I don't think that the problem with psych pain med applicants is their "intrinsic worth" as much as it their ability to have had certain experiences and exposure to interventional training in their residencies. Anesthesiology residents are required by their RRC to get at least 3 months of dedicated pain medicine exposure during their residency while most PM&R residents get 2-4 months of exposure to various aspects of pain medicine/interventional spine in their programs primarily through the use of elective time.
Personally, I think that the PM&R RRC should step up to the plate and require demonstrated competency in fundamental skills related to axial injections and pain medicine, but that is a rant for another day. Currently both PM&R and Neruology specialty boards have a bit of a credibility problem by co-sponsoring and promoting subspecialty certification in a field that they do not currently have stringent RRC training requirements for their primary base specialty. The situation would be analgous to internal medicine residencies not offering a required nephrology rotation for their residents.
Thus, some anesthesiologists see this as more evidence that their specialty is still the only one willing to both "talk the talk" and "walk the walk" when it comes supporting the academic base of pain medicine. In their eyes, PM&R and Neuro still remain "Johnny Come Latelies" to the field. For all the huffing and puffing that PM&R does about its role in pain medicine, the board doesn't seem interested in putting its money where its mouth is:
Anesthesia RRC requirements, "at least 3 months in pain medicine that may include one month in an acute perioperative pain management rotation, one month in a rotation for the assessment and treatment of inpatients and outpatients with chronic pain problems, and one month of regional analgesia experience in pain medicine"
PM&R RRC requirements: "The resident must have opportunities for progressive responsibility in diagnosing, assessing, and managing the conditions commonly encountered by the physiatrist in the rehabilitative management of patients of all ages of at least the following: (1) acute and chronic musculoskeletal syndromes, including sports and occupational injuries, (2) acute and chronic pain management, etc"
Neurology RRC requirements: " Residents must receive instruction in appropriate and compassionate methods of end-of- life palliative care, including adequate pain relief and psychosocial support and counseling for patients and family members about these issues."
Psychiatry RRC requirements: "Residents must receive comprehension instruction in the diagnosis and treatment of neurologic disorders commonly
encountered in psychiatric practice, such as neoplasms, dementia, headaches, traumatic brain injury, infectious diseases, movement disorders, multiple sclerosis, Parkinson's disease, seizure disorders, stroke, intractable pain, and other related disorders."