Pain Fellowship Reviews

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Thoughts on Michigan and BIDMC?
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One more thing about Montefiore: remember that it’s in NYC. And it’s 2020 NYC that it’s in, not 2019 NYC. Very big difference...
 
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Peterluger said:
One more thing about Montefiore: remember that it’s in NYC. And it’s 2020 NYC that it’s in, not 2019 NYC. Very big difference...
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Have the NY programs not recovered in volume? Seems like the covid situation is much better there than in other places
 
procedure volume is one thing. It’s down because many have left the city, and others fear coming into the city for medical care. Murder volume has increased by 35% thus far this year. And what I mean by NYC not being the NYC of 2019...just visit and see for yourself. Tell me if it seems like a reasonable and safe place to live today compared to last year, and if its really worth it to you
 
Montefiore is in The Bronx. It would be easier for you to live in the suburbs and commute into The Bronx for your rotations.
City (Manhattan) is getting busier and I expect it to get busier with school opening- Granted things are not back to normal, it's still a good/safe place to live (best time to invest in apartments if you have the finances to do so). Safety wise- certain areas will always be safer than other areas and specifically for Montefiore, you'll be driving into work so safety is less of a factor imo as supposed to commuting via mass transit.
 
nynydoc said:
Montefiore is in The Bronx. It would be easier for you to live in the suburbs and commute into The Bronx for your rotations.
City (Manhattan) is getting busier and I expect it to get busier with school opening- Granted things are not back to normal, it's still a good/safe place to live (best time to invest in apartments if you have the finances to do so). Safety wise- certain areas will always be safer than other areas and specifically for Montefiore, you'll be driving into work so safety is less of a factor imo as supposed to commuting via mass transit.
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Have you asked yourself WHY those apartments are down in value now? And if anything, the possible surge in COVID with schools opening will decrease procedural volume even further from how ABSURDLY low procedure volume is now. And even if there is no second covid surge for NYC, no one doubts that elective surgical volume, especially pain, will continue to remain down until at LEAST 2022
 
Peterluger said:
Montefiore is a PM&R-department-based fellowship, if that matters to you
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Evene though they are PM&R, it sounds like they are not a lot of things PM&R about that program. Any thoughts on Louisville?
 
I was primarily looking for programs with strong OR/advanced case exposure, so my impressions were largely impacted by this. Also regional preferences. Congrats to all who matched this year and good luck to those in the coming year!

Dartmouth-Hitchcock
Overall: Excellent program with strong interventional focus and solid advanced procedure numbers.
Pros: ~40 SCS (perms + trials), ~5 IT pumps, procedure suite 3-4 days/week & clinic 1-2 days/week, no acute pain call, little scut work, very collegial faculty, strong name.
Cons: IR does vertebral augmentation cases, fairly remote location
Fellows: 4
Interviewed ~45

Ohio State University
Overall: I knew little about this program prior to my interview but was super impressed. Very strong neuromodulation program.
Pros: PD felt like they were top 5% for interventional volume and top 2% for neuromodulation volume. 60-80 perm SCS implants. Some exposure to IS spacers, SIJ fusion, kyphos (don't recall exact numbers), young and collegial faculty.
Cons: Potentially location?, less name recognition
Fellows: 2
Interviewed ~20

UVA
Overall: Very complete and well rounded program.
Pros: Broad advanced case exposure (SCS, IT pumps, kyphos, MILD, PNS, maybe adding vertiflex), strong educational focus and emphasize appropriate clinical workup alongside procedural skills, more IT pump cases than many programs which is helpful for surgical skills, super collegial faculty, strong name, Charlottesville is a cool city
Cons: Not as many SCS cases
Fellows: 6
Interviewed ~55

