Subspecialty Certification Research
Current Status and Trends in Subspecialty Certification in Physical Medicine and Rehabilitation
Summary by Sunil Sabharwal, MD
The motivation for this paper was to promote understanding of the overall state and evolution of sub-specialty certification in physical medicine and rehabilitation (PM&R). For each of the seven approved subspecialty certificates issued by the American Board of Physical Medicine and Rehabilitation (ABPMR), we examined: a) the number of certificates issued to ABPMR diplomates through December 31, 2019, b) recertification rate, c) yearly trends for total active, new, and expired certificates, and d) for ABPMR-administered subspecialties, recertification rates for those entering the subspecialty through fellowship completion versus a “grandfathered” practice pathway.
Of 11,421 ABPMR diplomates in the United States in 2019, 3,560 (31.2%) had a total of 3,985 active subspecialty certificates. Pain Medicine (PM) was the most common subspecialty certification (15.5% of all ABPMR diplomates) followed by Sports Medicine (SM, 6.6%), Brain Injury Medicine (BIM, 4.8%), Spinal Cord Injury Medicine (SCIM, 4.2%), Pediatric Rehabilitation Medicine (PRM, 2.5%), Neuromuscular Medicine (NMM, 0.7%), and Hospice and Palliative Medicine (HPM, 0.5%). For diplomates with more than one subspecialty certification, PM and SM was the most frequent combination.
Both the recertification rate and the end of practice track eligibility impacted certification trends for individual subspecialties differently. The average number of new certificates added annually for every subspecialty was higher before the temporary practice track-based eligibility ended than after; the difference was significant (P < .05) for SCIM, PM, SM, and NMM. The recertification rate for all subspecialties combined was 73.4%. For the subspecialties (SCIM, PRM) that this data was available, fellowship candidates had higher recertification rates than those grandfathered through a practice track.
Despite the limitations inherent in a retrospective review, this report provides information that may be of value to diplomates, policymakers, and other stakeholders and may assist in future projections and planning for the field.
Sabharwal, S; Kinney, CL; Raddatz, MM; Driscoll, SW; Francisco, GE; Robinson, LR; Geis, C; Micheo, W. Current Status and Trends in Subspecialty Certification in Physical Medicine and Rehabilitation. PM R. 2022 Jan 17. doi: 10.1002/pmrj.12763. Epub ahead of print. PMID: 35038251.