Pain Medicine fellowship requirement changes

[nvrsumr]

Received this letter from ABPMR. I actually support the changes to require multidisciplinary programs and only one fellowship per institution.


Dear Colleagues:


Recently, the Accreditation Council for Graduate Medical Education (ACGME) released a proposed major revision to their Program Requirements for Graduate Medical Education in Pain Medicine. In the view of the American Board of Physical Medicine and Rehabilitation (ABPMR), the program requirements have negative implications for physical medicine and rehabilitation (PM&R) specifically. The revisions are currently open for comment (scroll down to ‘Pain Medicine’); we urge you to review the changes and submit a comment before the deadline on October 18, 2018.


In our view, there are two main negative implications for PM&R:

1. Related to I.B.1.a), the current requirement states that only multidisciplinary programs will be accredited. There are many examples of PM&R-based programs located in stand-alone rehabilitation facilities which are not associated with or part of a multidisciplinary institution. This requirement unnecessarily prohibits the development of pain medicine fellowships at PM&R facilities.
   
   
2. Related to I.B.1.b), the current requirement states that There must be only one ACGME-accredited pain medicine program within a sponsoring institution… The two major concerns with this requirement are:
   1. By prescribing the specific number of programs that a sponsoring institution can have, the ACGME is limiting the number of fellows that can be trained in Pain Medicine and creating potential bias regarding whom is accepted into these programs. (There is prevailing perspective that PM&R residents are at a disadvantage when applying to programs administered outside the specialty; an institution should be able to decide whether to have pain medicine programs under PM&R, Anesthesiology, or both, and determine how they will fund them.)
   2. By limiting the number of pain programs, the total quantity of physicians properly trained to treat pain is inadequate, which negatively impacts patient care.

If approved as is, these requirements will continue to negatively impact the field of PM&R by leading to larger polarization of specialties and limiting opportunities for PM&R physicians to be accepted to Pain Medicine programs. Ensuring competence in pain medicine is only achievable through engaging as many eligible physicians as possible in the training process, particularly considering the rising opioid epidemic in the United States.


Again, we encourage you to visit the ‘Review and Comment’ page, view the proposed changes for Pain Medicine, and submit a comment before the Oct. 18 deadline. This is an opportunity to influence the future of PM&R opportunities in pain medicine training and we invite you to join us in raising our collective voice in support of PM&R.


Sincerely,



Anthony Chiodo MD

Chair, ABPMR Board of Director


Carolyn Kinney MD

Executive Director, ABPMR

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[willabeast]

It sounds as if they are going to enforce a previously existing requirement for multi-discipline pain training programs. Nothing wrong with that. PMR could then offer spine fellowships in addition, and make sure they are not multi-disciplinary. So there could be pain fellows and spine fellows.

 

[paindoc007]

Yep, as a physiatrist I’m also strangely okay with these changes. Think it’s a good thing...

 

[Orin]

• By prescribing the specific number of programs that a sponsoring institution can have, the ACGME is limiting the number of fellows that can be trained in Pain Medicine and creating potential bias regarding whom is accepted into these programs. (There is prevailing perspective that PM&R residents are at a disadvantage when applying to programs administered outside the specialty; an institution should be able to decide whether to have pain medicine programs under PM&R, Anesthesiology, or both, and determine how they will fund them.)

• By limiting the number of pain programs, the total quantity of physicians properly trained to treat pain is inadequate, which negatively impacts patient care.

I don't disagree with these points.

The rest of the changes actually make it easier though for anesthesia based fellowships to take in non-anesthesia based applicants, as they remove minimum numbers needed for intubations, IVs, LESIs, etc.

They seem to argue that the changes will increase the # of specialists available though, but I'm not sure I get it.

 

[drusso]

Received this letter from ABPMR. I actually support the changes to require multidisciplinary programs and only one fellowship per institution.


Dear Colleagues:


Recently, the Accreditation Council for Graduate Medical Education (ACGME) released a proposed major revision to their Program Requirements for Graduate Medical Education in Pain Medicine. In the view of the American Board of Physical Medicine and Rehabilitation (ABPMR), the program requirements have negative implications for physical medicine and rehabilitation (PM&R) specifically. The revisions are currently open for comment (scroll down to ‘Pain Medicine’); we urge you to review the changes and submit a comment before the deadline on October 18, 2018.


In our view, there are two main negative implications for PM&R:

1. Related to I.B.1.a), the current requirement states that only multidisciplinary programs will be accredited. There are many examples of PM&R-based programs located in stand-alone rehabilitation facilities which are not associated with or part of a multidisciplinary institution. This requirement unnecessarily prohibits the development of pain medicine fellowships at PM&R facilities.
   
   
2. Related to I.B.1.b), the current requirement states that There must be only one ACGME-accredited pain medicine program within a sponsoring institution… The two major concerns with this requirement are:
   1. By prescribing the specific number of programs that a sponsoring institution can have, the ACGME is limiting the number of fellows that can be trained in Pain Medicine and creating potential bias regarding whom is accepted into these programs. (There is prevailing perspective that PM&R residents are at a disadvantage when applying to programs administered outside the specialty; an institution should be able to decide whether to have pain medicine programs under PM&R, Anesthesiology, or both, and determine how they will fund them.)
   2. By limiting the number of pain programs, the total quantity of physicians properly trained to treat pain is inadequate, which negatively impacts patient care.

If approved as is, these requirements will continue to negatively impact the field of PM&R by leading to larger polarization of specialties and limiting opportunities for PM&R physicians to be accepted to Pain Medicine programs. Ensuring competence in pain medicine is only achievable through engaging as many eligible physicians as possible in the training process, particularly considering the rising opioid epidemic in the United States.


Again, we encourage you to visit the ‘Review and Comment’ page, view the proposed changes for Pain Medicine, and submit a comment before the Oct. 18 deadline. This is an opportunity to influence the future of PM&R opportunities in pain medicine training and we invite you to join us in raising our collective voice in support of PM&R.


Sincerely,



Anthony Chiodo MD

Chair, ABPMR Board of Director


Carolyn Kinney MD

Executive Director, ABPMR

I think that PM&R has rested on it's laurels too long with establishing PM&R-based pain fellowships and now it looks like the train is leaving the station. Amphab (RIP) and I worked on this and related fellowship training issues ad-naseum with the Academy nearly 15 years ago. It seems little has changed...I would urge the Academy, Dr. Chiodo, et al to revisit the work completed by the RPC on this topic circa 2004-2005.

ACGME accredited Sports Medicine Fellowships