Pain Anesthesia vs. Non-anesthesia

[ThankGod]

Hi,

I'm a med. student interested in pursuing pain management as a future career and I have a question regarding pain fellowship pre-requisites.

Are there pain fellowship programs that only accept applicants who were trained in anesthesiology (versus PM&R or neurology)? In other words, are anesthesiology residents at an advantage for pain fellowship programs compared to residents in PM&R, neurology or psychiatry who want to go into pain medicine?

I would appreciate any feedback.

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[PMR 4 MSK]

All ACGME programs must accept applications from anyone From any field who has or will complete an ACGME residency. A pathology resident can apply for a pain fellowship.

That does not mean they will be given an interview, only that the application cannot be rejected on the basis of residency.

However, traditionally, anesthesia residents have more options, as many more programs are anesthesia-friendly than are PM&R friendly.

For non-ACGME programs, anything goes.

 

[PinchandBurn]

All ACGME programs must accept applications from anyone From any field who has or will complete an ACGME residency. A pathology resident can apply for a pain fellowship.

That does not mean they will be given an interview, only that the application cannot be rejected on the basis of residency.

However, traditionally, anesthesia residents have more options, as many more programs are anesthesia-friendly than are PM&R friendly.

For non-ACGME programs, anything goes.

 

[Ducttape]

its also my experience that most academic pain programs are affiliated with anesthesiology programs. in my program, everyone had to do 2 months of chronic pain, and there was a requirement to do 20 chronic pain evaluations during residency. also, the chronic pain attendings spend some time in the OR and/or crosscover, and the anesthesiology residents have to cover chronic pain overnight.

it leads to a much cozier relationship and perpetuates anesthesia involvement in pain.

 

[Jcm800]

do you have to go to medical school to do PMR? What a waste of time

apparently you dont have to if you wnat to do anesthesia or pain. See post about CRNA pain

 

[clubdeac]

I know when I was applying several years ago, Richard L. Rauck, M.D. at Wake Forest told me they only accept anesthesiology fellows. This was after the merger and ACGME changes. I complained to the AAPMR board of directors but it fell on deaf ears......

 

[lobelsteve]

I know when I was applying several years ago, Richard L. Rauck, M.D. at Wake Forest told me they only accept anesthesiology fellows. This was after the merger and ACGME changes. I complained to the AAPMR board of directors but it fell on deaf ears......

AAPMR is silent on too many issues and it is hurting our membership retention.

 

[PMR2008]

AAPMR is silent on too many issues and it is hurting our membership retention.

Absolutely. This is the last year I plan on being an AAPM&R member. My money is going to ASIPP.

 

[101N]

do you have to go to medical school to do PMR? What a waste of time

Did a 6mo PM&R residency in Motego just out of high school. It was great, skipped the MCATs and that USMLE nonsense.

 

[Ducttape]

Did a 6mo PM&R residency in Motego just out of high school. It was great, skipped the MCATs and that USMLE nonsense.

i did mine online via the University of Phoenix-Great Falls Campus...

 

[Jcm800]

Did a 6mo PM&R residency in Motego just out of high school. It was great, skipped the MCATs and that USMLE nonsense.

wow, what a waste of 5 extra months

 

[Louisville04]

Absolutely. This is the last year I plan on being an AAPM&R member. My money is going to ASIPP.

I keep debating about renewing my AAPMR membership. It really jumps in price from fellow to attending.

 

[PMR2008]

I keep debating about renewing my AAPMR membership. It really jumps in price from fellow to attending.

Absolutely. Here is the latest breakdown

ASIPP: Attending level - $450 per year ($6000 for life). Free - fellows/residents
AAPM&R: Attending level - $645 per year. Medical student Free, Resident/fellow - $75
AMA: Attending level - up to $420 per year.
ISIS:Attending level - $395. Fellow/Resident - $95
AOA: Attending level - up to $683. Fellow/Resident - $69
ASA: Attending level - $625. Fellow/Resident - $25
AAPM: Attending level - $375. Fellow/Resident - Free

I am going to pick the one that is most actively fighting for my right to practice.

