Generally speaking, a pain management fellowship consists of four to five years of training in various clinical settings. It includes Interventional procedures, inpatient pain services, case conferences, research, and ACGME accreditation.
Research
Whether you are interested in becoming an academic clinician or a community practitioner, a Research into Pain Management Fellowship can significantly enhance your expertise. During the 12 months of the fellowship, you’ll learn about pain management and how to diagnose and treat complex pain disorders. You’ll also be able to participate in ongoing clinical and basic research and publish your findings in peer-reviewed journals.
The fellowship curriculum includes a variety of topics, including cancer pain, pediatric pain management, and interventional pain management. You’ll be able to rotate through many different departments, which will help you gain a wide range of experiences. Some fellowships also include rotations at the VA and in rural communities.
During the fellowship, you’ll learn about peripheral nerve blocks, trigger point injections, suprapatellar and acromioclavicular injections, and more. You’ll also get trained on regional partnerships and perform diagnostic and therapeutic pain management procedures, such as cryoanalgesia, radiofrequency ablation, and vertebroplasty. You’ll also be exposed to various advanced surgical procedures, such as splanchnic nerve block, celiac plexus block, and continuous thoracic epidurals.
In addition to developing procedural skills, fellows will have the opportunity to work with faculty mentors to conduct basic or clinical research. You’ll be able to design your study protocol and publish your findings in a peer-reviewed journal. In addition, you’ll have the chance to present your findings at national and international meetings.
In addition to learning about diagnosis and treatment, you’ll also have the opportunity to learn about the neurobiology of pain perception. You’ll develop strong skills in designing pain research studies.
You’ll also have access to various resources, such as audiovisual equipment and a library. You’ll have ample time for didactic sessions and will have a dedicated faculty mentor.
Interventional procedures
During a pain management fellowship, fellows learn a wide variety of interventional procedures. These include neuromodulation techniques, peripheral nerve stimulation, spinal cord stimulators, implantation of intrathecal pumps, and cryoanalgesia blocks. These are performed under direct faculty supervision.
In addition to training, fellows will participate in research and consultative care of inpatients with chronic pain conditions. They will also present at national and international conferences. They are encouraged to publish their findings in peer-reviewed journals.
The didactic education program for the fellows includes a wide range of topics, including reimbursement issues, the business of pain, and continuing quality improvement. A pain medicine journal club meets monthly to review various influential papers and current research. It is also essential for residents to network with fellow-trained physicians.
The Pain Medicine Fellowship is based at the Mayo Clinic in Rochester, Minnesota. The main campus is about twenty minutes away from satellite sites. The satellites are in OB, obstetrics, orthopedics, cardiology, and cancer. Most procedures are done on the main campus, with fewer complicated cases occurring on satellites.
The fellowship is composed of nine four-week blocks of training. On average, a fellow will participate in approximately 100- to 175-procedures per month. However, the number of cases per month will vary based on the fellowship program.
The program also offers several procedures not included in the primary curriculum, such as spinal cord stimulation and sympathetic neurolysis. These procedures require extensive training and specific equipment. The fellows also perform essential surgical procedures in ambulatory operating rooms.
The fellows are required to participate in a minimum of two weekend days calls per month. During their year of service, they are expected to present a scientific paper at the annual meeting of the American Society of Anesthesiologists.
Inpatient pain service experience
During your inpatient pain service experience at a pain management fellowship, you will be a member of a multidisciplinary team specializing in diagnosing and treating complex pain. The team also provides counseling and therapy to patients suffering from chronic pain.
The fellowship program is designed to develop world-class physicians who are adept practitioners of comprehensive pain medicine. The program emphasizes patient safety and quality improvement. Fellows work directly under the supervision of a pain medicine program director and pain clinic faculty. Some fellowships include rotations at the VA or community settings.
Trainees gain extensive experience treating a variety of complex, neuropathic, and sympathetically mediated pain. They are introduced to interventional analgesic techniques, including peripheral nerve stimulation, discography, vertebral augmentation, and spinal cord stimulator/intrathecal pump implantation. The trainees also learn about pain pathology and how to organize a hospital-based pain service.
The didactic educational program for fellows is based on the IASP curriculum and includes two hours of pain-related topics each week. This consists of an awareness of the cost of various medications, reimbursement issues, and the pain business. In addition, they participate in a continuous quality improvement project.
Pain management fellowships also focus on narcotic infusions and procedures. Some programs offer additional rotations in community or rural settings. The length of time required to complete a pain medicine fellowship varies from one program to another. However, most of the clinical time is spent in an inpatient setting.
APM is a rapidly evolving specialty. Recent efforts have expanded the scope of recovery and postoperative pain control. APM fellows should be familiar with the latest approaches to these areas and should remain on the cutting edge.
ACGME accreditation
Obtaining ACGME accreditation for a pain management fellowship is necessary to develop your career in pain medicine. Before applying, you should familiarize yourself with the program’s curriculum and benefits. It is essential to determine whether the fellowship will provide you with the necessary clinical and didactic training to meet the needs of your patients.
An ACGME-accredited pain management fellowship is a 12-month postgraduate program that provides advanced postgraduate training in interventional pain management. The training involves:
- A comprehensive multidisciplinary didactic curriculum.
- Various interventions to relieve chronic pain.
- Opportunities for both primary and clinical research.
Adult pain fellows treat various conditions, including cancer and nonmalignant pain. They will be exposed to multiple pain procedures, including spinal cord stimulation, intravenous infusions, and neuromodulation. They will also have experience with electrophysiology and imaging interpretation. They will learn how to conduct a complete history and physical examination and perform appropriate physical exams for their patients. They will also learn how to prescribe medications for pain.
Pediatric pain medicine fellows treat children suffering from acute and chronic pain. They will have exposure to fluoroscopy-guided procedures and ultrasound-guided pain management techniques. They will also have access to a complete didactic program, a journal club, and wellness education. They can participate in conferences, presentations, and educational activities.
Three positions are available in the ACGME-accredited Pain Medicine Fellowship at the University of Colorado. They are housed in the Spine Center and Pain Clinic. They interact with other specialties, such as neurology and internal medicine.
Case conferences
During your pain management fellowship, you will attend several case conferences that will help you stay up-to-date on the latest information. These friendly and non-threatening forums will allow you to learn about interdisciplinary care. These conferences will also help you to develop your skills as a teacher.
A typical Case Conference will involve a fellow presenting a case. This may include reviewing imaging and pathology. In addition, the case may be presented in an evidence-based fashion.
Each case is reviewed by a faculty member who modifies the discussion. The case presenter will choose a topic that is interesting to them and will give a short presentation about the clinical course. The presentation’s last 3-5 minutes should be devoted to teaching points and a literature review.
The didactic educational program for your pain management fellowship includes weekly lectures and fluoroscopy case presentations. This educational program will cover various topics, including the basic foundations of pain management, new treatments, and technology within the pain medicine specialty.
A monthly pain medicine journal club also reviews various influential papers and provides a comprehensive background of evidence-based clinical practice. In addition, there are quarterly multidisciplinary patient comfort conferences.
Other didactic educational programs for your pain management fellowship include a contract negotiation month and a month devoted to practice building. In addition, fellows are encouraged to participate in research projects. They will submit a research project and are expected to incorporate peer feedback into their patients’ care.
In addition, you will be required to present a scholarly project at national meetings. If you choose to do so, your presentation will be evaluated based on your communication ability, personal qualities, and academic credentials.
