Not enterable from prevocational years. Pain medicine is a distinct specialty run as a faculty of ANZCA: two years after (or alongside the end of) a primary fellowship — a Core Training Stage in accredited multidiscipli…

Who picks youthe employerthe employer hires you, then the college registers you
Typical entryPGY5n/a for prevocational doctors — post-fellowship (or late in a primary program). GP route…
Unaccredited3 yrstypical, before a training post
To fellowship10 yrs2 minimum from the start of training
Competitivenessnot publishedencoder's rating, 1–5

Pathway, med school to consultant

Pain medicine pathway by PGY yearmed schoolPGY1PGY2PGY3PGY4PGY5PGY6PGY7PGY8PGY9PGY10PGY11PARENT FELLOWSHIP FIRST — choose with pain in mind: anaesthesia (most procedural/US-guided exposure, ~8 yrs), rehab (no BPT, ~6 yrs, baclofen/botulinum), GP (fastest, ~4 yrs), RACP (~7 yrs), psychiatry, ED, rheum, neuro, palliativePARENT FELLOWSHIP FIRST — choose with pain in…Optional taster: pain-unit RMO/HMO term (Acute Pain Service rounds, chronic pain clinic)Optional taster: pain-unit RMO/HMO term (Acute Pain Service rounds, chronic pain clinic)Win an accredited pain unit post (NSW PF early round May); FPM trainee application ($3,300)Win an accredited pain unit post (NSW PF early round May); FPM trainee applicatio…Core Training Stage in accredited multidisciplinary pain units; Foundations MCQ; long casesCore Training Stage in accredited multidisciplinary pain units; Foundations MCQ; long casesPractice Development StagePractice Development StageFPM Fellowship ExaminationFPM Fellowship ExaminationFFPMANZCA awardedFFPMANZCA awardedPain specialist — mostly part-time pain + part-time parent specialty; limited public posts; private interventional workPain specialist — mostly part-time pain + part-time parent specialty; limited public posts; private interventional wo…Pain medicine pathway by PGY yearuniPGY1PGY2PGY3PGY4PGY5PGY6PGY7PGY8PGY9PGY10PGY11PARENT FELLOWSHIP FIRST — choose with pain in mind: anaesthesia (most procedural/US-guided exposure, ~8 yrs), rehab (no BPT, ~6 yrs, baclofen/botulinum), GP (fastest, ~4 yrs), RACP (~7 yrs), psychiatry, ED, rheum, neuro, palliativePARENT FELLOWSHIP FIRST — choose with pain in mind: anaesthesia (most procedural/US-guided exposure, ~8…Optional taster: pain-unit RMO/HMO term (Acute Pain Service rounds, chronic pain clinic)Optional taster: pain-unit RMO/HMO term (Acute Pain Service rounds, chronic pain clinic)Win an accredited pain unit post (NSW PF early round May); FPM trainee application ($3,300)Win an accredited pain unit post (NSW PF early round May); FPM trainee application ($3,300)Core Training Stage in accredited multidisciplinary pain units; Foundations MCQ; long casesCore Training Stage in accredited multidisciplinary pain units; Foundations MCQ; long casesPractice Development StagePractice Development StageFPM Fellowship ExaminationFPM Fellowship ExaminationFFPMANZCA awardedFFPMANZCA awardedPain specialist — mostly part-time pain + part-time parent specialty; limited public posts; private interventional workPain specialist — mostly part-time pain + part-time parent specialty; limited public posts; private int…
prevocationalselectiontrainingexamfellowship

Typical start years; people vary by a year or two. Diamonds are exams. Stage list and sources in the pathway tab.