Colorado
Overall: Unique program, essentially a sports fellowship with bread and butter spine. (PM&R)
Pros: Call is sports coverage (Denver U & U of Colorado), great ultrasound training, great location, collegial faculty
Cons: Essentially only bread & butter fluoro cases
Fellows: 1 PM&R, 2 anesthesia
Interviewed ~10 for PM&R

Mayo Clinic, Jacksonville
Overall: Excellent program with great interventional exposure.
Pros: Education >> service, ~30 SCS implants, ~6 IT pumps, ~40 PNS implants, some regenerative injections, kyphos done with IR but can go in on these cases, faculty seemed flexible to tailor to fellows interest, several cadaver courses at Mayo, Rochester, strong name and network through Mayo, next to the beach
Cons:
Fellows: Increased to 2 this year. Planning to increase to 3 the following year
Interviewed ~12

Vanderbilt
Overall: Great program with strong advanced case exposure.
Pros: 40-50 SCS (perms + trials), some DRG & Kyphos (don't know numbers), small number of IT pumps, some vertiflex, collegial faculty, strong educational focus, strong name, Nashville is a cool city
Cons: No MILD or regenerative inj
Fellows: 4
Interviewed ~24

NYP/Columbia
Overall: Well rounded and broad exposure, less advanced cases.
Pros: PD seemed strongly invested in fellows education, broad exposure 15-20 SCS trials & 10 perms, some DRG, some vertiflex, pretty strong name
Cons: More inpatient than most, very limited kyphos, no IT pumps +/-, no PNS, location +/-
Fellows: 3
Interviewed ~30

LSU
Overall: Good program. They take almost exclusively PM&R/LSU natives
Pros: More vertiflex than most programs, SCS numbers seemed solid (didn't provide numbers), collegial faculty
Cons: Less name recognition
Fellows: 5
Interviewed ~40

University of Washington
Overall: Not an interventional focused program.
Pros: Strong academic medicine name, good location
Cons: Seemed very limited as far as interventions, information conveyed during the interview was limited regarding specifics
Fellows: 5
Interviewed ~35


**Feel free to DM with any questions
 
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Propofool123 said:
Thoughts on Michigan and BIDMC?
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I trained at BIDMC a few years ago. IMHO the best pain fellowship out there. high marks on didactics, high marks on procedures, including advanced techniques for bread and butter as well as less common procedures. I also did a portion of my fellowship at BWH. Both are great and have different strengths weaknesses but would pick BIDMC.
 
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does anyone have updated reviews/impressions on the following programs:
Columbia
Mt Sinai
Cedars Sinai
Cleveland Clinic
Kansas
NYU
Montefiore
 
GandalfTheWhite said:
does anyone have updated reviews/impressions on the following programs:
Columbia
Mt Sinai
Cedars Sinai
Cleveland Clinic
Kansas
NYU
Montefiore
Click to expand...
Columbia: faculty were odd, fellows were somewhat odd as well. One fellow kept talking about how columbia’s name “opened doors” for him, but the job he got was somewhere in the woods. So I’m not sure what he meant by that. LOL.

Sinai: you have to be able to tolerate the culture at Sinai in general, but its probably about average nationally as a program. Bread and butter procedures, split amongst 8 fellows (although i haven’t heard that bread and butter numbers are necessarily a problem there).

Cedars-Sinai: IMG friendly, but not a particularly strong fellowship, especially in a state with Stanford, UCSD, UCSF, UCLA etc. Will deal with arrogant, entitled patients who won’t let you touch them. Forced anesthesia OR trauma call. You have 1 year to learn Pain, which is a very short period of time. don’t spend it dealing with entitled idiots and forced anesthesia OR work (even if in-house call is not often, it still detracts from your ability to learn Pain, as in-house call has indirect effects like fatigue etc). This is all aside from dealing with LA quality of life issues.

Cleveland Clinic: what can I say? This is where all the innovations in Pain happen. This place has been at the forefront of chronic and acute pain for decades. Probably a top 3 program.

