History and evolution of regional anesthesiology and acute pain medicine fellowship training

2020 ◽  
Vol 45 (4) ◽  
pp. 311-314 ◽  
Author(s):  
David Michael Shapiro ◽  
Mary J Hargett ◽  
Sandra Kopp ◽  
Joseph M Neal ◽  
Edward R Mariano ◽  
...  
Keyword(s):  
Regional Anesthesia ◽  
Acute Pain ◽  
Training Programs ◽  
Medical Center ◽  
Fellowship Training ◽  
Specific Information ◽  
Subspecialty Training ◽  
Pain Medicine ◽  
Current State ◽  
The Usa

IntroductionIn 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.MethodsWe 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.ResultsThe 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.DiscussionThe 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.

Cosmetic Surgery: A Subspecialty That Needs Specialized Training and Recognition

2021 ◽  
pp. 074880682110518
Author(s):  
Kamran Dastoury ◽  
Jacob Haiavy ◽  
Jane Petro ◽  
Martha Ayewah
Keyword(s):  
American Academy ◽  
Plastic Surgery ◽  
Cosmetic Surgery ◽  
Training Programs ◽  
Aesthetic Surgery ◽  
Fellowship Training ◽  
Subspecialty Training ◽  
Plastic And Reconstructive Surgery ◽  
Surgery Training ◽  
American Society

Introduction: This study was performed to provide a comprehensive review of the breadth and depth of fellowship training provided by the American Academy of Cosmetic Surgery (AACS), with direct comparison with other current aesthetic surgery training programs available in the United States. We hypothesized that this subspecialty training provides essential experience and confidence to perform aesthetic procedures, which are likely not adequately imparted during traditional residency training. We also address the notion that Cosmetic Surgery is not under the sole ownership of one specialty, but rather a subspecialty that flourishes by collaboration between multidisciplinary surgical backgrounds. Materials and Methods: We performed a cross-sectional study of survey data from 2 distinct groups—current fellows in a 1-year AACS program and surgeons who completed an AACS fellowship between July 2008 and June 2017, who have been in active cosmetic surgery practice ranging from 6 months to over 6 years. A survey was administered via email and distributed by the AACS central office. The responses were compared with data published in the Annals of Plastic Surgery concerning Recent Trends in Resident Career Choices after Plastic Surgery Training. Results: The Accreditation Council for Graduate Medical Education (ACGME) requirements for aesthetic surgical cases in a 6-year Plastic Surgery program are 150 cases, but 50% of graduating seniors feel inadequately prepared to transition straight into aesthetic surgery practice, whereas among AACS graduating fellows, 100% feel very prepared to go on the aesthetic surgery practice, having completed an average of 687 cases within the yearlong training program. We note that the survey response rate was 81% among current fellows versus 35% among practicing surgeons. Discussion: We believe that focused subspecialty training in cosmetic surgery after completion of a primary surgical residency in a form of a structured fellowship through AACS, American Society of Plastic Surgery, American Academy of Facial Plastic and Reconstructive Surgery, Commission on Dental Accreditation, and American Society of Ophthalmic Plastic and Reconstructive Surgery (Oculoplastic) is the ideal preparation for the future. As we learn from each other through fellowship training, academic conferences, and research, this will further advance the subspecialty and ultimately improve patient care and outcomes. There is no evidence that these training programs provide less adequate preparation, although they are not accredited by the ACGME. To the contrary, the additional experience and knowledge gained during these fellowship training programs result in better outcomes and more competent practitioners. Conclusions: The development of subspecialty training and board certification for surgeons committed to cosmetic surgery yields the highest level of qualified providers. The diverse backgrounds of these providers continue to allow us to expand and innovate in this field. This study is aimed at moving this conversation forward in a positive direction.

Radiation safety and knowledge: an international survey of 708 interventional pain physicians

2021 ◽  
pp. rapm-2020-102002
Author(s):  
David Anthony Provenzano ◽  
Samuel Ambrose Florentino ◽  
Jason S Kilgore ◽  
Jose De Andres ◽  
B Todd Sitzman ◽  
...  
Keyword(s):  
Regional Anesthesia ◽  
Radiation Safety ◽  
Geographical Location ◽  
Fellowship Training ◽  
Safety Training ◽  
Further Education ◽  
Evidence Based ◽  
Pain Medicine ◽  
Safety Practices ◽  
Survey Questions

IntroductionInterventional pain procedures have increased in complexity, often requiring longer radiation exposure times and subsequently higher doses. The practicing physician requires an in-depth knowledge and evidence-based knowledge of radiation safety to limit the health risks to themselves, patients and healthcare staff. The objective of this study was to examine current radiation safety practices and knowledge among interventional pain physicians and compare them to evidence-based recommendations.Materials and methodsA 49-question survey was developed based on an extensive review of national and international guidelines on radiation safety. The survey was web-based and distributed through the following professional organizations: Association of Pain Program Directors, American Academy of Pain Medicine, American Society of Regional Anesthesia and Pain Medicine, European Society of Regional Anesthesia and Pain Therapy, International Neuromodulation Society, and North American Neuromodulation Society. Responses to radiation safety practices and knowledge questions were evaluated and compared with evidence-based recommendations. An exploratory data analysis examined associations with radiation safety training/education, geographical location, practice type, self-perceived understanding, and fellowship experience.ResultsOf 708 responding physicians, 93% reported concern over the health effects of radiation, while only 63% had ever received radiation safety training/education. Overall, ≥80% physician compliance with evidence-based radiation safety practice recommendations was demonstrated for only 2/15 survey questions. Physician knowledge of radiation safety principles was low, with 0/10 survey questions having correct response rates ≥80%.ConclusionWe have identified deficiencies in the implementation of evidence-based practices and knowledge gaps in radiation safety. Further education and training are warranted for both fellowship training and postgraduate medical practice. The substantial gaps identified should be addressed to better protect physicians, staff and patients from unnecessary exposure to ionizing radiation during interventional pain procedures.

