Overview
Pain medicine is Australia's formal second-fellowship specialty: FPM trains specialists from anaesthesia (the majority), rehabilitation, psychiatry, general practice and elsewhere in the sociopsychobiomedical management of chronic pain, multidisciplinary clinics, medication stewardship, and interventional procedures from epidurals to spinal-cord stimulators.
For junior doctors it's a destination to file rather than a first program: pick the primary specialty you'd love anyway (anaesthesia, physician training, psychiatry, GP), and keep pain medicine as the two-year capstone.
The pathway
- Primary fellowship firstANZCA, RACP, RANZCP, RACS, ACEM, RACGP/ACRRM, all recognised feeders (check FPM entry rules).
- FPM training (2 years)Accredited multidisciplinary pain units; core practice year + development year; exam + case reports.
- FFPMANZCA → consultantPublic pain clinics, private interventional practice, or blended with the primary specialty.
Formal requirements
- A recognised primary specialist qualification (or senior training standing), see FPM handbook.
- Appointment to an accredited pain-medicine training unit; FPM registration + assessments.
Selection and points
How selection works
| Component | What it involves |
|---|---|
| Unit-level application | Senior CV + referees + interview at accredited pain units. |
Points & scoring
- No matrix; procedural background (anaesthesia) helps for interventional units, psychiatry/rehab backgrounds valued in multidisciplinary teams.
- Most trainees are recruited from doctors already working around the unit (acute pain services, rehab wards); proximity is the pathway.
Competition & demographics
Competitiveness
- Small senior field; posts limited but rarely fiercely contested; the constraint is accredited-unit capacity.
Who's in the program
- Mixed parent specialties (anaesthesia majority); mid-career entrants standard.
Exams
| Exam | When | Format | Cost | Pass rate |
|---|---|---|---|---|
| FPM Examination | During the 2-year program | Written + viva/clinical | ≈ $5,000–6,500 | ≈ 70–85% (indicative) |
Fees and pass rates are indicative; check the college's current fee schedule and exam reports.
What training costs
- FPM training and exam fees on top of primary-college costs; modest by college standards.
How to improve your chances at each stage
StageMedical student
- Just note it exists; no undergraduate moves are needed beyond choosing a feeder specialty you love.
StageIntern (PGY1)
- Same: pick your primary pathway; an acute-pain-service term is interesting exposure.
StageResident (PGY2–3)
- If pain draws you, weight your primary choice toward anaesthesia, rehab, psychiatry or physician training and mention the interest to pain unit directors early.
StageRegistrar years & applications
- During primary training: do pain unit rotations, a pain-related project, and build relationships at your intended FPM unit.
StageIf you don't get on (or change your mind)
- The primary fellowship is the backup; that's the point of the structure.
See also the general strategy guide: universal CV, referee and interview advice that applies across specialties.
Job market & workforce outlook
- Public multidisciplinary clinics chronically under-provisioned; private interventional practice strong (with MBS scrutiny of some procedures); medicolegal work plentiful.
Income
- Interventional private practices indicatively $400,000–700,000+; public/multidisciplinary careers at standard senior packages.
Pre-tax, indicative, and highly variable with hours, setting and billing model. ATO figures are averages of taxable income by reported occupation.
International medical graduates
- FPM SIMG assessment via ANZCA processes; not on the expedited list.
Official links
Community: questions and perspectives
❓ Questions & answers
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🩺 Experiences, corrections & perspectives
If you've trained in pain medicine, or tried to, share what the page can't capture: what it's really like, what's changed, what you wish you'd known.
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