Employer Perspective on Pain Fellowship Education: A Survey to Understand the Current State of Pain Medicine Training

Sayed E Wahezi,1 Ugur Yener,1 Tahereh Naeimi,1 Heejung Choi,2 Yashar Eshraghi,3 Scott G Pritzlaff,4 Trent Emerick,5 Corey W Hunter,6 Moorice Caparo,1 Michael E Schatman,7 Farshad Ahadian,8 Charles Argoff,9 Timothy Deer,10 Dawood Sayed,11 Miles Day,12 Alaa Abd-Elsayed,13 Giuliano Lo Bianco14 1Department of Physical Medicine & Rehabilitation, Montefiore Medical Center, Bronx, NY, USA; 2Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; 3Department of Anesthesia, Ochsner Medical Health Center, New Orleans, LA, USA; 4Department of Anesthesiology and Pain Medicine, University of California, Davis, CA, USA; 5Division of Chronic Pain, Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; 6Ainsworth Institute of Pain Management, Department of Rehabilitation & Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA; 7Department of Anesthesiology, Perioperative Care and Pain Medicine, Department of Population Health - Division of Medical Ethics, NYU Grossman School of Medicine, New York, NY, USA; 8Department of Anesthesiology, Center for Pain and Palliative Medicine, University of California, San Diego Medical Center, San Diego, CA, USA; 9Department of Neurology, Albany Medical Center, Albany, NY, USA; 10The Spine and Nerve Center of the Virginias, West Virginia University Hospitals, Charleston, WV, USA; 11Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA; 12Department of Anesthesiology, Texas Tech University Health Sciences Center, Lubbock, TX, USA; 13Department of Anesthesiology, University of Wisconsin, Madison, WI, USA; 14Anesthesiology and Pain Department, Fondazione Istituto G. Giglio Cefalù, Palermo, ItalyCorrespondence: Sayed E Wahezi, Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, 1250 Waters Place, Tower #2 8th Floor, Bronx, NY, 10461, USA, Tel +1 718-920 7246, Fax +1 929-263-3950, Email [email protected]: Pain medicine care has expanded to encompass a wider range of conditions, necessitating updated education and training for pain specialists to utilize emerging technologies effectively. A national survey was conducted through several verified Pain organizations regarding pain physician employers’ perspectives on pain medicine fellowship training and education. The survey aimed to gather insights from a diverse range of geographic locations, practice types (academic and private practice), and practice settings. The findings emphasize the need for educational programs to adapt to the evolving landscape of pain medicine.Methods: A survey was disseminated through several national professional pain societies, including the AAPM, ASIPP, NANS, and ASPN, and Pain DocMatters forum, an online verified pain physician forum to ensure a wide reach among potential respondents. The survey received responses from 196 participants, 39 from the Pain DocMatters forum and 157 through pain societies’ channels.Results: Most survey respondents reported a need for additional training and experience beyond what is offered during the one-year ACGME-approved fellowship. Professionalism and basic interventional skills were identified as the highest valued attributes of pain physician candidates by potential employers. Employers rated spinal cord stimulator (SCS) trials as the most important advanced procedure for trainees to learn. Other advanced procedures such as SCS implants, PNS implants, interspinous spacers, and percutaneous procedures involving the vertebral body were also rated as either very important or somewhat important by most respondents. A significant gap in training has been identified, with only 7% of respondents feeling that fellows were adequately prepared to independently practice in the current educational model. A vast majority of respondents stated that fellows need additional training following graduation from fellowship to practice independently.Conclusion: Training programs should provide more robust education to prepare their graduates for independent practice.Keywords: graduate medical education, fellowship training, analysis, multidisciplinary, independence