How competitive, against the other 31 guides

Competitiveness rating by specialty, 1 to 512345Dermatology: 5DermatologyNeurosurgery: 5NeurosurgeryOrthopaedic Surgery: 5Orthopaedic SurgeryPlastic & Reconstructive Surgery: 5Plastic & Reconstructive Su…Cardiothoracic Surgery: 5Cardiothoracic SurgeryClinical radiology: 4.5Clinical radiologyGeneral Surgery: 4General SurgeryOtolaryngology Head & Neck Surgery (ENT): 4Otolaryngology Head & Neck…Sport and exercise medicine: 4Sport and exercise medicineUrology: 4UrologyAnaesthetics: 4AnaestheticsPaediatric Surgery: 4Paediatric SurgeryOphthalmology: 4OphthalmologyPaediatric emergency medicine: 4Paediatric emergency medici…Vascular Surgery: 4Vascular SurgeryPaediatrics (Basic Training in Paediatrics & Child Health): 3.5Paediatrics (Basic Training…Obstetrics and gynaecology: 3.5Obstetrics and gynaecologyGeneral practice and rural generalism: 3General practice and rural…Basic Physician Training (Adult Internal Medicine): 3Basic Physician Training (A…Radiation oncology: 3Radiation oncologyPathology: 3PathologyPublic health medicine: 3Public health medicinePalliative medicine: 2Palliative medicineMedical administration: 2Medical administrationEmergency Medicine: 2Emergency MedicineIntensive Care Medicine: 2Intensive Care MedicinePsychiatry: 2PsychiatryRehabilitation medicine: 2Rehabilitation medicineSexual health medicine: 2Sexual health medicineOccupational and environmental medicine: 1.5Occupational and environmen…Addiction medicine: 1.5Addiction medicine
15
Dermatology5
Neurosurgery5
Orthopaedic Surgery5
Plastic & Reconstructive Surgery5
Cardiothoracic Surgery5
Clinical radiology4.5
General Surgery4
Otolaryngology Head & Neck Surgery (ENT)4
Sport and exercise medicine4
Urology4
Anaesthetics4
Paediatric Surgery4
Ophthalmology4
Paediatric emergency medicine4
Vascular Surgery4
Paediatrics (Basic Training in Paediatrics & Child Health)3.5
Obstetrics and gynaecology3.5
General practice and rural generalism3
Basic Physician Training (Adult Internal Medicine)3
Radiation oncology3
Pathology3
Public health medicine3
Palliative medicine2
Medical administration2
Emergency Medicine2
Intensive Care Medicine2
Psychiatry2
Rehabilitation medicine2
Sexual health medicine2
Occupational and environmental medicine1.5
Addiction medicine1.5

Not rated for a prevocational audience — undersubscribed at the fellowship level ('after completing your initial fellowship, most people just want to stop and breathe'), with limited accredited training jobs, highly var… Ratings are the encoder's 1–5 call from college numbers and r/ausjdocs; applicant-to-place ratios double-count people who apply in several states. Evidence rows are in getting selected.

In one paragraph

ary pain units plus a Practice Development Stage — with a Foundations MCQ, long case assessments and a Fellowship Examination. 'The rate limiting step for training is often obtaining an accredited training job and completion of exams. There are also limited public jobs after completion.' Route speed: RACGP fastest (~4 years to starting pain training), AFRM ~6, RACP ~7, anaesthetics ~8 — but 'judging purely on speed is an error'. Show as 'choose a parent specialty'.

Two cautions, two encouragements

No amount of money is worth that shit 😂

u/AltruisticEchidna · Apr 2026 · comment

Sydney rehab is incredibly profitable, especially when combined with the two year pain medicine qualification (which you can do and knock 1 year off rehab, making it a 4 year dual specialty). The bosses I know in the field report earnings over $650k per year doing both

u/HushFunded · Dec 2025 · NSW · comment

Not a pain physician but was a reg once. Let’s just say you really need a rather mental health mindset.

u/FroyoAny4350 · former pain registrar · Apr 2026 · comment

Do it. Lots of private practice money making options.

u/AussieFIdoc · anaesthetist · May 2025 · comment

All 43 curated quotes by topic, trajectories and threads.

