Many pain patients present with a complex set of symptoms and comorbidities that defy the acumen of any one specific medical specialty; thus the knowledge and skills of the pain physician must, out of necessity cross specialty borders. The competency that comes from mastering essential skills is accomplished during the pain medicine training. The goal of pain medicine training in the United States is to provide the postgraduate trainee with the exposure to multiple disciplines of medicine, as well as multiple interventions, so that upon completion of training, the pain physician will have the necessary skill set to provide competent, appropriate, comprehensive care for the often medically complicated pain patient. In the United States, many training programs are governed by guidelines that have been established by the Accreditation Council for Graduate Medical Education (ACGME).