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Format of the Examination in Pain Medicine

Format of the Examination in Pain Medicine

The examination consists of written-only component that includes two three-hour papers each containing 35-50 short answer questions. The written component measures knowledge and application of knowledge necessary to function as a competent specialist in pain medicine. Most questions will concentrate on the medical expert role, but some can also assess the intrinsic competencies (Communicator, Professional, Health Advocate, Leader, Collaborator and Scholar). The examination will test the candidate’s clinical competence in the evaluation, diagnosis, treatment, and rehabilitation of patients with acute and chronic non-cancer and cancer pain, as well as prevention of symptoms, in a multidisciplinary framework. The examination will encompass knowledge of pain mechanisms, patient management and basic science.

The subjects covered in this examination will include, but are not limited to, foundational knowledge, acute pain management, addiction medicine, cancer pain management, pain intervention, musculoskeletal pain management, neurology and psychiatry, as well as pediatrics and sleep medicine as they pertain to comprehensive pain management. Foundational knowledge will include, but will not be limited to, anatomy, pharmacology and pathophysiology.

Questions may cover all competencies as described in the Objectives of Training in the Subspecialty of Pain Medicine.

Study materials include but are not limited to (please note that an update reference list will be available in the Royal College website by end of April each year):

  • Self-Assessment Module for Pain Medicine (SAM-PM). SAM-PM is a self-study continuing medical education (CME) program that covers established knowledge in the subspecialty field of pain medicine. With the SAM-PM program you can assess areas of strength and weakness in pain medicine knowledge and target ongoing education in these areas. It is established by the combined efforts of the American Society of Anesthesiologists (ASA) and the American Society of Regional Anesthesia (ASRA). Content includes 100 questions with answers, detailed discussions explaining the rationale for each answer and references for further study. Subscribers complete the program at their own pace and submit the answers online to receive CME credit.
  • Clinical Pain Management: A Practical Guide. Editors: Mary E Lynch, Kenneth D Craig and Philip WH Peng (Wiley-Blackwell). A book project of the Canadian Pain Society Education Special Interest Group covering the ISAP curriculum on pain medicine with concise summary of the topics.
  • Essentials of Pain Medicine and Regional Anesthesia. Editors: HT Benzon, SN Raja, SM Fishman, SS Lui. (Saunders-Elsevier). A popular book in the US used by trainees to prepare for examinations.
  • Wall & Melzack's Textbook of Pain, 6th Edition, 2013
  • Bonica's Management of Pain, 4th edition
  • Basic Science of Pain: An Illustrated and Clinically Orientated Guide. Philip Peng Educational Series. Available via iTune.

Subspecialty

  • Cancer Pain. Pharmacologic, Interventional, and Palliative Approaches. Editors: Oscar A. de Leon-Casasola, MD (Elsevier)

Psychiatry

  • Medically Unexplained Symptoms, Somatization and Bodily Distress: Developing Better Clinical Services. Editors: Frances Creed, Peter Henningsen and Per Fink. (Cambridge Medicine)
  • DSM-5, American Psychiatric Association
  • Dennis C. Turk, Roger B. Fillingim, Richard Ohrbach, and Kushang V. Patel. Assessment of Psychosocial and Functional Impact of Chronic Pain. The Journal of Pain; 17 (9) Suppl. 2, 2016: pp T21-T49
  • Katz J et al. Chronic Pain, Psychopathology, and DSM-5 Somatic Symptom Disorder Can J Psychiatry 2015;60(4):160–167
  • Morley S and Williams A. New Developments in the Psychological Management of Chronic Pain. Can J Psychiatry 2015;60(4):168–175

Pediatric

  • Oxford Textbook of Paediatric Pain. Editors: Patrick J McGrath, Bonnie J Stevens, Suellen M Walker, William T Zempsky

Miscellaneous

  • Health Canada Medical Marijuana document
  • Basbaum AI, Bautista DM, Scherrer G, Julius D. Cellular and molecular mechanisms of pain. Cell 2009;139(2):267-284.
  • Canadian Opioid guidelines 2017
  • Pharmacological management of chronic neuropathic pain: Revised consensus Canadian Pain Society, Pain Research Manag 2014;19(6):328-335.
  • Pelvic Pain Diagnosis and Management. Editors: Howard, Frederick. Lippincott, Williams, and Wilkins; Philadelphia: 2000.
  • World Health Organization 2012 measuring health and disability; Manual for WHO Disability Assessment Schedule, WHODAS 2, World Health Organization, 2010 Geneva
  • Kendall et al. Guide to Assessing Psycho-social Yellow Flags in Acute Low Back Pain. ACC & NZGG, Wellington, NZ. (2004 Ed.)
  • 2012 Canadian guidelines for the diagnosis and management of fibromyalgia syndrome
  • Quebec Task Force Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders
  • Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache disorders: 2nd Edition.
  • Rome III Diagnostic Criteria for Functional Gastrointestinal disorders.
  • Narouze, S., Benzon, H. T., Provenzano, D. A., Buvanendran, A., De Andres, J., Deer, T. R., et al. (2015). Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications. Regional Anesthesia and Pain Medicine, 40(3), 182–212.
  • The CanPain SCI Clinical Practice Guidelines for Rehabilitation Management of Neuropathic Pain after Spinal Cord:introduction, methodology and recommendation overview. Spinal Cord (2016) 54, S1-S6
  • Bogduk N. Practice guidelines for spinal diagnosis and treatment procedures. 2nd edition. ISIS San Francisco 2013
  • Complementary, Alternative, or Integrative Health/ What’s In a Name? | NCCIH. Accessed https://nccih.nih.gov/health/integrative-health
  • Latremoliere, A., & Woolf, C. J. (2009). Central Sensitization: A Generator of Pain Hypersensitivity by Central Neural Plasticity. The Journal of Pain, 10(9), 895–926.
  • Information for Health Care Professionals: Cannabis (marihuana, marijuana) and the cannabinoids. Prepared 2013 by Health Canada Accessed: https://www.canada.ca/en/health-canada/services/drugs-health-products/medical-use-marijuana/information-medical-practitioners/information-health-care-professionals-cannabis-marihuana-marijuana-cannabinoids.html
  • Harden RN, Bruehl S, Stanton-Hicks M, Wilson PR. Proposed new diagnostic criteria for complex regional pain syndrome. Pain Med 2007;8(4):326–31.

Revised May 2018


[SAMPLE SAQ EXAM]