 

[ampaphb]

Absolutely. Here is the latest breakdown

ASIPP: Attending level - $450 per year ($6000 for life). Free - fellows/residents
AAPM&R: Attending level - $645 per year. Medical student Free, Resident/fellow - $75
AMA: Attending level - up to $420 per year.
ISIS:Attending level - $395. Fellow/Resident - $95
AOA: Attending level - up to $683. Fellow/Resident - $69
ASA: Attending level - $625. Fellow/Resident - $25
AAPM: Attending level - $375. Fellow/Resident - Free

I am going to pick the one that is most actively fighting for my right to practice.

You should pick the one that actrively generates studies to defend your ability to practice, rather than one that lobbys legislators.

 

[kstarm]

You should pick the one that actrively generates studies to defend your ability to practice, rather than one that lobbys legislators.

Trying to decide where to place my money. Thoughts on which group is the best at generating studies to support us as pain physicians?

 

[sweetalkr]

ampaphb,
I respectfully disagree. I believe we have seen that medical studies can be fabricated easily and used as ammunition to pay or not pay for a procedure/treatment. Additionally, once the damage is done, it is difficult to reverse. As conspiracy as this sounds, I truly believe Evidence Based Medicine is a ploy by insurance companies to justify not paying for things. we all know that there are things we do that help they won't pay for. why not? Because it is unethical to have a double blinded RCT in Pain secondary to ethical issues. no one will agree to a sham treatment.
So as much as I love the "science" behind our procedures, I am more worried about legislation. Do you know why? Ask yourself what studies show when a C-section should be performed in "failure to thrive", and why insurance companies pay for it. Legislation rules over any scientific studies, hence how CRNAs are getting the ability to practice anesthesia by themselves even with basic common sense showing that the training of an MD is far superior to a nurse.
Join ASIPP or any organization you believe stands for your legislative beliefs first. Science second. Welcome to the new American Health Care System.

 

[Ligament]

Washing lobbyists are far more important to our ability to survive and practice than science, im afraid. Perfect example: CRNAs getting paid by the govt to do pain management

 

[PMR2008]

Washing lobbyists are far more important to our ability to survive and practice than science, im afraid. Perfect example: CRNAs getting paid by the govt to do pain management

Exactly my point of view. Even though it is nice to go to AAPM&R and ISIS conferences and listen in on what various docs from around the world are doing but in the end unfortunately it is lobbying that gets the job done. I am planning on keeping my ISIS and ASIPP membership in the long run but regardless of what your opinion might be about Lax and the gang they are out there fighting for our rights to practice.

 

[SSdoc33]

ampaphb,

Science second. Welcome to the new American.

i fixed it for you.


ISIS is clearly the better organization from a purely medical standpoint.

neither the AAPMR or the ASA seem to have the best interests (getting paid) of pain docs in mind.

its an ugly truth, but money talks, and lobbying is a necessary evil. it kills me to have to give money to lax and ASIPP, but I don't see a better option.

 

[thedeepend]

Did a 6mo PM&R residency in Motego just out of high school. It was great, skipped the MCATs and that USMLE nonsense.

You guys think that little of PM&R docs? Just out of interest do you practice with any? Thanks.

 

[lobelsteve]

You guys think that little of PM&R docs? Just out of interest do you practice with any? Thanks.

Most of us are PMR. We make fun of ourselves. The anesthesia guys cannot type too well.
Or they are busy getting their third in a series while we are screwing around on the forums.

 

[Aether2000]

Why stop at 3? lol.

Both ISIS and ASIPP have brought things to the table that are important. Both are controlled for life by 1-3 individuals. Both have been very active with furthering the goals and maintaining patient access to the profession. Both have had successes and failures in this realm. Both are worthy of membership.

 

[Ducttape]

Most of us are PMR. We make fun of ourselves. The anesthesia guys cannot type too well.
Or they are busy getting their third in a series while we are screwing around on the forums.

most of the anesthesia docs are busy spending the extra money they are making compared to non-anesthesia pain.