THE ROYAL COLLEGE OF CHIROPRACTORS
PAIN FACULTY APPLICATION FORM 2014/15
INTRODUCTION
The RCC Pain Faculty has been launched to help ensure standards of pain management are raised and promoted and to establish links with other pain organisations thus fostering interdisciplinary collaboration and understanding. The Pain Faculty will promote relevant courses (both academic and CPD) to the profession, thereby developing expertise, and aims to offer a repertoire of short CPD courses on a regional basis. A number of work streams have been developed reflecting the faculty’s objectives, including:
Non-physical factors - Non-physical factors (psychological and social) can have important influences on how patients experience pain and respond to treatment.
Patient communication and education - Effective communication and education are paramount in the management of patients with MSK pain.
Pharmacology - Management of MSK pain often benefits from a multidisciplinary, integrated approach.
Acupuncture / Dry Needling - Acupuncture is used both as a primary treatment and an adjunct to care by many health care professionals, including chiropractors.
Manual therapy - Manual therapy and exercise prescription are probably the most widely used conservative treatments worldwide for neuro-MSKpain management and are the mainstay of chiropractic care.
Membership of the RCC Specialist Faculties is based on achievement of M-level credits, or equivalent, in relevant fields, but during the first year of a new faculty’s existence, a grandfathering period allows a more flexible approach to be taken to membership admission. This takes account of a broader range of professional experience and activity than will subsequently be the case, including relevant continuing professional development activities. Please note that the grandfathering period for the RCC’s Pain Faculty expires on 31st December 2014.
In order to ensure you achieve full credit for your pain-related professional activity, please complete the following form with as much detail as possible attaching additional information where appropriate. To ensure that the detail you include will be deemed relevant to the Pain Faculty, please refer to the relevance statement provide as an appendix to this application form.
PERSONAL DETAILSFirst name: / Middle initial/s:
Surname:
Email address:
FORMAL POSTGRADUATE MODULES/QUALIFICATIONS THAT MAY BE RELEVANT TO THE PAIN FACULTY
*PLEASE APPEND FULL COURSE DETAILS INCLUDING MODULE TITLES/SUMMARIES AVAILABLE, AND PROOF OF COMPLETION*
Qualification
(i.e. PhD, MSc, PGDip, PGCert) / Subject/Title / Validating institution / Month/year
graduated/expected / Office use only
OTHER FORMAL QUALIFICATIONS THAT MAY BE RELEVANT TO THE PAIN FACULTY
*PLEASE APPEND FULL COURSE DETAILS IF AVAILABLE, AND CERTIFICATE OR OTHER PROOF OF COMPLETION*
Qualification
(e.g. BA, BSc) / Subject / Validating institution / Month/year
Graduated/expected / Office use only
CERTIFICATED LEARNING THAT MAY BE RELEVANT TO THE PAIN FACULTY
*PLEASE APPEND FULL COURSE DETAILS IF AVAILABLE, AND CERTIFICATE OR OTHER PROOF OF COMPLETION*
Qualification
(e.g. Dry Needling) / Month/year
completed / Office use only
CPD EVENTS & ACTIVITIES UNDERTAKEN THAT MAY BE RELEVANT TO THE PAIN FACULTY
*PLEASE APPEND PROGRAMMES IF AVAILABLE*
Title/description / Month/year / Office use only
TEACHING/MENTORING/EXAMINING ACTIVITY, IF APPLICABLE
Provide full details of any teaching, mentoring or examining you undertake/ have undertaken in the field of pain, including topics and dates:
(attach additional information as necessary) / Office use only
OTHER PROFESSIONAL ACTIVITY, IF APPLICABLE
Provide details of other significant professional experience or activity, e.g. society membership, committee work, clinical audit, production of patient information, journal subscriptions etc, in the field of pain, including dates where appropriate.
(attach additional information as necessary) / Office use only
PUBLICATIONS
List below the references of any peer-reviewed or other articles you have published in the field of pain
Office use only
DECLARATION
I declare that the information provided above is a true record.
Signature:
(can be typed if submitting form electronically) / Date: / Office use only
Please forward your completed form to:
Pain Faculty Membership Applications
The Royal College of Chiropractors
Chiltern Chambers
St Peters Avenue
Reading RG4 7DH
United Kingdom
Email:
Tel: +44 (0)118 946 9727
Fax: +44 (0)118 946 9730
NOTES:
1) Use this form to apply for any level of Royal College Pain Faculty membership, including Fellowship. Eligibility for Associate Member, Licentiate Member [LRCC (Pain)], Member [MRCC (Pain)] or Fellow [FRCC (Pain)] will be determined by the Court of Electors (Membership Committee), the decision of which is final.
2) The annual faculty membership fee for 2013/14 is £50 (UK and overseas). There is no pro rata rate and payment will be sought once your application is successful (concessions are applicable to former Pain Society members).
3) The College’s membership year runs from 1 October to 30 September.
APPENDIX – RCC PAIN FACULTY RELEVANCE STATEMENT
When pursuing membership of a specialist faculty, the activity for which you are claiming credit must be relevant to that faculty. Relevance, in the context of the Royal College of Chiropractors Pain Faculty, refers to study, research and/or other activity that is concerned with one or more of the following topics:
General· Anatomy and physiology of pain pathways
· Acute vs chronic pain
· Psychological and social mechanisms in pain
· Designing, reporting and interpreting clinical research studies about treatments for pain
· Ethical standards in pain management and research / Assessment of Pain
· Pain measurement
· Placebo and pain
· Investigations for pain (nerve function studies and imaging)
· Epidemiology
· Psychosocial and cultural aspects of pain
· Sex and gender issues in pain
Clinical states
· Taxonomy of pain syndromes
· Chronic pain
· Spinal pain (neck, mid back & lower back)
· Radicular pain (cervical or lumbar)
· Musculoskeletal pain
· Headache & Facial pain
· Nerve damage (Neuropathic pain & complex regional pain syndromes)
· Other cases
Ø Paediatric pain
Ø Geriatric pain
Ø Post operative pain
Ø Cancer pain
Ø Visceral pain / Treatment of pain
· Physical therapy
· Pharmacology
· Rehabilitation
· Psychological treatments
· Stimulation produced analgesia (including dry needling)
· In the workplace
· Complimentary therapies