ASRA Pain Medicine News, February 2023

Match Process Implemented by Majority of United States RAAPM Fellowship Programs for 2023-2024 Academic Year Recruitment

Feb 2, 2023, 08:54 AM by Bradley M. Budde, MD; Nabil Elkassabany, MD, MSCE, MBA; Mary J. Hargett, BSci; Raymond S. Joseph, Jr., MD; Mandip Singh Kalsi, MD; and Brian F. S. Allen, MD, FASA

Cite as: Budde B, Elkassabany N, Hargett M, Joseph R, Kalsi MS, Allen B. Match process implemented by majority of U.S. RA/APM fellowship programs for 2023-2024 academic year recruitment. ASRA Pain Medicine News 2022;47. https://doi.org/10.52211/asra020123.013  


The Regional Anesthesiology and Acute Pain Medicine Fellowship Directors Group is a group of educators dedicated to advancement of the sub-specialty of regional anesthesia and acute pain medicine (RAAPM) through formulation of consensus guidelines and collective effort. In this article, we highlight our group’s history and its current initiative to improve the experience of fellowship candidates and create consistency for programs and candidates alike.

The RAAPM Fellowship Directors Group was started in 2001 by Hospital for Special Surgery (HSS) as a forum for all the directors of United States and Canada RAAPM fellowships. Between 2001-2023, this voluntary group grew tremendously, from approximately 15 fellowships at its inception to over 90 programs in North America.

Since 2002, this group of RAAPM fellowship programs met twice annually, during the American Society of Regional Anesthesia and Pain Medicine (ASRA Pain Medicine) meeting each spring and the American Society of Anesthesiologists (ASA) annual meeting each fall to discuss the current and future state of RAAPM education and training. From those semi-annual meetings, along with an increase in electronic communication through the years, many important efforts that have advanced the sub-specialty were initiated. Fellowship training guidelines were first published in 2005 and subsequently updated twice to reflect changes in practice.1-3 Other group initiatives benefiting programs and fellows included creation of shared resources, such as question-based national fellowship curricula, recommended reading lists, the fellowship alumni directory, dedicated space on the ASRA Pain Medicine website, common fellowship applications, longitudinal workforce surveys, and numerous other projects. This group also successfully petitioned, lobbied, and received accreditation from the Accreditation Council for Graduate Medical Education (ACGME) for RAAPM fellowships as a nationally recognized subspecialty of anesthesiology. Several publications derive from the efforts of this group.4,5

The COVID-19 pandemic prevented live meetings for 2020 and 2021, but even as in-person activities were disrupted, collaborations and development of new initiatives continued apace. By the time of the ASRA Spring 2022 meeting in Las Vegas, our first in-person meeting in 2 years, two major projects were brewing. Consensus was reached to explore the feasibility of a joining a Match for RAAPM fellowships, and there was discussion of formalization of the group into an independent, non-profit entity (since 2001, the group has received full financial and administrative support from the Department of Anesthesiology, Critical Care & Pain Management at HSS).

Most anesthesiology fellowship training programs currently utilize a Match system for trainees, including pain medicine, cardiac, critical care, pediatric, and obstetric anesthesiology programs. Matching processes analogous to the residency Match have developed to allow fellowship applicants an opportunity to visit and evaluate various training programs systematically over a defined period without the requirement to select a program immediately after interviewing. The resulting system improves the equity of the process, with benefits for both applicants and programs. First and foremost is removal of any pressure to commit to a single institution before evaluating all options. This significantly reduces the tension inherent to the process, building flexibility and discretion into the interview season. At the conclusion of their evaluation process, applicants can rank programs in a confidential fashion with the opportunity to match at their “best-fit” program.

The RAAPM group has elected to partner with the San Francisco (SF) Match as our vendor for the interview season starting in 2023 with selection of candidates for the 2024-25 academic year. SF Match currently operates a match for critical care, adult cardiac, and obstetric anesthesiology. The SF Match provides the best way to continue utilizing the common RAAPM fellowship application (adapted from the pediatric fellowship application by John Eck, MD) and to meet the diversity of programmatic requirements.

