Subspecialty accreditation: is being special good?

PURPOSE OF REVIEW

We examined the advantages and disadvantages of certifying additional subspecialties in anesthesiology from five vantage points - patients, generalist anesthesiologists, subspecialist anesthesiologists, departments of anesthesiology, and society as a whole - in order to recommend a course of action.

RECENT FINDINGS

The published literature does not provide conclusive data on the relative benefits or costs of subspecialization in anesthesiology. Currently, only critical care medicine and pain medicine are recognized officially as subspecialties of anesthesiology. Pediatric anesthesia and cardiothoracic anesthesia have accredited fellowships, and a fellowship accreditation application is under review for obstetric anesthesia.

SUMMARY

Based on our examination, from the five perspectives given above, we recommend that training in all subspecialties of anesthesiology be encouraged. Official fellowship accreditation and subspecialty certification, however, should be reserved for subspecialties in which anesthesiologists provide services comparable to those provided by nonanesthesiologist subspecialists, such as critical care medicine and pain medicine.