Pain and MSK Interventional Ultrasound Certificate

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Contents

Scope of Pain and MSK Interventional Ultrasound Certification
Eligibility Requirements
Programming
Policies
Content Outline
Recommended Texts
Reapplying/Renewals
FAQs

Scope of Pain and MSK Interventional Ultrasound Certification

In recent years, one of the most important new developments in  interventional pain management has been the introduction of  ultrasound-guided pain procedures and musculoskeletal  (MSK) injections. Real-time  viewing of the target structures, the block needle trajectory, and  injectate spread, as well as the critical structures to avoid, can  ensure superior success and safety in pain management procedures.  This is a quantum leap in technology for those interested in  this pursuit, and ultrasound-guided pain intervention is drawing a  large number of pain practitioners to adopt these new techniques.  However, sonography images are subject to individual interpretation  depending on one’s experiences and training.

Eligibility Requirements

In order to attain the certificate, the candidate must first provide a completed application form and fulfill all of the following six requirements.

1. Documentation of being a physician in good standing with: a. Valid, unrestricted license to practice medicine in the U.S. or your practicing country; b. Board certification in primary specialty (e.g., anesthesiology, physical medicine and rehabilitation, neurology...) or equivalent.
2. Letters of recommendation from two colleagues who can testify to the applicant’s experience in Pain and MSK Interventional Ultrasound and his or her ethical and professional standards.
3. One letter of recommendation from the chair of the applicant’s department or equivalent who can attest to the applicant’s good standing, experience in practice, and ethical and professional standards, as well as assess the quality of the individual’s independent practice in Pain and MSK Interventional Ultrasound.
4. Documentation of participation in a minimum of 20 hours of AMA PRA Category 1 Credits™ or equivalent in CME program focused on ultrasound-guided pain and MSK intervention in the preceding two years. If the candidate attends a conference without such specification, only the workshop hours relevant to pain and MSK intervention will be included.
5. Completed and signed procedure list (see application).
6. Attestation of adherence to ethical and professional standards (see application).

Payment of the $150 application fee must be submitted upon confirmation of a complete application. 

If eligibility is met, the candidate will be asked to pay the $950 (member/sister society member*)/$1,300 (non-member) certification fee** prior to being scheduled for the certification exam.

*Members include membership in ASRA Pain Medicine, ESRA, AFSRA, LASRA, and/or AOSRA-PM.

**Candidates in low-income and lower-middle income economies according to The World Bank will be eligible for a discounted certification fee of $850.

Please mail completed application form and all required materials to ASRA Pain Medicine, Attn: Certificate Application, Three Penn Center West, Suite 224, Pittsburgh, PA 15276.

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Programming

The ASRA Pain Medicine Pain and MSK Ultrasound Cadaver Course is an example of a course that qualifies for the ultrasound training requirement. The ASRA Pain Medicine Pain and MSK Ultrasound Cadaver Course currently offers 11.75 credits; therefore, additional CME program participation is needed to fulfill the entire 20-hour requirement.

Additional courses that have been approved for this requirement include:

• Ultrasound workshops provided at the ASRA Pain Medicine Annual Pain Medicine Meeting
• Ultrasound workshops provided by the American Society of Anesthesiologists (ASA)
• Ultrasound workshops provide by the European Society of Regional Anesthesia and Pain Therapy (ESRA), African Society for Regional Anesthesia (AFSRA), Asian & Oceanic Society of Regional Anesthesia and Pain Medicine (AOSRA-PM), and Latin American Society of Regional Anesthesia (LASRA)
• MSK workshops sponsored by the American Institute of Ultrasound Medicine (AIUM)
• Multidisciplinary International Association of Musculoskeletal Pain Ultrasound Congress (Hong Kong)
• Ultrasound Course for Interventional Pain, Musculoskeletal and Regenerative Medicine (NYSORA)
• World Academy of Pain Medicine Ultrasonography (WAPMU)
  

Additional courses will be evaluated for eligibility based on a strict set of requirements by an independent volunteer committee. NOTE: Approval of course(s) for this program does not indicate or imply ASRA Pain Medicine involvement in the development of or endorsement of those course(s).

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Policies

1. The application and supporting material must be submitted together. Candidates will be invoiced for the $150 application fee upon confirmation of a complete submission. Forms submitted without all required materials will not be considered.

2. Only complete applications that are received by the deadline will be considered.

3. If the application is approved, the applicant will be notified that he or she has been approved as a Candidate for the Pain and MSK Interventional Ultrasound Certificate exam. Applicants not accepted as Candidates will not be refunded their application fee.

4. Approved Candidates must submit a $950 (member/sister society member*)/$1,300 (non-member) exam fee prior to being scheduled for the exam.

• Candidates in low-income and lower-middle income economies according to The World Bank will be eligible for a discounted exam fee of $850.

5. If a Candidate must reschedule a scheduled exam, a $200 rescheduling fee will be charged.

6. All correspondence will be sent to the address on the file. 

7. The examination and all correspondence related to the examination will be in English.

8. Exam results are mailed to the Candidate at the address on file. Candidates may provide consent for results to be emailed to them by indicating on the application form and providing an email address.

9. Exam results will only be provided to the Candidate.

10. Both the written and practical exam components have minimum passing scores. Passing scores will not be shared.

11. Candidates must pass both the written and practical portions of the exam to earn the certificate.

12. Candidates who do not pass both the written and practical portions of the exam will be notified of their scores, the minimum passing score, and areas for improvement. These Candidates may reapply for the next testing period. See “Reapplying for the Examination.”

13. Candidates who fail the written exam and wish to challenge the results may request that the exam be rescored and verified. Candidates must appeal within 10 days of receiving exam results.

