What does pain management entail?

[Deuce 007 MD]

I'm just an ignorant premed w/many questions. What exactly do you do in pain management? How can you get there, through gas or pm&r? How long total residency, including prelim & fellowship years? How competitive do you need to be? thanks.

[wundabread]

I'd also like to hear a pain doc (or someone who has worked closely with one) give a run-down of "a week in the life of a pain management doc".

I'm also very interested in what procedures an interventional pain specialist does.

Thanks in advance.

[emdoc21]

Anesthesia and PM&R are both 4 years of residency, including a preliminary year first that may or may not be included in your specialty residency. If it's not included you have to do it elsewhere. Pain management is a 1 year fellowship after anesthesia. I'm not sure what it is after PM&R, but it's probably the same. Anesthesia was more competitive this year that it was for many year, but the degree is subject of much debate. PM&R isn't really competitive, but is a newer field and less well known in some parts of the USA. The competitiveness of fields goes in cycles and anesthesia has been up, down and now up again in the past 10+ years. You're still a few years away, so there's no way to know how it difficult it will be to get into when you're at that point.
Pain management is a multidisciplinary field that is practiced by docs in different fields, but mainly anesthesia, PMR, and Psych. There are a decent amount of procedures and alternative therapies can be involved to varying degrees. There will always be patients who are drug seeking that you will have to deal with. Some (not all) of the patients have significant psychiatric issues. You try to focus on getting people functional (physical therapy and nerve blocks, etc.) not getting rid of their pain, because you won't be able to get rid of pain for many. It is different than the rest of anesthesia because you see patients in an office over a long period of time and they are your patient.

http://www.spinalinjection.com/ISIS/

Check out the above website to read about some of the procedures done in Interventional Pain Management. I think the market for Anesthesiologists right now is such that there are fewer Anesthesia residents pursuing a Pain Fellowship. The fellowships are offered by both Anesthesia and PM&R. The Anesthesia fellowships are open to PM&R and Anesthesia residents. Psychiatrists and Neurologists can do Pain Fellowships as well, but they usually don't do the Interventional procedures. If you want to do purely Pain Management, PM&R is a better option in my opinion. You receive more neuromusculoskeletal training, can do EMGs, and generally get training that's more relevant to Pain Management in general. Here are a few other websites you might want to take a look at:

http://www.spine.org/

http://www.healthsystem.virginia.edu...r/pmrspine.cfm

This link provides a description of the training that this Pain Fellowship will provide:

http://www.painmed.org/career/

How real is the incidince of drug addiction among pain docs? I keep hearing that whenever pain medicine is brought up and you never know if people are joking around or repeating some hearsay.

[painres]

Originally posted by GeneralTso
How real is the incidince of drug addiction among pain docs? I keep hearing that whenever pain medicine is brought up and you never know if people are joking around or repeating some hearsay.

Probably not any higher than anesthesiology in general. Although it does have one of the highest drug addiction rates around.