anzca.edu.au for the facts and summary, read 12 Sept 2026 · rating and pathway encoded by hand from the same sources · quotes are verbatim r/ausjdocs comments, community view not policy

Pathway

Pain medicine pathway by PGY yearmed schoolPGY1PGY2PGY3PGY4PGY5PGY6PGY7PGY8PGY9PGY10PGY11PARENT FELLOWSHIP FIRST — choose with pain in mind: anaesthesia (most procedural/US-guided exposure, ~8 yrs), rehab (no BPT, ~6 yrs, baclofen/botulinum), GP (fastest, ~4 yrs), RACP (~7 yrs), psychiatry, ED, rheum, neuro, palliativePARENT FELLOWSHIP FIRST — choose with pain in…Optional taster: pain-unit RMO/HMO term (Acute Pain Service rounds, chronic pain clinic)Optional taster: pain-unit RMO/HMO term (Acute Pain Service rounds, chronic pain clinic)Win an accredited pain unit post (NSW PF early round May); FPM trainee application ($3,300)Win an accredited pain unit post (NSW PF early round May); FPM trainee applicatio…Core Training Stage in accredited multidisciplinary pain units; Foundations MCQ; long casesCore Training Stage in accredited multidisciplinary pain units; Foundations MCQ; long casesPractice Development StagePractice Development StageFPM Fellowship ExaminationFPM Fellowship ExaminationFFPMANZCA awardedFFPMANZCA awardedPain specialist — mostly part-time pain + part-time parent specialty; limited public posts; private interventional workPain specialist — mostly part-time pain + part-time parent specialty; limited public posts; private interventional wo…Pain medicine pathway by PGY yearuniPGY1PGY2PGY3PGY4PGY5PGY6PGY7PGY8PGY9PGY10PGY11PARENT FELLOWSHIP FIRST — choose with pain in mind: anaesthesia (most procedural/US-guided exposure, ~8 yrs), rehab (no BPT, ~6 yrs, baclofen/botulinum), GP (fastest, ~4 yrs), RACP (~7 yrs), psychiatry, ED, rheum, neuro, palliativePARENT FELLOWSHIP FIRST — choose with pain in mind: anaesthesia (most procedural/US-guided exposure, ~8…Optional taster: pain-unit RMO/HMO term (Acute Pain Service rounds, chronic pain clinic)Optional taster: pain-unit RMO/HMO term (Acute Pain Service rounds, chronic pain clinic)Win an accredited pain unit post (NSW PF early round May); FPM trainee application ($3,300)Win an accredited pain unit post (NSW PF early round May); FPM trainee application ($3,300)Core Training Stage in accredited multidisciplinary pain units; Foundations MCQ; long casesCore Training Stage in accredited multidisciplinary pain units; Foundations MCQ; long casesPractice Development StagePractice Development StageFPM Fellowship ExaminationFPM Fellowship ExaminationFFPMANZCA awardedFFPMANZCA awardedPain specialist — mostly part-time pain + part-time parent specialty; limited public posts; private interventional workPain specialist — mostly part-time pain + part-time parent specialty; limited public posts; private int…
prevocationalselectiontrainingexamfellowship
Show the 8 stages with their sources
  1. PARENT FELLOWSHIP FIRST — choose with pain in mind: anaesthesia (most procedural/US-guided exposure, ~8 yrs), rehab (no BPT, ~6 yrs, baclofen/botulinum), GP (fastest, ~4 yrs), RACP (~7 yrs), psychiatry, ED, rheum, neuro, palliative — from PGY1, 72 months reddit.com
  2. Optional taster: pain-unit RMO/HMO term (Acute Pain Service rounds, chronic pain clinic) — from PGY2, 3 months reddit.com
  3. Win an accredited pain unit post (NSW PF early round May); FPM trainee application ($3,300) — from PGY7, 3 months anzca.edu.au
  4. Core Training Stage in accredited multidisciplinary pain units; Foundations MCQ; long cases — from PGY8, 12 months anzca.edu.au
  5. Practice Development Stage — from PGY9, 12 months anzca.edu.au
  6. FPM Fellowship Examination — from PGY9, 1 months anzca.edu.au
  7. FFPMANZCA awarded — from PGY10 anzca.edu.au
  8. Pain specialist — mostly part-time pain + part-time parent specialty; limited public posts; private interventional work — from PGY10 reddit.com

Terms to pick

Term advice: nothing encoded yet — not published.

