1. Minimum 5 years in full time practice (or equivalent) prior to sitting the certification examination
  2. Minimum 1 years as IVAPM member prior to sitting the certification examination
  3. CV/Biography with picture of applicant
  4. 3 letters of recommendation
    1. Letters preferably written by a Diplomate (AVMA, AVA, ECV, or regional equivalent), CVA, CCRP, CCRT, CCRA, VTS, or DAAPM1
      1. Alternative option:
        1. For those members that lack access to any of the above veterinary pain related certified professionals, consider any licensed veterinary health professional or licensed human health professional2
          1. Member should include a letter clarifying their need for this alternative option
    2. A standardized form should be provided by the IVAPM to facilitate the reference process
  5. CME requirements
    1. DVM, PTs, LVTs, PTAs, and those allied health professionals with an Associates degree (or its equivalent) in a related health care field and two years of clinical experience working with animals in pain.
      1. 90 hours pain management related CME during past 8 years
        1. Acceptable CME3
          1. Major veterinary and human meeting pain related CME
            1. Judgments will have to be made, as inclusively as is reasonable, by the Applications Committee
          2. Rehab and acupuncture training programs
            1. Canine Rehabilitation Institute, U of Tennessee Rehab
            2. Chi Institute, MAS/Colorado, IVAS
          3. Internship/observation time spent at anesthesia/pain management services, up to a limit of 45 total CME equivalent hours. The candidate will need to include a letter describing the characteristics and capabilities of pain management related services at which they are observing patient care. The observational mentor will need to sign a log listing the days and hours the applicant spent on their service.
            1. Veterinary Teaching Hospital with Diplomate (ACVA, ACVECC, AVA, ECVAA, AAPM or regional equivalent), VTS (ECC, Anesthesia) conducting advanced pain management services.
            2. Private veterinary pain management practice with Diplomate (ACVA, ACVECC, AVA, ECVAA, AAPM or regional equivalent), VTS (ECC, Anesthesia) conducting advanced pain management services.
            3. Human pain management practice (with pain management physician). Approval will be on a case by case basis by the Applications Committee.
            4. Diplomates not listed in (i.) and (ii.) above will be considered as suitable observational mentors assuming they are conducting advanced pain management services. Approval will be on a case by case basis by the Applications Committee.
          4. Internship/observation time spent observing pain oriented patient management with a certified veterinary or licensed human rehabilitation professional OR internship/observation time spent with a certified veterinary or human acupuncturist up to a limit of 20 total CME equivalent hours. The candidate will need to include a letter describing the characteristics and capabilities of pain management related services at which they are observing patient care. The observational mentor will need to sign a log listing the days and hours the applicant spent on their service.
          5. RACE approved onsite or online pain management CME hours
          6. Online pain related CME from all major veterinary and human pain related organizations (APS, IASP, WIP, ASRA, AAPM, IVIS, VIN)
            1. Non-RACE approved online Industry based CME will be considered on a case by case basis by the Applications Committee
  6. Test4
    1. 100 multiple choice, time limited (3 hour), closed book examination
    2. The test will be the same for all qualified applicants
    3. This test would emphasize foundational pain related principles while including elements specific to physical rehabilitation therapy and acupuncture as they relate to pain management
    4. This test must, eventually, be accessible internationally. Target date is no later than 2010.
    5. Develop second year test while aiming toward larger test pool
    6. Develop an example test at some point in the future
    7. Alternative testing pathway option – until the IVAPM test is available at more sites and more locations, consideration will be given for the acceptance of the candidate’s successful passing of the AAPM examination5
      1. Members that certify under this provision may be subject to additional recertification requirements above and beyond those required of members credentialing with the IVAPM examination
  7. The applicant must be able to demonstrate competency in any 10 of the following pain management related skills subcategories6
    1. Skills subcategories
      1. Allopathic oriented skills (9 options)
        1. Epidural drug selection
        2. Epidural needle placement
        3. Epidural catheter placement
        4. Local/regional anesthesia/analgesia drug selection (injectable, transdermal) and placement for blocks in at least three of the following subcategories
          1. Declaw ring block
          2. Dental blocks (3 minimum)
          3. Intra-testicular
          4. Intra-articular
          5. Intercostal
          6. Transdermal applications
        5. Advanced local/regional anesthesia/analgesia drug selection and drug placement in at least two of the following subcategories
          1. Axillary, sciatic, or femoral nerve
          2. Intrapleural or intraperitoneal
          3. Bier Block
          4. Continuous local anesthetic administration (Intrapleural, Soaker catheter)
        6. Use of nerve locator for regional anesthesia/analgesia application purposes
        7. Constant rate infusion analgesic drug selection
        8. Constant rate infusion analgesic drug dose/volume calculations and administration using a volume base syringe pump
        9. Constant rate infusion analgesic drug dose/volume calculations and administration using IV fluids
      2. Physical rehabilitation skills (11 options)7
        1. Goniometry
        2. Muscle mass measurement
        3. Neurologic examination/assessment
        4. Low level laser utilization (LLLT)
        5. NMES
        6. TENS
        7. Therapeutic U/S
        8. Joint compressions
        9. Joint mobilizations
        10. Joint traction
        11. Therapeutic massage
      3. Acupuncture skills (4 options)8
        1. Needle placement techniques
        2. Needle removal techniques
        3. Pain related acupuncture point selection
        4. Electro-stimulation unit utilization
    2. Verification of skills competency
      1. Signed off by Diplomate (AVMA, AVA, ECV, AAPM or regional equivalent), CVA, CCRP, CCRT, CCRA, VTS, DAAPM9
      2. Alternative option:
        1. For those members that lack access to any of the above pain related certified professionals, consider any licensed veterinary health professional or licensed human health professional10
          1. Member should include a letter clarifying their need for this alternative option
        2. Video documentation may be considered as an option for applicant when an AVMA Diplomate, AVA/ECV Diplomate, CVA, CCRP, CCRT, CCRA, VTS, DAAPM, or other licensed veterinary or human health professional are not available
  8. The applicant must list and include digital images of the following pain management related elements based upon the particular pain related services provided by the applicant
    1. Available pain management drugs for those providing allopathic based therapy
      1. List should reflect drugs from the major analgesic categories listed below
        1. Opioids
        2. NMDA antagonists
        3. Na channel blockers
        4. Ca channel blockers
        5. NSAIDs
      2. Pictures should include the controlled drug storage and record keeping as required by regional laws and regulations
      3. For drugs that are not available onsite, member must describe their access to these medications
    2. Equipment based on the pain management related services provided by the applicant
      1. Allopathic oriented examples (3  required)
        1. IV fluid pump or IV syringe pump
        2. Epidural supplies
        3. CRI calculators/recipe resources
        4. Nerve locator
      2. Rehabilitation (7 required)
        1. Rehab equipment
          1. Goniometer
          2. Gulick tape measure
          3. TENS
          4. NMES
          5. Therapeutic U/S
          6. Low level laser
          7. Cavaletti rails
          8. Therapy balls, therapy bands
          9. Balance boards
      3. Acupuncture/TCVM (2 required)
        1. Needles
        2. Herbals
        3. Electro-stimulation unit
    3. Alternative pathway option – the IVAPM acknowledges that some members are not currently in a setting that allows access to any of the above drugs and equipment. An example would be those in a purely teaching oriented position. A waiver will be considered for those in similarly limited settings with such waivers being extended by the Applications Committee on a case by case basis.
      1. Member should include a letter clarifying their need for this alternative option
  9. Case reports
    1. Two total case reports will be required
      1. These case reports may pertain to perioperative pain management, major acute or chronic pain management and should reflect a well structured, balanced analgesic strategy.
      2. These two case reports must represent different pain related scenarios.
    2. Case reports review criteria would be the same for DVMs, LVTs, and PTs (CCRP, CCRT)
    3. Case reports should involve patient care delivered during the 5 year period preceding the applicant’s packet submission.
    4. The applicant must have successfully completed the examination requirement prior to case report submission.
    5. Case reports to be submitted within 6 months of the successful completion of the examination.
    6. Case reports must be accepted within two years of the successful completion of the examination.
    7. These case reports should reflect a coherent thought process regarding patient assessment and management – we are not looking for clinical case reports as might be considered for publication in JAVMA or other peer reviewed journal indexed in Pubmed.
  10. Candidate must satisfy all requirements within 3 years of the application deadline for which the applicant is accepted as being credential eligible or they will be required to reinitiate the credentialing application process.
  11. Future planning and adaptations
    1. A lab animal/exotics subcommittee will be convened to adapt this program, if needed, to this area of veterinary practice
    2. A large animal/food animal subcommittee will be convened to adapt this program to this area of veterinary practice
    3. An international subcommittee will be convened to adapt all aspects of this program to other regions around the world
      1. This subcommittee will need to work with the Examination Committee to structure the most appropriate deployment  of our examination to other regions of the world
 
