RT Journal Article
SR Electronic
T1 History and evolution of regional anesthesiology and acute pain medicine fellowship training
JF Regional Anesthesia & Pain Medicine
JO Reg Anesth Pain Med
FD BMJ Publishing Group Ltd
SP 311
OP 314
DO 10.1136/rapm-2019-100915
VO 45
IS 4
A1 David Michael Shapiro
A1 Mary J Hargett
A1 Sandra Kopp
A1 Joseph M Neal
A1 Edward R Mariano
A1 Gregory Liguori
YR 2020
UL http://rapm.bmj.com/content/45/4/311.abstract
AB Introduction In 2016, individual training programs in regional anesthesiology and acute pain medicine (RA/APM) became eligible for accreditation by the Accreditation Council for Graduate Medical Education (ACGME), thereby culminating a process that began 15 years earlier. Herein, we review the origins of regional anesthesia training in the USA, the events leading up to accreditation and the current state of the fellowship.Methods We reviewed pertinent literature on the historical aspects of RA/APM in the USA, related subspecialty training and the formation and current state of RA/APM fellowship training programs. Additionally, a survey was distributed to the directors of the 74 RA/APM fellowships that existed as of 1 January 2017 to gather up-to-date, program-specific information.Results The survey yielded a 76% response rate. Mayo Clinic Rochester and Virginia Mason Medical Center likely had the first structured RA/APM fellowships with formalized curriculums and stated objectives, both starting in 1982. Most programs (86%), including ACGME and non-ACGME fellowships, came into existence after the year 2000. Six responding programs have or previously had RA/APM comingled with another subspecialty. Eight current programs originally offered unofficial or part-time fellowships in RA/APM, with fellows also practicing as attending physicians.Discussion The history of RA/APM training in the USA is a tortuous one. It began with short ‘apprenticeships’ under the tutelage of the early proponents of regional anesthesia and continues today with 84 official RA/APM programs and a robust fellowship directors’ group. RA/APM programs teach skills essential to the practice and improvement of anesthesiology as a specialty.