Fall 2024

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Niche Specialties in PM&R ACGME Training

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   Rosalynn R.Z. Conic, MD, PhD, MPH
   PGY-4, Incoming PHiT President
   University of Florida and University of Missouri

   Kevin De Jesus, MD
   PGY3, Incoming PHiT Vice President
   University of Puerto Rico

There are many accredited and non-accredited fellowship pathways within PM&R. In this article, we highlight some of the lesser-known fellowship options. For additional information on fellowships, check out the AAPM&R Roadmap to Fellowship!

1. Occupational and Environmental Medicine

Description: Occupational and Environmental Medicine is a residency or fellowship program, which combines public health, environmental health and worker health. Typically, a master’s in public health is completed during training, where population health, toxicology, disease surveillance and health administration are learned. Those who complete this training would have a career in worker’s compensation, worker health and pre-employment physicals. Applications follow the residency cycle—starting in September with Match Day in March.

Certification: Exists through residency (2 or 3-years, advanced or categorical), a one-year fellowship or a practice pathway that requires 2-years of practice within the field (for those who completed one of the other American Board of Preventive Medicine Core Residencies).

Resources:

Conferences:

 

2. Clinical Informatics

Description: Clinical Informatics is a rapidly growing area, that combines knowledge of informatics and patient care to improve individual and population-based health outcomes. These physicians are interested in the improvement of clinical information systems, including clinical decision support. Most programs require completion of a master’s degree in clinical informatics. Applications start in July, and Match Day is in December.

Certification: Requires a 2-year fellowship or a practice pathway through 2025 for those with prior clinical informatics degrees, and/or work experience.

Resources:

Conferences:

 

3. Addiction Medicine

Description: Addiction Medicine focuses on the diagnosis, treatment, recovery and prevention of people who struggle with addiction, typically substance related. This subspecialty combines psychiatry, psychology, mental health counseling, internal medicine, family medicine and public health to treat addiction. It became recognized as a new subspecialty in 2016. Applications follow the NRMP Medicine and Pediatric Specialties Match, with applications due in July and Match Day in December.

Certification: Requires a one-year fellowship or completion of a practice pathway (open through 2025).

Resources:

Conferences:


4. Health Care Administration, Leadership and Management

Description: Health Care Administration, Leadership and Management fellowship is focused on integrating medical knowledge with health system science with the goal of developing physician executives. Fellowship accreditation was first established in September 2021. Fellowships open in the summer/fall and are rolling acceptances.

Certification: Requires either a fellowship or practice pathway available through 2030. More information regarding the practice pathway can be found here. This fellowship can be 12- or 24-months long and may include master’s level coursework. Alternatively, a non-ACGME option to become a Fellow certificate of the American College of Healthcare Executives exists.

Resources and Conferences:

    1. ABPM- Health Care Administration, Leadership and Management
    2. American College of Healthcare Executives (ACHE)

     

    5. Performing Arts Medicine

    Description: Performing Arts Medicine focuses on the prevention, diagnosis and treatment of injuries and medical conditions affecting performing artists, such as musicians, dancers and actors. This specialty addresses both physical and psychological aspects, helping artists maintain their health and performance abilities.

    Certification: Certification can be obtained through non-ACGME programs and organizations like the Performing Arts Medicine Association (PAMA). Many providers that are interested in this area complete a Sports Medicine Fellowship Program.

    Resources:

    1. Performing Arts Medicine Association (PAMA)
    2. British Association For Performing Arts Medicine (BAPAM)

    Conferences:

    1. Annual Symposium on Medical Problems of Performing Artists


    6. Vestibular Rehabilitation

    Description: Vestibular Rehabilitation specializes in treating patients with dizziness, vertigo and balance disorders. Through customized exercise programs, this therapy aims to improve balance, reduce dizziness and enhance patients' quality of life.

    Certification: Vestibular Rehabilitation certification can be obtained through the American Institute of Balance (AIB) and Vestibular Disorders Association (VEDA).

    Resources:

    1. Vestibular Disorders Association (VEDA)
    2. American Institute of Balance (AIB)

    Conferences:

    1. International Vestibular Rehabilitation Conference

     

    7. Pelvic Floor Rehabilitation

    Description: Pelvic Floor Rehabilitation focuses on treating disorders of the pelvic floor muscles, such as urinary incontinence, pelvic pain and pelvic organ prolapse. This therapy involves exercises, biofeedback and other interventions to improve pelvic floor function.

    Certification: Women's Health Rehabilitation Fellowship Programs are non-ACGME alternatives for providers interested in pelvic floor pathology. Certification for Pelvic Floor Rehabilitation can be obtained through programs such as the Herman & Wallace Pelvic Rehabilitation Institute and the American Physical Therapy Association (APTA).

    Resources:

    1. International Pelvic Pain Society (IPPS)
    2. Herman & Wallace Pelvic Rehabilitation Institute
    3. American Physical Therapy Association (APTA) – Section on Women's Health

    Conferences:

    1. World Congress on Abdomino-Pelvic Pain  
    2. International Continence Society

     

    8. Transplant Rehabilitation

    Description: Transplant Rehabilitation involves the management and rehabilitation of patients before and after organ transplantation. This specialty aims to optimize physical function, enhance recovery and improve the overall quality of life for transplant recipients.

    Certification: There is no specific ACGME certification for Transplant Rehabilitation. Nonetheless, there are non-ACGME programs that offer Cardiac Rehabilitation Fellowship Training. Additional training may be acquired through specialized programs offered by transplant centers and professional organizations.

    Resources and Conferences:

     

    9. Disaster Medicine

    Description: Disaster Medicine focuses on providing medical care during disasters and emergencies, including natural disasters, pandemics and mass casualty incidents. This specialty involves planning, response, and recovery efforts to manage and mitigate the impact of disasters on communities.

    Certification: Certification in Disaster Medicine can be obtained through non-ACGME programs and organizations such as the American Board of Disaster Medicine (ABODM) and the American Academy of Disaster Medicine (AADM).

    Resources and Conferences:

     

    10. Lifestyle Medicine

    Description: Lifestyle Medicine utilizes the six pillars of whole food, plant-predominant diet, physical activity, sleep, stress management, avoidance of risky substances and positive social connections to treat and reverse chronic conditions. Some residency and fellowship programs offer this training or can be paid through the American College of Lifestyle Medicine (ACLM).

    Certification: Certification is provided through the American Board of Lifestyle Medicine (ABLM). ACLM is working on being accepted under the American Board of Medical Specialties umbrella.

    Resources and Conferences:

     

    11. Integrative Medicine

    Description: Integrative Medicine uses various conventional and complementary alternative therapies along with lifestyle changes to heal the whole person. The emphasis is on treating the whole person rather than a single organ. The application of integrative approaches is growing, especially among cancer patients and veterans.

    Certification: There is a two-year online program with a three-week long immersion retreat that costs $34,550 and results in Board Certification. Applications begin in the Spring for a January start or Fall for an August start. Some residencies offer an Integrative Medicine Residency curriculum which results in a General Certificate.

    Resources:

    Conferences:

    International Congress on Integrative Medicine and Health