{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T17:41:54Z","timestamp":1791394914295,"version":"4.3.3"},"reference-count":23,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2020,1,11]]},"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>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\u2009years 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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>The history of RA\/APM training in the USA is a tortuous one. It began with short \u2018apprenticeships\u2019 under the tutelage of the early proponents of regional anesthesia and continues today with 84 official RA\/APM programs and a robust fellowship directors\u2019 group. RA\/APM programs teach skills essential to the practice and improvement of anesthesiology as a specialty.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rapm-2019-100915","type":"journal-article","created":{"date-parts":[[2020,1,30]],"date-time":"2020-01-30T05:05:32Z","timestamp":1580360732000},"page":"311-314","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["History and evolution of regional anesthesiology and acute pain medicine fellowship training"],"prefix":"10.1136","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5212-5735","authenticated-orcid":false,"given":"David Michael","family":"Shapiro","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Perioperative and Pain Medicine, Mount Sinai Medical Center, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0528-4909","authenticated-orcid":false,"given":"Mary J","family":"Hargett","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Kopp","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Mayo Clinic Graduate School for Biomedical Sciences, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph M","family":"Neal","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Virginia Mason Medical Center, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2735-248X","authenticated-orcid":false,"given":"Edward R","family":"Mariano","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Care Service, VA Palo Alto Health Care System, Palo Alto, California, USA"},{"name":"Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Liguori","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,1,29]]},"reference":[{"key":"2025101113255548000_45.4.311.1","unstructured":"Labat G . Regional anesthesia: its technique and clinical application. Philadelphia: WB Saunders, 1922."},{"key":"2025101113255548000_45.4.311.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rapm.2004.07.050"},{"key":"2025101113255548000_45.4.311.3","doi-asserted-by":"crossref","unstructured":"Mulroy M . A History of Regional Anesthesia. In: Eger E , Saidman L , Westhorpe R , eds. The Wondrous story of anesthesia. New York: Springer, 2014: 859\u201370.","DOI":"10.1007\/978-1-4614-8441-7_63"},{"key":"2025101113255548000_45.4.311.4","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000676"},{"key":"2025101113255548000_45.4.311.5","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1097\/00000542-200607000-00031","article-title":"The Mayo clinic World War II short course and its effect on anesthesiology","volume":"105","author":"Martin","year":"2006","journal-title":"Anesthesiology"},{"key":"2025101113255548000_45.4.311.6","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1097\/AAP.0b013e31822b88c5","article-title":"Daniel C. Moore, MD, and the renaissance of regional anesthesia in North America","volume":"36","author":"Mulroy","year":"2011","journal-title":"Reg Anesth Pain Med"},{"key":"2025101113255548000_45.4.311.7","unstructured":"Tracy R . Directory of Approved internships and residencies. Available: https:\/\/www.acgme.org\/portals\/0\/PDFs\/1972-1973.pdf"},{"key":"2025101113255548000_45.4.311.8","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1097\/00000542-198502000-00014","article-title":"A modification in the training requirements in anesthesiology: requirements for the third clinical anesthesia year. 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Accredit Counc Grad Med Educ."},{"key":"2025101113255548000_45.4.311.20","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1097\/ACO.0000000000000639","article-title":"The road to accreditation for fellowship training in regional anesthesiology and acute pain medicine","volume":"31","author":"Mariano","year":"2018","journal-title":"Curr Opin Anaesthesiol"},{"key":"2025101113255548000_45.4.311.21","unstructured":"About Us . Accreditation Council for graduate medical education. Available: https:\/\/www.acgme.org\/About-Us\/Overview [Accessed 30 May 2019]."},{"key":"2025101113255548000_45.4.311.22","unstructured":"The ACGME for Residents and Fellows . Accreditation Council for Graduate Medical Education. Available: http:\/\/www.acgme.org\/Residents-and-Fellows\/The-ACGME-for-Residents-and-Fellows [Accessed 30 May 2019]."},{"key":"2025101113255548000_45.4.311.23","unstructured":"Application for Accreditation . Regional Anesthesiology and Acute Pain Medicine. 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