Pain Medicine Fellowship from Family Medicine

[patelfmpain]

Hello fellow medical students and soon to be physicians!

Match week is done and I accepted a position at a family medicine residency. I will be a DO. It is a new residency (i am the third incoming class) that serves rural areas. I have always been interested in anesthesia and pain management in general. So my questions are:

1. How difficult is it to obtain a pain medicine fellowship coming from a family medicine residency?
2. Does it matter that i am coming from a relatively new residency from a rural area?
3. What things can i do during residency to optimize my chances for a pain medicine fellowship position?

Hoping for any help, have not really found any concrete help or advice on other threads.

Thank you everyone!!

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[DO2015CA]

Not sure it’s possible. I’m aware of anesthesia, PM&R, and surprisingly psychiatry as the eligible specialties for pain fellowships

 

[Dantes]

Not sure it’s possible. I’m aware of anesthesia, PM&R, and surprisingly psychiatry as the eligible specialties for pain fellowships

EM, rads, and I think neuro as well.

OP, while I haven't personally heard of FM going into pain medicine, it seems like it's possible, at least according to this: Family Medicine - American Board of Medical Specialties

I have no idea if it would be an uphill climb though. I just know gas and PM&R are the two most popular.

 

[DO2015CA]

EM, rads, and I think neuro as well.

OP, while I haven't personally heard of FM going into pain medicine, it seems like it's possible, at least according to this: Family Medicine - American Board of Medical Specialties

I have no idea if it would be an uphill climb though. I just know gas and PM&R are the two most popular.

Interesting, I guess I’m aware of interventional pain with those I listed. From reading the description on that link, is FM pain fellowship interventional offering procedures?

 

[idkthrowaway]

Interesting, I guess I’m aware of interventional pain with those I listed. From reading the description on that link, is FM pain fellowship interventional offering procedures?

For neurology folks, they have to match to either anesthesia- or PM&R-associated pain medicine fellowships. And in that case they end up learning all the interventional procedures that the anesthesia or PM&R folks learn. I would surmise that in the case of psych, EM, rads, and apparently FM they would follow the same path. So the real challenge is just matching to a pain medicine fellowship in the first place, but once their you learn it all.

Also to the OP, your question is much more likely to be well answered in the Pain medicine forum than here.

 

[patelfmpain]

For neurology folks, they have to match to either anesthesia- or PM&R-associated pain medicine fellowships. And in that case they end up learning all the interventional procedures that the anesthesia or PM&R folks learn. I would surmise that in the case of psych, EM, rads, and apparently FM they would follow the same path. So the real challenge is just matching to a pain medicine fellowship in the first place, but once their you learn it all.

Also to the OP, your question is much more likely to be well answered in the Pain medicine forum than here.

thanks everyone!!! do you have the link to the pain medicine forum??

 

[idkthrowaway]

thanks everyone!!! do you have the link to the pain medicine forum??

Pain Medicine

For practicing pain physicians and pain fellows.

forums.studentdoctor.net

 

[hallowmann]

1. Its possible, very difficult and very uncommon to do it from FM. You won't be competitive for a lot of places. You may be able to do it by doing a Sports med fellowship followed by pain fellowship. Keep in mind though that sports med fellowship is one of the harder fellowships to land in FM (whereas getting into others would take less effort, you need to plan and cater your app towards sports med from the beginning).

2. Yes. That will make it hard on all fronts.

3. This is a tough one, because there are not a ton that do it, but research, making connections in the field(s), going to conferences will all help.

Its going to be an uphill battle honestly, but its not impossible.

 

[Sardonix]

Do a palliative care fellowship. Extremely rewarding and you get to use pain medications on a regular basis that most specialties only know in name.

 

[Mr Kenobi]

I am an outgoing PM&R resident --> incoming interventional pain fellow who matched a competitive Anesthesia based pain program this last cycle.

Bulk of the fellowship programs are under the anesthesiology banner. Handful are under PM&R and an even smaller number of places under neurology. In terms of competitiveness per primary specialty to obtain a pain fellowship spot, it typically goes: Anesthesia>PM&R>>>Neurology>>Psych>>everything else. Anesthesia and PM&R are getting close to equal. There do always seem to be a handful of EM folks who match every year. It is somewhat rare imo...but it does happen. FM would be exceedingly rare these days and I have personally not heard of a match out of FM in the recent years I have been monitoring the situation and speaking to folks about getting in to pain medicine.

There is a ton of variability between the actual pain fellowships themself. The typical "top tier" programs are usually the really interventional/procedural heavy ones. Most of these places stick to only looking at candidates from anesthesia/PM&R. There is a portion of programs that are much less interventional and more focused on "multidisciplinary" (less interventional based) pain management and these seem to the programs more open to the other specialties outside of anesthesia and PM&R.

Pain is considered a competitive subspecialty even within Anesthesia and PM&R. There are lots of candidates trying to get spots out of those two specialties alone. Overall, I would agree with what most have said here-- nothing is outside the realm of possible, but it would be extremely unlikely to get into even a bottom tier pain fellowship from FM currently with how many strong candidates from the other typical "pain track" specialties are applying.

TL;DR If you know you want to do pain medicine (especially the interventional/procedural side of it), you'd be most wise to aim for entrance into an anesthesiology or PM&R residency from the get go. If you are not competitive enough out of med school to get in to Anesthesiology/PM&R, the odds are very very low for you to match into pain fellowship out of some other specialty.