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Pain Medicine Residency > Fellowship


Full Member
5+ Year Member
Mar 25, 2015
  1. Attending Physician
    I have read a scattering of articles and seen comments on making a residency for pain medicine fellowship:

    lobelsteve (9-15-2005):
    "PGY1-surgical prelim
    PGY2-3 mo IM, 3 mo neurology, 3 mo pscyhiatry, 3 mo Ortho
    PGY3-3 mo neurosurgery, 6 month acute pain service 3 mo pain clinic
    PGY4-mixed acute pain and clinic depending on what practice you will be going into.
    THat is an easy enough 4 years and readily modifiable to be more useful."

    Pain medicine: The case for an independent medical specialty and training programs. (6-2014)
    "Over the last 30 years, pain has become one of the most dynamic areas of medicine and a public health issue. According to a recent Institute of Medicine report, pain affects approximately 100 million Americans at an estimated annual economic cost of $560 to $635 billion and is poorly treated overall. The American Board of Medical Specialties (ABMS) recognizes a pain subspecialty, but pain care delivery has struggled with increasing demand and developed in an inconsistent and uncoordinated fashion. Pain education is insufficient and highly variable. Multiple pain professional organizations have led to fragmentation of the field and lack of interdisciplinary agreement, resulting in confusion regarding who speaks for pain medicine. In this Perspective, the authors argue that ABMS recognition of pain medicine as an independent medical specialty would provide much needed structure and oversight for the field and would generate credibility for the specialty and its providers among medical peers, payers, regulatory and legislative agencies, and the public at large. The existing system, managed by three ABMS boards, largely excludes other specialties that contribute to pain care, fails to provide leadership from a single professional organization, provides suboptimal training exposure to pain medicine, and lengthens training, which results in inefficient use of time and educational resources. The creation of a primary ABMS conjoint board in pain medicine with its own residency programs and departments would provide better coordinated training, ensure the highest degree of competence of pain medicine specialists, and improve the quality of pain care and patient safety."

    Has there been any recent movement to truly move in this direction, or is this something that simply will not occur? Personally: I feel fortunate to be able to pursue a one-year fellowship to be able to practice in this field, but I believe that a 4-year residency would help strengthen the field of pain management and it's future prospects for those practicing.


    Full Member
    10+ Year Member
    Mar 7, 2011
    1. Attending Physician
      my two cents (probably worth less than two cents) . i doubt the ABMS is going to like the idea of a new residency . i figure a spine fellowship program and spine board additional qualifications certification will come before a pain residency.

      A Witty Fool

      King Richard III
      7+ Year Member
      Oct 3, 2013
      The Round
      1. Resident [Any Field]
        My one cent.

        PGy1 - 3 mo IM, 2 mo neuro inpatient, 2 mo neuro outpatient, 1 mo psychiatry inpatient, 1 mo psych outpatient, 3 mo Ortho outpatient clinic
        PGY2 - 2 mo Anes, 2 mo acute pain, 6 mo pain clinic & procedures, 2 mo rehabilitation clinic
        PGY3 - mixed acute and clinic & procedures with 3 mo electives
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        15+ Year Member
        May 3, 2005
        1. Attending Physician
          I served on an ama task force to examine a pain residency around 5 years ago....the anesthesiology programs absolutely did not want this. The concept should have been adopted at that time to provide a stronger argument against PAs, NPs, CRNAs etc doing pain procedures and surgeries. It is too late now.
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          Full Member
          7+ Year Member
          Mar 5, 2012
          1. Attending Physician
            I served on an ama task force to examine a pain residency around 5 years ago....the anesthesiology programs absolutely did not want this. The concept should have been adopted at that time to provide a stronger argument against PAs, NPs, CRNAs etc doing pain procedures and surgeries. It is too late now.

            Yet another shining example of the academic "leadership" in medicine making a stupid decision...

            National shortage of anesthesiologists? Don't increase the number of grads substantially! Nope, let CRNAs crank out more grads to fill the gap. Never mind the fact that the AANA will continue fighting for practice independence in every conceivable practice setting. Why train more physicians to fill the gap when we can simply have advanced practice nurses accomplish this goal AND, better yet, they can eventually compete against anesthesiologists for the same positions. Brilliant solution!!! Kudos to the academic "leaders" in anesthesiology!

            CRNAs practicing pain independently, a national shortage of appropriately trained specialists in pain, and a national crisis of prescription opioid abuse and overuse of pain procedures? God forbid we create a separate pain medicine residency that will increase the number of appropriately trained specialists in the field, improve the overall training for these specialists, and make it extremely difficult for CRNAs to justify practicing pain on their own. Nope! That's a ludicrous idea! The better option is to maintain the status quo, because CLEARLY that's working out really well on a national scale.

            F'ing *****s...


            Membership Revoked
            5+ Year Member
            Apr 7, 2011
            Middle of Oregon
            1. Attending Physician
              Whoa, this is coming from a direction that I never would have anticipated.
              pg 27

              1.3 PROVIDE PHYSICIAN TRAINING IN PAIN MANAGEMENT AND OPIOID PRESCRIBING AND ESTABLISH A RESIDENCY IN PAIN MEDICINE FOR MEDICAL SCHOOL GRADUATES. Federal and state agencies, state medical boards, and medical societies should assure pre-graduate and post-graduate training in pain management and opioid prescription, including: continuing medical education (CME); graduate medical education (GME); post graduate education; and creation of a full three-year residency training program in pain medicine, which currently does not exist. Rationale: Training in pain management is needed in order to move toward more effective, less risky treatments. An estimated 10,000 pain specialists cannot meet the treatment needs of the millions of chronic pain sufferers in the U.S. Current Status: The American Association of Medical Colleges (AAMC) has endorsed efforts to increase the instruction of pain medicine in medical schools, however standards have not yet been defined. There is no full three-year residency training program in pain medicine in the U.S., and although legislation to support such a residency has been proposed and endorsed by leadership of the American Medical Association, it has been refused by the American Board of Medical Specialties.26 Accredited post-graduate fellowship training in pain medicine is available only for specialists in select fields, such as anesthesiology, neurology, psychiatry and rehabilitation medicine and not for general practitioners or specialists in family or internal medicine. Also available are continuing medical education (CME) courses, generally sponsored by pharmaceutical manufacturers, through the FDA’s Risk Evaluation and Mitigation Strategies (REMS).


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              Nov 21, 1998
              Over the rainbow
              1. Attending Physician
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