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In the last decade, management of acute and chronic pain has attracted significant attention on both the patient and professional level. The need of qualified personnel to supply services for the patients who have pain has increased. Pain medicine as a subspecialty has been well recognized by the public. Therefore, several organizations offer credentialing and certification.


Pain syndromes often involve exceedingly complex issues and no single, traditional, established specialty can simply and effectively cover all aspects of pain-related problems. Pain management is truly a multidisciplinary medical practice that involves application of a wide variety of techniques to which no single currently existing specialty can lay sole claim. Pain management still exists as a division of a larger department throughout most parts of the country—and not as a department of its own. Pain medicine has not been established as a generally accepted teaching course in medical schools even though some pioneer medical schools offer elective introduction courses to medical students. Medical school education in pain is usually minimal. In the first 2 years of formal lectures, it is common for coverage of this field to be limited to 1 to 2 hours. During the second 2 years of clinical rotations, students often receive additional informal education; however, little if any of this education is provided by experts in the field. Some medical schools (including Harvard Medical School) have started to offer didactic sessions as well as elective rotations in pain centers for senior students. These rotations can vary from 1 day to 1 month. Overall, however, medical school education in pain medicine remains minimal. Postgraduate training is mainly affiliated with other pain-related subspecialties or as part of training in such subspecialties. A distinct residency program in pain management has not been accepted. Additionally, the overwhelming majority of pain fellowship programs are affiliated with various primary specialty programs: mostly anesthesiology. The number of anesthesiology pain management fellowship programs, however, has increased significantly in the past 10 years. The Accreditation Council for Graduate Medical Education (ACGME) also expects the anesthesiology residency programs to provide some pain management training in a pain clinic setting.


There are several different pain management certifications offered currently. The American Board of Anesthesiology (ABA) took the first step. The ABA, founded in 1941, first notified the American Board of Medical Specialties (ABMS) of their intention to subcertify physicians in pain management in 1989, and then held discussions with other ABMS member boards interested in certifying physician in pain management. On September 26, 1991, the ABMS agreed with the ABA to issue a pain management certificate. The first subspecialty pain certificate to the qualified ABA diplomates was issued in 1993.1 Five years later, with the support of the American Board of Anesthesiology, the American Board of Physical Medicine and Rehabilitation (ABPM&R), and the American Board of Psychiatry and Neurology (ABPN) submitted a joint proposal to offer subspecialty certification in pain management. The first certification of subspecialty in pain management was ...

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