NYU: asked one the fellows what they like about their program the most, they said “we don’t work much”. And that was it. LMFAO. Nothing else. Although the fellows didn’t seem unhappy. Maybe it’s because they were the type of people to be happy doing less work. NYU are known for often taking not the best applicants, and the tough part about the local politics is that its overshadowed by some of the other places in NYC in terms of prestige, and by local I mean literally blocks away (except for Sinai, because while Sinai might be a better program, most laypeople outside of NYC don’t know who or what a Mount Sinai is, NYU would be more recognizable than Sinai in that sense, if you’re planning on leaving the tristate area).

montefiore: good program, the PD will have your back, great exposure. It’s based out of the PM&R dept for what its worth. But it’s better than most other places in NYC.
 
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Any updated reviews on Maryland, Vermont, and Syracuse?

I think my number one choice is Northwell but having difficulty ranking 2-6 among Rush, Maryland, Vermont, Syracuse and NYU.

Any feedback much appreciated. TIA
 
PA3587 said:
Any updated reviews on Maryland, Vermont, and Syracuse?

I think my number one choice is Northwell but having difficulty ranking 2-6 among Rush, Maryland, Vermont, Syracuse and NYU.

Any feedback much appreciated. TIA
Click to expand...

Vermont is a hot mess. From what I know, they've had a lot of turnover and internal strife over the last few years, which resulted in an unstable fellowship with subpar exposure. Their reputation in the community also sucks, and patients prefer to travel further to go to other institutions. Given the others on your list, I wouldn't rank them very highly. Rush is a very solid choice - if you can stomach another year of hard work, you will have spectacular numbers and good surgical training.
 
Anyone have any information on programs in Texas? Particularly UTSW
 
Can anyone give anymore info on Washington university in St. Louis, MO?
I'd also love any info on Oklahoma, Loyola, and medical college of Georgia, it's all hard to find and they're all tiny programs.
 
Loyola has a poor reputation in Chicago - it was one of the few places my PD specifically told me not to bother with, citing a ton of turnover and quality of education and experience that's really suffered as a result. Who knows, maybe things changed drastically in the last 1.5 years... but I sincerely doubt it. The name doesn't necessarily hurt, but unless they really wow you during the interview I would rank them lower.
 
chromuffin said:
Anyone have any information on programs in Texas? Particularly UTSW
Click to expand...
Can't comment on UTSW but here is a review of the program I graduated from in Texas:

I have been a long time lurker on SDN and used information found here to help me during my
pain fellowship interview process. I know that during each interview cycle there is a lot
of discussion about the best fellowship programs in the country and I am most certain
that Baylor Scott and White deserves to be in that conversation. Being that I graduated
4 months ago, I can give a very up to date review.

The program was established in 2012 but came out the gates as a well-oiled running
machine. It is located in Temple, Texas. Temple is a small town, however, it is
approximately 45 minutes north of Austin and 30 minutes south of Waco (town of Chip
and Joanna Gaines). Temple was a great place for my family. There is no traffic and the
communities are incredibly safe. There are multiple nice homes and apartments close to
the hospital. My drive to the Temple pain clinic was about 7 minutes. There are several
parks and playgrounds to explore including splash pads and water parks. There are 2
lakes very close by which offer excellent opportunities for fishing. Additionally, I found
that the community there was very close as most people there work at the hospital or
are in the military. Although the city's population is only about 75,000, the hospital is still
a busy fully staffed multi-specialty academic Level I trauma center hospital and it serves
an enormous portion of central Texas. Baylor Scott & White is the largest non-profit
healthcare system in Texas, so you can imagine that there will be plenty of patient
volume at this fellowship. However, you will not feel overworked here and you are not
treated as a scut monkey. Ancillary staff and residents/students respect you as a fellow
and understand you have completed a residency already. Two of the former fellows
have even completed two residencies.