Stages: reddit.com, anzca.edu.au · terms: r/ausjdocs term-strategy collection, counted by distinct author, community view not policy

Requirements

"Mandatory" is the college's word. Amber "community" rows are what the sub says panels actually want.

Before you can be selected 2

primary_specialist_qualification mandatoryfrom the 2027 intake
Must have completed, or be actively training toward, a primary specialist qualification acceptable to the FPM Board (by-law 3.1.3). In practice anaesthesia, rehabilitation medicine, psychiatry, ED, general practice, rhe…
other · anzca.edu.au
accredited_pain_unit_post mandatoryfrom the 2027 intake
Employer-recruited post in an accredited multidisciplinary pain management unit (major tertiary hospitals); NSW runs a Pain Medicine Provisional Fellow early round (4-14 May 2026). Trainees typically 'work 1 or 2 weeks…

During training 3

core_training_and_practice_development mandatoryfrom the 2027 intake
Two years post-specialist: a Core Training Stage in accredited multidisciplinary pain management units plus a Practice Development Stage tailored to your career. Recognition of Prior Experience available ($1,525).
rotation · anzca.edu.au
foundations_mcq_long_cases_fellowship_exam mandatoryfrom the 2027 intake
Workplace-based assessments, a Foundations MCQ exam ($2,100), long case assessments ($1,805), and the Fellowship Examination ($3,700).
exam · anzca.edu.au
annual_fee_deadline mandatoryfrom the 2027 intake
Annual training fee $3,195 due 31 January; unpaid by 28 Feb → interrupted training; by 31 March → withdrawal. 50% hardship bursaries exist.

By state

NSW

Pain Medicine Provisional Fellow early round in the NSW JMO campaign, 4-14 May 2026 for the 2027 year.

  • Pain Med PF early round opens — 4 May 2026 (2027 intake)
  • Pain Med PF early round closes — 14 May 2026 (2027 intake)

health.nsw.gov.au

VIC

'An enormous wait list in Victoria' for public chronic pain clinics; trainees typically split time between pain and their other specialty.

reddit.com

Dates drift a week or two each year; the calendar has confirmed vs expected windows.

What the CV rubric scores

  • A masters is not scored here.
  • No exam is required before selection.

Gate is a primary specialist qualification (held or actively training toward) per by-law 3.1.3; posts employer-recruited; no CV rubric published.

Referees and attempts

Refereessee noteemployer_set
Attempt capnone publishedNot published by FPM/ANZCA - the cap is unknown, which is not the same as 'no cap' (cap_known: false; GAPS Part 2 gap 10).

Requirements and rubric: anzca.edu.au, health.nsw.gov.au · state mechanics: health.nsw.gov.au, reddit.com · community rows from r/ausjdocs

Exams

  • Foundations MCQ — Core Training Stage · $2,100
  • Long case assessments — During training · $1,805
  • FPM Fellowship Examination — End of training · $3,700

What it costs

Cost to get on$6,766Trainee application, Long case assessment, AHPRA/Medical Board general registration - application fee (one-off, national)
College schedule$19,2239 published items over the whole of training

College schedule

Pain medicine official feesFellowship exam: $3,700$3,700Trainee application: $3,300$3,300Annual training fee (due 31 Jan): $3,195$3,195Foundations MCQ: $2,100$2,100Long case assessment: $1,805$1,805AHPRA/Medical Board general registration - application fee (one-off, national): $1,661$1,6613 smaller items: $3,462$3,462
Fellowship exam $3,700Trainee application $3,300Annual training fee (due 31 Jan) $3,195Foundations MCQ $2,100Long case assessment $1,805AHPRA/Medical Board general registration - application fee (one-off, national) $1,6613 smaller items $3,462

"Cost to get on" is a name-based pick of the one-off fees paid before or at selection. The college schedule is a lifetime-of-training list at each item's own year, not one bill; community amounts overlap it and are never summed. Courses, travel and repeat sittings are the part the sub complains about.