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Footnotes
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1. This encourages networking with colleagues who are often well positioned to be supportive of pain related case management

2. This option removes any restriction associated with professionals in more remote settings while helping the applicant network with their colleagues on the subject of pain management

3. The intent here is to parallel the established North American certification programs to establish legitimacy within our current core membership with adjustments considered as needed by the International subcommittee as this program is deployed around the world. In addition, we need to be VERY broad based in our early acceptance of CME equivalence as an acknowledgement that this discipline is in its infancy and that it is currently very difficult to gain 90 CME hours in a lecture setting, especially for technicians.

4. A Test Committee will be formed to develop this specific component

5. This option is included to avoid the marked limitation to the general membership of having only one site and date for the IVAPM examination (which will be the case for the foreseeable future) and to avoid having test committee members penalized by their participation in the examination development process. It will encourage those with AAPM test familiarity to participate in the test development process adding valuable insight into our sister organization’s parallel test process.  This shares a common theme with our alternative pathway CME equivalent options above; a way to broaden initial membership eligibility and satisfy the intent of the certification requirement.

6. One hoped for aspect of the skills list is to encourage networking with allied pain related professionals. An allopathic only practitioner will be encouraged to gain a few physical rehab skills or learn more about acupuncture’s ability to enhance pain management.

7. PTs and PTAs will need to accomplish all of their skills within the physical rehabilitation therapy category. I do not think that they will be able to legally perform the allopathic related techniques or acupuncture on animals.

8. In general, the acupuncturists should also be DVMs making them eligible to perform all of the allopathic techniques listed.

9. This encourages networking with colleagues who are often well positioned to be supportive of pain related case management

10. This option removes any restriction associated with professionals in more remote settings while helping the applicant network with their colleagues on the subject of pain management
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