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The current state of training in pain medicine fellowships: An Association of Pain Program Directors (APPD) survey of program directors. Pain Pract 2024 Mar 30

Date

03/30/2024

Pubmed ID

38553945

DOI

10.1111/papr.13373

Scopus ID

2-s2.0-85189965773 (requires institutional sign-in at Scopus site)

Abstract

INTRODUCTION: The Accreditation Council for Graduate Medical Education (ACGME) approved the first pain medicine fellowship programs over three decades ago, designed around a pharmacological philosophy. Following that, there has been a rise in the transition of pain medicine education toward a multidisciplinary interventional model based on a tremendous surge of contemporaneous literature in these areas. This trend has created variability in clinical experience and education amongst accredited pain medicine programs with minimal literature evaluating the differences and commonalities in education and experience of different pain medicine fellowships through Program Director (PD) experiences. This study aims to gather insight from pain medicine fellowship program directors across the country to assess clinical and interventional training, providing valuable perspectives on the future of pain medicine education.

METHODS: This study involved 56 PDs of ACGME-accredited pain fellowship programs in the United States. The recruitment process included three phases: advanced notification, invitation, and follow-up to maximize response rate. Participants completed a standard online questionnaire, covering various topics such as subcategory fields, online platforms for supplemental education, clinical experience, postgraduate practice success, and training adequacy.

RESULTS: Surveys were completed by 39/56 (69%) standing members of the Association of Pain Program Directors (APPD). All PDs allowed fellows to participate in industry-related and professional society-related procedural workshops, with 59% encouraging these workshops. PDs emphasized the importance of integrity, professionalism, and diligence for long-term success. Fifty-four percent of PDs expressed the need for extension of fellowship training to avoid supplemental education by industry or pain/spine societies.

CONCLUSION: This study highlights the challenge of providing adequate training in all Pain Medicine subtopics within a 12-month pain medicine fellowship. PDs suggest the need for additional training for fellows and discuss the importance of curriculum standardization.

Author List

Wahezi SE, Emerick TD, Caparó M, Choi H, Eshraghi Y, Naeimi T, Kohan L, Anitescu M, Wright T, Przkora R, Patel K, Lamer TJ, Moeschler S, Yener U, Alerte J, Grandhe R, Bautista A, Spektor B, Noon K, Reddy R, Osuagwu UC, Carpenter A, Gerges FJ, Horn DB, Murphy CA, Kim C, Pritzlaff SG, Marshall C, Kirchen G, Oryhan C, Swaran Singh TS, Sayed D, Lubenow TR, Sehgal N, Argoff CE, Gulati A, Day MR, Shaparin N, Sibai N, Dua A, Barad M

Author

Gwynne Kirchen MD Associate Professor in the Anesthesiology department at Medical College of Wisconsin