Exams and fees: anzca.edu.au, medicalboard.gov.au · claims, prep and costs quoted: r/ausjdocs exams-and-costs collection, community view not policy · paid prep products need three independent non-suspect authors and a free alternative to appear

Open jobs that count

Scored by the Pain medicine rules — whether or not the title names the specialty — highest first, closing soonest next.

Rehabilitation RegistrarBairnsdale Regional Health Service · Gippsland - East Gippsland, VICAccredited regRehabilitation medicine26 Septstrong match · advances 1 requirement: primary specialist qualificationPain Management Senior RegistrarCanberra Health Services · Canberra Hospital, Garran ACT, Canberra Hospital, Garran ACT, ACTAccredited regPain medicine8 Octstrong match · advances 2 requirements: accredited pain unit post, primary specialist qualificationCaution: Post-fellowship (or late-primary-training) posts. Not enterable from PGY2-4 — if you're prevocational, this ad is not for you yet.2027 ANZCA Pain Medicine Advanced Trainee (Second Year) Epworth HealthCare · Epworth Corporate, Geelong, VICAccredited regPain medicineno close datestrong match · advances 2 requirements: accredited pain unit post, primary specialist qualificationCaution: Post-fellowship (or late-primary-training) posts. Not enterable from PGY2-4 — if you're prevocational, this ad is not for you yet.Emergency Medicine Special Skills Registrar Positions - ACEM Training Year 2027SA Health · Adelaide Metro Southern, SAAccredited regEmergency medicinePublic health medicinecloses todaystrong match · advances 1 requirement: primary specialist qualification2027 Anaesthetic RegistrarEastern Health · location not stated, VICAccredited regAnaestheticscloses todaystrong match · advances 1 requirement: primary specialist qualificationRural Registrar Psychiatry Trainee (RPTWA) - Transfer PoolWA Health · Busselton Health Campus, Kalgoorlie Health Campus, Broome Regional Hospital, Bunbury Health Campus, Geraldton Regional Hospital, WA Country Health Service, Albany Health Campus, Narrogin Health Service, Busselton Health Campus, WAAccredited regPsychiatryRemote10 Decstrong match · advances 1 requirement: primary specialist qualificationPsychiatry Senior Registrar - Coffs Harbour Community Acute CareMid North Coast Local Health District · Coffs Harbour Health Campus, Coffs Harbour, NSWAccredited regPsychiatryno close datestrong match · advances 1 requirement: primary specialist qualificationDoctors in Training Recruitment Campaign 2027 - Senior Registrar/Fellow Pain MedicineTasmanian Department of Health · South, South, TASAccredited regPain medicine10 Decweak match · title mentions pain

See all 8 on the board →

Show the 2 feeder posts the sub keeps recommending

When offers land

"Has anyone heard back?" reports on r/ausjdocs, 2023–2026 folded onto one calendar year; dashed line is the official date for the 2027 intake where published.

NSW 16 reports

Pain medicine offer reports by week, NSWweek of 2026-08-10: 3week of 2026-08-17: 5week of 2026-08-24: 3week of 2026-08-31: 1week of 2026-09-07: 2week of 2026-09-14: 0week of 2026-09-21: 0week of 2026-09-28: 1week of 2026-10-05: 0week of 2026-10-12: 0week of 2026-10-19: 0week of 2026-10-26: 15SepOctNov

