Disclosures: Sunil Sabharwal, MD: No financial relationships or conflicts of interest

Background and/or Objectives: There is a need to better understand the overall state of sub-specialization in physical medicine and rehabilitation (PM&R). Our objective was to examine the status and trends in subspecialty certification for each of the seven subspecialties approved for American Board of Physical Medicine and Rehabilitation (ABPMR) diplomates.

Design: Retrospective study

Setting: De-identified information from the ABPMR database

Participants: Physicians certified by ABPMR through 2019

Interventions: Interventions: not applicable.”

Main Outcome Measures: For each subspecialty, we examined: a) the number of certificates issued to ABPMR diplomates, 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.

Results: 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.

Conclusions: This report informs stakeholders about the state and evolution of subspecialty certification in PM&R over time.

Level of Evidence: Level III

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/subspecialty-certification-trends-in-physical-medicine-and-rehabilitation/