World Institute of Pain

REQUIREMENT OF Ethical and Professional Standards

Please give this form to each recommending physician.

Two (2) letters of recommendation from practicing physicians must be submitted on behalf of each applicant for certification.

Both letters must be from physicians who can speak to the applicant’s practice in
Pain Medicine. ONLY ONE (1) letter may be from a physician partner. The second letter MUST be from another physician who can speak to the applicant’s practice in pain medicine. Letters from relatives will not be considered.


Monique Steegers, MD, PhD, FIPP
Registrar of Examination
World Institute of Pain
301 Main Street
Suite 2604
Winston-Salem, NC 27101 USA

Phone: 1.336.760.2939 – Fax: 1.336.760.5770

E-mail: [email protected]

As the recommending physician, it is expected that your letter of recommendation will speak to the applicant’s practice in Pain Medicine, as well as serve as additional confirmation that the applicant has met the other WIP Certification Requirements.

Specifically, please include a summary of his or her overall practice, including information concerning specific evaluation, management and procedures in Pain Medicine.

For your information, the WIP-CIPS Board of Examination defines the field of Pain medicine as the following.

Definition of Pain Medicine

The specialty of Pain Medicine is the study evaluation, treatment, and rehabilitation of persons in pain. Some conditions may have pain and associated symptoms arising from a discrete cause, such as postoperative pain or pain associated with a malignancy, or may be conditions in which pain constitutes the primary problem, such as neuropathic pains or headaches. The evaluation of painful syndromes includes interpretation of historical data; review of previous laboratory, imaging, and electrodiagnostic studies; assessment of behavioral, social, occupational, and avocational issues; and interview and examination of the patient by the pain specialist. It may require specialized diagnostic procedures, including central and peripheral neural blockade or monitored drug infusions. The special needs of the pediatric and geriatric populations, and patients’ cultural contexts, are considered when formulating a comprehensive treatment plan.

The pain physician serves as a consultant to other physicians but is often the principal treating physician and may provide care at various levels, such as direct treatment, prescribing medication, prescribing rehabilitative services, performing interventional procedures, directing a multidisciplinary team, coordinating care with other health care providers and providing consultative services to public and private agencies pursuant to optimal health care delivery to the patient suffering from pain. The pain physician may work in a variety of settings and is competent to treat the entire range of pain conditions in all age groups.