16 dated reports, weekly bins

Show the 2027 intake campaign windows by state
2027 intake campaigns by stateJunJulAugSepACTACT · applications 2026-06-29 → 2026-08-02NSWNSW · applications 2026-05-04 → 2026-05-14NTNT · applications 2026-06-01 → 2026-06-28QLDQLD · applications 2026-06-01 → 2026-06-29QLD · offers 2026-08-03SASA · applications 2026-06-10 → 2026-07-01SA · offers 2026-09-17TASTAS · applications 2026-05-25 → 2026-06-22VICVIC · applications 2026-07-27 → 2026-08-21VIC · interviews 2026-08-24VIC · offers 2026-09-23WAWA · applications 2026-05-25 → 2026-06-22WA · offers 2026-08-17
applications openinterviews / offers

Jobs: last night's scrape, scored by hand-written rules (no AI) · units and offer reports: r/ausjdocs, counted by distinct author · campaign windows: canberrahealthservices.act.gov.au, health.nsw.gov.au, healthjobs.nt.gov.au +4

What the regs say

Verbatim, one caution beside one encouragement per topic where both exist, the rest folded. Every quote links to the comment.

Getting on 16

That’s because anaesthetists have better options.

u/Environmental_Yak565 · anaesthetics advanced trainee · Mar 2025 · comment

I reckon it would be very useful, for you and your department. Maybe talk with your director about how they could support it/ meet with pain specialists in your hospital (if they exist), or local area. When Ive spoken to pain specialists the overwhelming difference is, they have time to talk with the patient and…

u/DrPipAus · emergency physician · Apr 2025 · read full
Show all 16 quotes on getting on

Depends. Are you ED because of the attention span and chaotic nature? Not sure if pain fits that personality. Private money seems good from what colleagues say. Joining a private practice group and work 2-3 days a fortnight in pain seems the way. I couldn't imagine anything worse than dealing with chronic pain as a…

u/TazocinTDS · FACEM · Apr 2025 · read full

Ast and arst..the SITE is what is accredited not the supervisor. So that would be an absolute no.

u/StatisticianClear858 · Aug 2026 · comment

If you like managing chronic pain syndromes in complex patients plus being accredited to do perineural injections, radiofrequency ablations and insert/manage spinal cord stimulators, then go for it. It's best if you work as part of a multi-disciplinary chronic pain service or clinic with other allied health…

u/Familiar-Reason-4734 · GP/rural generalist · Apr 2025 · read full

Many are drawn to anaesthesia because they like: sessional, in-patient work; no patient ownership beyond a single case; rapidly manipulated real-time physiology, using expert knowledge of pharmacology; theatre work, rather than wards or clinics. Pain, in contrast, involves chronic on-going patient care of patients in…

u/Environmental_Yak565 · anaesthetics advanced trainee · Mar 2025 · read full

Amongst all anaesthetists? Not very. Most people in anaesthetics didn’t go into it because they wanted to spend time sitting in clinic talking to patients about containment strategies and multidisciplinary approaches, so there’s a limited group interested in the first place It’s also not a subspecialty of anaesthesia…

u/cochra · anaesthetist (cardiac/thoracic) · Mar 2025 · read full

Chronic pain is an option. But may I suggest addiction medicine. Satisfying work with astronomical need public and private which huge comorbidty and brief health interventions which would dovetail your FACEM skills.

u/ironic_arch · Apr 2025 · comment

RACGP would definitely be faster (min 4 years to starting pain training) RACP isn’t really - you have to complete AT to have letter so it’s still 7 years (as compared to the typical 8 for anaesthetics) AFRM is another option that’s not uncommon amongst pain physicians and is slightly faster (6 years) Judging purely…

u/cochra · anaesthetist (cardiac/thoracic) · Mar 2025 · read full

The Faculty of Pain Medicine is a part of the College of Anaesthetists, but doctors with Fellowships from other colleges are also able to complete pain medicine training. My experience has been that there is a small subset of anaesthetists who like treating chronic pain patients, and a much larger subset who want…

