Associate Professor Scott Pritzlaff, and Clinical Fellow Christine Kerr at the UC Davis Health Pain Intervention Center in Sacramento, California. (UC Davis Health courtesy photo) Credit UC Davis Health
A new study from UC Davis School of Medicine delivers a stark warning: the U.S. is facing a sharp drop in applications for pain medicine fellowship programs, raising concerns about the future availability of pain specialists.
The study, published in PAIN Practice, found that applications from anesthesiology residents—the primary pool for pain medicine fellows—plummeted by an alarming 45% between 2019 and 2023. This trend raises the prospect of longer wait times, rushed care, and fewer treatment options for patients suffering from chronic pain.
While 24.3% of U.S. adults report having chronic pain, fewer physicians are choosing to specialize in pain medicine. Applications from female physicians dropped by 27.5%, and overall, applications from all specialities fell by 14.2%.
A Complex Problem Stemming from the Opioid Epidemic
The opioid crisis has cast a long shadow over the field. Although pharmaceutical companies were primarily targeted in lawsuits, the publicity around cases involving physicians may have made pain medicine seem legally and ethically risky, particularly to young medical students.
Broader Impacts and Recruitment Challenges
Specializing in pain medicine means an additional year of training after completing an anesthesiology residency—a path fewer physicians are now choosing despite anesthesiologists’ high demand and lucrative salaries.
The study uncovered some positive trends: applications from residents in physical medicine and rehabilitation jumped by nearly 33%, while emergency medicine saw a staggering 190% increase in applicants.
A Call to Action
UC Davis Health’s Pain Medicine Division has ramped up its recruitment efforts, from early outreach to medical students to a more substantial social media presence to reverse this worrying decline.
“Pain medicine is caught in a strange paradox,” said David Copenhaver, a study co-author and chief of the Division of Pain Medicine. “