At the time of this writing, approximately 60 RAAPM fellowship programs have articulated a commitment to participating in the SF Match this year. The RAAPM-specific application portal, built by SF Match, opened for Academic Year (AY) ‘24-’25 applications in January 2023. While the primary goal of the Match is to create a common timeline for considering applications and filling positions, the system will also serve as a central online hub to facilitate the application process. Reduced administrative burden for both applicants and fellowship programs is expected with the use of the online system to coordinate interview invitations and scheduling, as well as hosting candidate submission documents.

By relieving the pressure of uncoordinated appointments and forced early choices under the previous arrangement, fellowship programs have a wider interview window as the participating programs will not make any candidate selections until the Match has been completed. While the system opened in January, program and candidate rank lists are not due until May 2023 for the ’24 -‘25 AY. The Match itself will run in June, with all programs and candidates notified promptly of the results and any unfilled spots and unmatched candidates given an opportunity to find a home. This January-May interview timeline with a June Match is expected to be continued each year, and be used to process all applicants who want to start their fellowship training in July/August of the following year.  

As recruitment for the '24-'25 AY will be the pilot year for this new initiative, feedback is encouraged. Please submit comments or questions on the Match, or any of the other RAAPM Fellowship Directors Group initiatives, to Mary Hargett.


Dr. Bradley Bubbe

Bradley M. Budde, MD, is an assistant professor of clinical anesthesiology at the Cincinnati College of Medicine and the program director of the Regional Anesthesiology and Acute Pain Medicine Fellowship at the University of Cincinnati in Cincinnati, OH.

Dr. Nabil Elkassabany
Nabil Elkassabany, MD, MSCE, MBA, is a professor and vice chair of clinical operations in the Department of Anesthesiology at the University of Virginia in Charlottesville, VA. 

Mary Hargett
Mary J. Hargett, BSci, is director of education and clinical initiatives in the Department of Anesthesiology, Critical Care & Pain Management at the Hospital for Special Surgery in New York, NY.

Dr. Raymond Joseph Jr.
Raymond S. Joseph, Jr., MD, is program director of the Regional Anesthesiology and Acute Pain Medicine Fellowship at Virginia Mason Franciscan Health in Seattle, WA.

Dr. Mandip Kalsi
Mandip Singh Kalsi, MD, is a clinical instructor of anesthesiology at Weill Cornell Medicine and program director of the Regional Anesthesiology and Acute Pain Medicine Fellowship at the Hospital for Special Surgery in New York, NY. 

Dr. Brian Allen
Brian F.S. Allen, MD, FASA, is an associate professor at Vanderbilt University Medical Center and program director of the Regional Anesthesiology and Acute Pain Medicine Fellowship at Vanderbilt Medical Center in Nashville, TN. 

 

References

  1. Hargett MJ, Beckman JD, Liguori GA, et al. Guidelines for regional anesthesia fellowship training. Reg Anesth Pain Med 2005;30(3):218-25. https://doi.org/10.1016/j.rapm.2005.02.008.
  2. Regional Anesthesiology and Acute Pain Medicine Fellowship Directors Group. Guidelines for fellowship training in Regional Anesthesiology and Acute Pain Medicine: Second Edition, 2010. Reg Anesth Pain Med 2011;36(3):282-8. https://doi.org/10.1097/aap.0b013e31820d439f.
  3. Regional Anesthesiology and Acute Pain Medicine Fellowship Directors Group. Guidelines for fellowship training in regional anesthesiology and acute pain medicine: Third Edition, 2014. Reg Anesth Pain Med 2015;40(3):213-7. https://doi.org/10.1097/AAP.0000000000000233.
  4. Shapiro DM, Hargett MJ, Kopp S, et al. History and evolution of regional anesthesiology and acute pain medicine fellowship training. Reg Anesth Pain Med 2020;45(4):311-4. https://doi.org/10.1136/rapm-2019-100915.
  5. Mariano ER, Rosenquist RW. The road to accreditation for fellowship training in regional anesthesiology and acute pain medicine. Curr Opin Anaesthesiol 2018;31(5):643-8. https://doi.org/10.1097/ACO.0000000000000639.

 

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