I trained at a large metro tertiary centre that "graduates" about 10-12 FANZCAs. Over the last 8 years that I've worked here as a trainee and consultant, I don't know a single person who then went on to do further subspecialty training in pain. I'm on the APS consultant roster, and I doubt any of our regular APS…

u/all_your_pH13 · anaesthetist · Mar 2025 · read full

Purely anecdotally, many of the Pain trainees and fellows I've met are GPs.

u/smoha96 · anaesthetics trainee · Mar 2025 · comment

It’s actually not uncommon. It’s just not…..common. I would say 5% of my cohort went into pain. And only about half of those went into pain full time. The rest do half half pain and anaesthesia. Most of them did it because they were genuinely interested in it. I’d rather lobotomise myself than go into chronic pain.…

u/toto6120 · anaesthetist · Mar 2025 · read full

I work in private pain and most of the consultants come from the rehab college. Ketamine and lignocaine infusions all day.

u/Excellent-Branch-996 · works in private pain · Mar 2025 · comment

There are a few in WA. Also some GPs, a neurosurgeon and the odd psychiatrist.

u/TubeVentChair · May 2025 · WA · comment

Very location specific question. You should be emailing your local hospital and sussing out options with them. Cobbling together relevant experience and skills is the best you can do without relocating to an accredited pain fellowship training centre.

u/Embarrassed_Value_94 · Aug 2026 · comment

Red flags 14

> I've spent some time in a public persistent pain clinic and, as expected, a lot of the patients are quite difficult/dysfunctional. Is the same true in private? Nah mate. Most of them are easy-going, intervention/opioid naive with no issues with chronic pain. Usually just need help choosing between paracetamol qid…

It's funny how we as ED docs work hard to get to becoming ED consultants. Once there, we work hard to get out of being ED consultants. I'm there with you, though. The limited potential to really only work in the public health system isn't spoken about much during training years. Regarding pain medicine, I am sure…

Show all 14 quotes on red flags

No amount of money is worth that shit 😂

u/AltruisticEchidna · Apr 2026 · comment

Not a pain physician but was a reg once. Let’s just say you really need a rather mental health mindset.

u/FroyoAny4350 · former pain registrar · Apr 2026 · comment

I did a few months of pain as a registrar. The amount of patients with psychiatric problems was very high. From my anecdotal experience a lot of anesthesiologists had a biological approach only when pain is clearly bio-psycho-social.

u/starminder · psychiatrist · Mar 2025 · comment

Pain specialists: Yes, that pain sounds terrible. Here, get on a six month wait list. Also pain specialists: I just don’t understand why GPs prescribe so many opioids for chronic pain patients.

u/Striking-Net-8646 · dual FRACGP/FAChPM · May 2026 · comment

I think just be aware- you have to have a very, very special wiring to do this role. Maximum patience Maximum empathy Whilst also being able to switch the latter off when you go home to avoid burnout. The era of “write a script” for persistent pain is over. The evidence makes this very, very clear. But it’s…

u/Plastic-Mountain-708 · Aug 2026 · read full

I’d agree. Pain patients are not normal. You need a thick skin to manage. I don’t think doing pain part-time will cut it.

u/Tall-Drama338 · Apr 2025 · comment

The issue is that there are often no easy answers and that is not what patients (particularly private patients who are paying a decent amount of money) want to hear.

Pain patients are the reason most people don't like pain as a speciality. A huge % who are on WorkCover and incentivise to stay sick.

u/warkwarkwarkwark · anaesthetist · Mar 2025 · comment

It requires a special kind of stamina, resilience and calmness. It’s not for the faint hearted and those who don’t want a large part of their time taken up writing reports and sitting in the witness box as it descends into the mud wrestling legal quagmire of disentanglement organic vs non-organic, patient credibility,…

Was going to say - private procedural can make bank but a lot of what they do has limited and or controversial evidence base and they use fluoro (due to training and accessibility) for procedures that really should be done under CT.

