In recent years we have witnessed beginnings of the emergence of "Pain Medicine" as a distinct academic discipline with delineated borders and aims. This trend has been accompanied by a shift away from the treatment of complex pain problems within the framework of classical medical disciplines, using a restricted toolbox of therapeutic agents in a purely symptomatic mode (for instance orthopedist treating back-pain, oncologists treating cancer pain). The emerging trend has been towards the development of Pain Centers and Pain Clinics within which pain, per se, is the central focus. Pain Centers specialize in the management of pain associated with a variety of medical conditions, typically using a multidisciplinary approach.

As a part of this trend, the European Federation of IASP Chapters (EFIC) has recently issued its "Declaration" which states that, whereas acute pain may reasonably be considered a symptom of disease or injury, chronic and recurrent pain is a specific healthcare problem, a disease in its own right. This position has been supported and endorsed by a wide variety of leading pain specialists around the world, including the International Association for the Study of Pain (IASP). EFIC's declaration distinguishes between acute pain, which is properly treated symptomatically within the framework of classical medical specialties whose central focus is curing the precipitating medical disorder, and chronic pain which requires more specialized pain treatment knowledge and a more comprehensive kit of pain management strategies. Most medical specialists lack specialized training on chronic pain.

Chronic, unrelieved pain is a major unsolved healthcare problem worldwide. It is universal, with no age, race, social class, national or geographic boundaries. It has enormous associated costs, financial (treatment compensation, and lost productivity) as well as a tremendous burden in terms of degraded quality of life for the sufferer and his/her family and immediate society. Rough estimates place the costs of chronic pain, as a disease state, in the very substantial category of cardiovascular disease and of cancer. The incidence of chronic pain tends to increase with age. With the success of curative and preventative medicine, and the consequent increase in average life-spans, the problem of chronic pain is likely to increase for the foreseeable future.

Given the enormous need, the time has come to focus greater awareness on the problem of chronic pain as a disease, and to recruit the human, financial and organizational resources required to face it. In the past decade, healthcare authorities of several countries in Europe and elsewhere have recognize this need, and have begun to establish programs for specialist training and certification in the field of Pain Medicine. The time has come to broaden the scope of pain specialization to cover all of Europe, using uniform, agreed upon standards of training and certification for pain specialists. Pan-European standards of training and certification, once in place, will ensure higher professional quality, uniformity and mobility among pain specialists, and ultimately better patient care. Such standards will also promote recognition among specialist and non-specialists alike, of the boundaries at which patients with complex chronic pain ought to be referred to a pain specialist for treatment. Finally, they will create a body of trained professionals qualified to provide guidance and leadership in the areas of therapeutic modalities, resource allocation, research, ethical considerations and public policy concerning chronic pain and its management.

EFIC calls for the establishment of a framework for realizing pan-European training and certification standards in Pain Medicine, which will include: 1) Creation of a core curriculum of basic and applied medical knowledge on pain. Some efforts have already been made toward this goal, including the core curricula developed by IASP. These constitute a good starting point for EFIC chapters, but there is a need to coordinate and further develop the existing knowledge. 2) Definition of a recognized toolkit of practical pain management resources including essential drugs and procedures, and 3) Subspecialty training (in some countries an alternative term might be adopted, such as "competence" or "capacity'") will include acquisition by candidates of clinical experience under supervision, leading to recognized professional certification in "Pain Medicine". The typical duration of such a training program is two years, including the period of practical training, although this period may be adjusted. Candidates entering the program will be required to already have obtained accreditation in an appropriate medical specialty such as Anesthesiology, Neurology or Rehabilitation Medicine.


Link List About Education on Pain