourselves more effectively.

 

[Prof Moriarty]

The purple journal article mentioned above is a good read but of course does not contain the answer, just more questions.

Couple of interesting old threads:

• http://forums.studentdoctor.net/threads/to-acgme-or-not-to-acgme.466700/#post-5829637
• http://forums.studentdoctor.net/thr...mary-sports-fellowships.976575/#post-13558418

A couple years ago one could do a non-ACGME sports and spine fellowship, and then get boarded in both (sports and pain). Several of these guys are still offering non-ACGME sports and spine type fellowships, while at the same time they of course maintain their board certification.

I think it boils down to what you want to do and where. If you know you want to be in a highly academic environment or a competitive geographic location, the board certification may put you over the top, or may be a requirement. If you know you don't want to be in one of those types of places, then it will likely be less of an issue. Purely in terms of exposure, some of the non-ACGME fellowships may actually offer a superior training, depending on what you want to do.

 

[TXPMR]

Just Putting this out there. Others may feel different. Unless you have not been fortunate enough to have much US EMG or spine interventions during residency...I don't see the advantage to doing a sports and spine fellowship. It doesn't count for subspecialty certification and payers may not eventually recognize reimbursement since not accredited. I guess if the s and s fellowship is with a group that you potentially want to stay with or in a desired geographic area it could make sense.

Yes, not everyone is as fortunate to be extremely competent in US and fluoro procedures since they are not part of the core competencies. There seems to be some variation in programs in this regard. Hence, some of the comments in the first thread Prof Moriarty linked about there not being a total standardization of MSK medicine in PM&R programs.

I also don't understand why there isn't a push for more PM&R ACGME accredited sports programs seeing that now one has to go to such a program to sit for the boards. To me, it's kind of a bad look that physiatrists have to go to another specialty for fellowship training (primary care) for something that we could do ourselves all while offering additional training in competencies that separate physiatrists from our colleagues in other fields.

 

[TXPMR]

Purely in terms of exposure, some of the non-ACGME fellowships may actually offer a superior training, depending on what you want to do.

Could you expand on that?

 

[drusso]

The beat goes on....get good base MSK training in residency and then use fellowship to hone specific skills.

 

[Prof Moriarty]

Could you expand on that?

Depends on the individual... what skills you already picked up in residency, what you want to add, and what you want to do and where. The acgme sports have some basic things in common, but then each one offers different aspects of training, and the S&S's can be highly variable in what they offer.

 

[MedBronc23]

Depends on the individual... what skills you already picked up in residency, what you want to add, and what you want to do and where. The acgme sports have some basic things in common, but then each one offers different aspects of training, and the S&S's can be highly variable in what they offer.

Couldn't agree more on the ACGME sports fellowships. They all have set criteria/experiences that fellows have to meet, but definitely each has own strengths and weaknesses.

 

[RUOkie]

The beat goes on....get good base MSK training in residency and then use fellowship to hone specific skills.

this