Regional Anesthesia Equipment

2020 ◽  
pp. 6-16
Keyword(s):  
Regional Anesthesia ◽  
Acute Pain ◽  
Local Anesthetics ◽  
Pain Medicine ◽  
Anesthesia Equipment

This chapter outlines the conditions, equipment, and documentation necessary for a successful regional anesthesia and acute pain medicine practice. Local Anesthetics and Additives

Regional Anesthesia Equipment

2019 ◽  
pp. 369-378
Keyword(s):  
Regional Anesthesia ◽  
Acute Pain ◽  
Local Anesthetics ◽  
Pain Medicine ◽  
Anesthesia Equipment

This chapter outlines the conditions, equipment, and documentation necessary for a successful regional anesthesia and acute pain medicine practice. Local Anesthetics and Additives

scholarly journals Parenting While in Training: A Comprehensive Needs Assessment of Residents and Fellows

2020 ◽  
Vol 12 (2) ◽  
pp. 162-167 ◽  
Author(s):  
Kirti Magudia ◽  
Thomas S. C. Ng ◽  
Alexander G. Bick ◽  
Megan A. Koster ◽  
Camden Bay ◽  
...  
Keyword(s):  
Clinical Training ◽  
Training Programs ◽  
Parental Leave ◽  
Fellowship Training ◽  
Parental Status ◽  
Specific Information ◽  
Online Questionnaire ◽  
Access And Affordability ◽  
Selection Of ◽  
Individual Training

ABSTRACT Background Parenting issues can affect physicians' choice of specialty or subspecialty, as well as their selection of individual training programs, because of the distinctive challenges facing residents and fellows with children. Specific information about how residents perceive these challenges is limited. Objective We sought to better understand the challenges associated with parenting during residency and fellowship training in order to inform policy and research. Methods In 2017, a voluntary online questionnaire was distributed to all 2214 Partners HealthCare graduate medical education trainees across 285 training programs. The survey queried attitudes of and about trainees with children and assessed needs and experiences related to parental leave, lactation, and childcare. Responses were compared between subgroups, including gender, surgical versus nonsurgical specialty, parental status, and whether the respondent was planning to become a parent. Results A total of 578 trainees (26%) responded to the questionnaire. Of these, 195 (34%) became parents during training. An additional 298 (52%) planned to become parents during training. Respondents overwhelmingly agreed that their institution should support trainees with children (95%) and that doing so is important for trainee wellness (98%). However, 25% felt that trainees with children burden trainees without children. Childcare access, affordability, and availability for sufficient hours were identified as key challenges, along with issues related to parental leave, lactation facilities, and effect on peers. Conclusions This survey highlights trainees' perspectives about parenting during their clinical training, signaling parental leave, lactation facilities, and childcare access and affordability as particular challenges and potential targets for future interventions.

scholarly journals Characteristics of Cancer Rehabilitation Fellowship Training Programs in the USA

2018 ◽  
Vol 33 (6) ◽  
pp. 1364-1367 ◽  
Author(s):  
Rajesh R. Yadav ◽  
An T. Ngo-Huang ◽  
Amy Ng ◽  
Jack B. Fu ◽  
Christian Custodio ◽  
...  
Keyword(s):  
Training Programs ◽  
Fellowship Training ◽  
Cancer Rehabilitation ◽  
The Usa

scholarly journals Primary Immunodeficiency Diseases in Iran: Past, Present and Future

2021 ◽  
Vol 24 (2) ◽  
pp. 118-124
Author(s):  
Asghar Aghamohammadi ◽  
Hassan Abolhassani ◽  
Nima Rezaei
Keyword(s):  
Developing Countries ◽  
Disease Management ◽  
Primary Immunodeficiency ◽  
Clinical Immunology ◽  
Training Programs ◽  
Medical Center ◽  
Fellowship Training ◽  
Primary Immunodeficiency Diseases ◽  
Future Directions ◽  
Immunodeficiency Diseases

Clinical immunology and its subset topics are rather newly emerging medical fields in Iran as well as other developing countries. Primary immunodeficiency diagnosis and treatment were revolutionized in the late 1970s; a period of time that coincided with the establishment of the Division of Clinical Immunology and Allergy at the Children’s Medical Center, Tehran. Subsequently, the launch of fellowship training programs (in 1988), the development of a national Iranian Primary Immunodeficiency Diseases Registry (in 1999), the inauguration of Research Center for Immunodeficiencies (in 2009), and recently, the national primary immunodeficiency network (in 2016) significantly changed the picture of disease management during the last 40 years. In this review, we seek to elucidate the most important past events, current challenges and future directions regarding the field of primary immunodeficiency.

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