14. All examination answer sheets will be destroyed six months after administration.

*Members include membership in ASRA Pain Medicine, ESRA, AFSRA, LASRA, and/or AOSRA-PM.

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Content Outline

Successful candidates for the Pain and MSK Interventional Ultrasound Certificate should have practiced a wide variety of the following procedures.

Peripheral structures

• Greater occipital nerve
• Stellate ganglion block
• Suprascapular nerve
• Intercostal nerves
• Iliohypogastric/ilioinguinal nerve/TAP block/QL block/ESP block
• Lateral femoral cutaneous nerve
• Celiac plexus block
• Inguinal canal/genital branch of genitofemoral nerve block
• Pudendal nerve
• UE/LE peripheral nerves
  

Axial structures

• Cervical selective nerve root
• Cervical facet periarticular
• Cervical medial branch
• Third occipital nerve
• Thoracic paravertebral block
• Lumbar medial branch
• Lumbar facet periarticular
• Sacroiliac joint
• Lumbar and thoracic interlaminar epidural
• Caudal and sacral foramina

MSK applications

• Upper extremity joints: Shoulder, elbow, wrist, hand
• Lower extremity joints: Hip, knee, ankle, foot
• Muscles (piriformis, etc.)
• Bursa
• Ligaments and peritendon space
• Nerves (e.g., Morton’s neuroma, Baxter nerve)
• Injection techniques (e.g., steroid, viscosupplement, platelet-rich plasma)
• Aspiration
• Fenestration/lavage/barbotage

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Recommended Texts

Jacobson JA. Fundamentals of Musculoskeletal Ultrasound. 3^rd ed. Elsevier; 2017

Narouze SN. Atlas of Ultrasound-Guided Procedures in Interventional Pain Management. 2^nd ed. New York, NY: Springer-Verlag New York; 2018.

Peng P, Finlayson R, Lee SH, Bhatia A. Ultrasound for Pain Management. New York; NY: Springer International Publishing; 2020.

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Reapplying/Renewals

Candidates who fail one or both portions of the examination process are eligible to reapply for the next available test by completing and submitting all required forms by deadline and paying all fees again. No fees will be refunded from the failed attempt. Feedback will be provided from each examination taken to assist the candidate in preparing for subsequent attempts. There is no limit to the number of times a candidate may apply for the certificate.

Confidentiality of Testing Candidates

ASRA Pain Medicine and its representatives will strive to maintain the confidentiality of applicants and candidates at all times and any information, including application status and test results, will only be released to the candidate at the address provided.

Certificate Renewal

The Pain and MSK Interventional Ultrasound Certificate is valid for a period of ten (10) years. Candidate wishing to renew the certificate will be required to provide documentation of practice and CME and pay a renewal fee. The acronym for use if a candidate obtains the certification is ASRA-PMUC.

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Frequently Asked Questions

1. Do you have to be a member of ASRA Pain Medicine to earn the certificate?
   No, you do not have to be a member of ASRA Pain Medicine or a sister society (i.e., ESRA, AFSRA, AOSRA-PM, or LASRA) to earn the certificate. The certificate process is open to anyone fulfilling the requirements.
2. How much does the certificate cost?
   The total cost is $1,100/$1,450: the application fee is $150, and candidates who are accepted for the certificate will then be required to pay a $950 (member/sister society member*)/$1,300 (non-member) certificate fee, which must be paid prior to being scheduled for the exam. Candidates in low-income and lower-middle income economies according to The World Bank will be eligible for a discounted certification fee of $850. Additional costs may be incurred to fulfill the CME requirement for eligibility. However, those costs are determined by the CME provider offering the respective course(s).
3. Does the certificate expire?
   The certificate is valid for 10 years, after which time the physician may renew the certificate.
4. How long is the written exam?
   The written exam consists of multiple-choice questions assessing the physician’s knowledge of pain and MSK interventional ultrasound techniques. Candidates will be given up to 90 minutes to complete the examination.
5. How long is the practical exam?
   The practical examination will be held in a one-on-one setting with an examiner and will consist of multiple stations assessing knowledge, judgment, and skill in pain and MSK intervention. Candidates will be given a clinical scenario and be asked to demonstrate critical thinking, medical knowledge, scanning and injection techniques, judgment, and communication. Candidates will be given up to two hours to complete this examination.
6. On which procedures will I be tested during the practical exam?
   You will be tested on the procedures that you use in practice, corresponding to the procedures you indicated on the “Procedure List” portion of the application.
7. How do I know if a CME course qualifies for the ultrasound training portion of the requirements?
   A list of acceptable courses will be provided on the ASRA Pain Medicine website and updated periodically to reflect new offerings. All courses must fulfill specific requirements that are reviewed by a volunteer committee of experts on an ongoing basis. Additional courses will be evaluated for eligibility based on a strict set of requirements by an independent volunteer committee. To propose a course for evaluation, send an email to asraassistant@asra.com. The ASRA Pain Medicine administrative assistant will forward the suggestion to the committee for review and consideration.
8. What's the acronym I can use if I've passed the exam?
   The acronym you can use is ASRA-PMUC.
9. If I fail the written or practical exam, can I take it again?
   If a physician fails one or both components of the exam, he or she must reapply at a future date. Application fees will not be reimbursed.
10. Can I apply online?
    The application form can be downloaded, completed electronically, and printed out to mail, along with the other required application materials, to the ASRA Pain Medicine office at the following address:

ASRA Pain Medicine 
Attn: Certificate Application
Three Penn Center West
Suite 224
Pittsburgh, PA 15276

Applications can also be emailed to asraassistant@asra.com as a PDF file.

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