Quite a lot in private. The unethical ones can make bank from procedural stuff on patients that will only escalate their rx Its can be basically drug dealing

u/Technical_Money7465 · Apr 2026 · comment

Also have a think if you like dealing with chronic pain patients. It's not the I broke my leg pts .... It's the... Oh I was injured decades ago, increasing my pain meds doesn't seem to actually help but I want to be in them. I cant move without them and it's your fault I can't exercise because you won't give me more…

Pay 6

I know Pain FANZCAs and have anaesthetised for some of their pain lists. The procedural lists do pay for than for the anaesthetic providers (with fairly average billing), but the overheads are much higher. The days consulting pay terribly, the patients are often tricky to deal with, and the group takes a large cut.

u/gasmanthrowaway2025 · anaesthetist · Mar 2025 · comment

Sydney rehab is incredibly profitable, especially when combined with the two year pain medicine qualification (which you can do and knock 1 year off rehab, making it a 4 year dual specialty). The bosses I know in the field report earnings over $650k per year doing both

u/HushFunded · Dec 2025 · NSW · comment
Show all 6 quotes on pay

You said it yourself, “paid appropriately”. Is $320,000 pa appropriate remuneration for the sacrifice required to become an ED consultant? Or any fellowed position in medicine for that matter? Might have been 10 or 20 years ago, but the world has changed. You should feel more “yuck” that the median income is only $65k,…

Interventional pain is way bigger money than private anaesthesia. That’s a motivation for some. It’s also more rewarding for some on professional level, in that for some patients you can see the tangible difference you are making in their lives whereas anaesthesia is more of a thankless background character most of the…

u/changyang1230 · anaesthetist · Mar 2025 · read full

The ones I know bill around $500-700/hour before practice costs. Can be very tough work, one has to be very good with boundary setting and the more challenging patients will often have some psych overlap.

u/PsychinOz · psychiatrist · Apr 2026 · comment

Do it. Lots of private practice money making options.

u/AussieFIdoc · anaesthetist · May 2025 · comment

Lifestyle 4

Not personally doing pain. I will say that most people I’ve seen doing pain fellowship as an anaesthetics trainee manage to negotiate some acceptable amount of theatre time during that. Why waste a perfectly good FANZCA when you can be running another endoscopy list.

u/PandaParticle · anaesthetist · May 2025 · comment

Definitely my experience. Had plenty of gifts and thank you cards from patients in private. And they were paying me out of their own pocket. Very rare to get any meaningful acknowledgement from public patients. Obviously YMMV but that’s been my experience. It’s the opposite of what I thought it would be while…

Show all 4 quotes on lifestyle

From what I understand, different services can vary widely in terms of rostered training hours (full time being 4 x 10 hour shifts per week vs 5 x 8 hours), clinic vs procedure mix, effectiveness of the MDT etc. As a non-trainee I’m not sure of the process, and these things may be difficult to select for your…

u/saturdaysonly · anaesthetics trainee who rotated through a pain service · June 2026 · read full

Not personally, but there are a few FANZCA / FPM fellows in our department. They’ve all managed to negotiate a mix of public and private work, and a mix of pain & theatre work in the public, so it seems to be very possible.

u/tklxd · anaesthetist · May 2025 · comment

Jobs 2

Not a pain specialist but in private many specialties want to see GP referrals in advance and triage aka screen the referrals, and can thus decline the referral. So your difficult/dysfunctional patients in private can be substantially reduced if thats how someone chooses to practice.

u/Prolific_Masticator · May 2026 · comment

I agree, but I’m also tired of referring patients 3 hours drive to the nearest pain centre.

u/HappinyOnSteroids · rural generalist registrar (RACGP) · Aug 2026 · comment

Competitiveness 1

It’s not common IME. Pain medicine - particularly chronic pain - attracts a fundamentally different sort of clinician to those who are usually drawn to anaesthesia.

u/Environmental_Yak565 · anaesthetics advanced trainee · Mar 2025 · comment

Best threads

r/ausjdocs comments and posts, hand-curated from the pain collection; scores as at the dump · community view, not policy

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