The Temple pain clinic is busy in itself, and the amazing thing is that many of the
patients are seen that day and their procedure is done immediately that same day also.
What better way to learn then see the patient, do the H&P, and immediately inject
the patient afterwards? Also there are several external Baylor Scott & White pain clinics
in surrounding cities that send in many of the more advanced or rarer procedures for the
fellows to do (SCS trials/implants, vertebroplasty, celiac plexus blocks, trigeminal
blocks, etc). As stated earlier, you will not feel overworked here and you will flourish on
the camaraderie and teamwork approach while in a very enjoyable, educational
environment. There are also NPs and anesthesia residents who will help see the clinic
patients, but they do NOT do the procedures unless the fellow does not want to do it.
Then the residents or attending get to do the procedure. NPs do not do any procedures
and setup patients for procedures and/or do medication management. Every procedure
is attending-supervised with the staff being in the room while you are driving the needle
and doing the entire injection. You are not just thrown in. The majority of procedures are
done standard under fluoroscopy, and the remaining are done by ultrasound or
anatomic landmark guidance.

Regarding the program itself, they take 2 fellows per academic year (July-June). It is a
highly competitive selection process, and to date, the program has taken their top two
candidates every single year. They only interview one day per year. Here are some of
the other major highlights to the program:


1. Procedural volume is second to none. On a year when we were still dealing with the
effects of COVID-19, my co-fellow and I performed over 90 spinal cord stimulator cases
(including trials and implants). Both you and your co-fellow are scrubbed into each case
even when on off-service rotations. We also performed over 10 vertebroplasties. Prior to
COVID, the average number of SCS cases for the fellows were ~100-125/year and ~25
vertebroplasties/year. During my year, we were able to get hospital approval and
privileges to perform MILD, vertiflex, and Intracept. I got to do about 3-4 MILDs but
unfortunately no vertiflex or Intracept. However, the current fellows have already done
some Vertiflex. Overall, I would describe this program as highly interventional with high
volume. On average, there were approximately 30-40 procedures to be completed per
clinic day. You will be very VERY comfortable performing ESIs, MBB/RFAs, major joint
injections, sympathetic blocks, and all other bread and butter procedures. Intrathecal
pumps are implanted by the chair of Neurosurgery, and he is incredibly kind and will
notify the fellows in advance and we scrub in with him in the OR. Pumps are managed
later by an outside private group of pain physicians. As with all pain fellowships, we do
learn medical management as well. However, the clinic and procedural-mindset is much
geared towards a private practice setting with more focus on interventions and less
focus on medical management.

2. Lifestyle is phenomenal. Clinic starts at 7am and ends (on average) before 4pm each
day. Fridays are usually half days so you get to start the weekend off early. NO CALL.
Yes, no call. There is no inpatient chronic pain service. If there is a surgical
complication, the on-call anesthesiology resident will be the first notified and then they
would reach out to us, fellows. I would then discuss with the resident the plan. Over the
course of a full year this happened approximately twice. You do not work weekends or
holidays. Years ago, there was a regular opportunity to work one half day on Saturday
per month but you would get moonlighting pay during this. That only happened once my
year. Moonlighting opportunities are excellent and 100% optional as an in-house
anesthesia staff at the ambulatory surgical center (ASC). The pain clinic is actually
housed in the same building as the ASC and physically about 50 feet from the ASC.
The ORs that you staff are with senior anesthesia residents or seasoned CRNAs. So
basically you are completing your pain charts after clinic ends while getting paid as
anesthesia staff.

3. Culture at BSW is great. This was one of the biggest reasons I ranked it #1. I have
been in Florida all my life including medical school and Anesthesiology residency, but I
still wanted to be here. The night before the interview, all the applicants are welcomed
to a relaxed and unpressured dinner at the PD’s home. Incredibly, one (if not both) of
the fellows from every prior year come back to meet the applicants. It felt like a
family. The dedication and care that the prior fellows have for the program is unlike any
other fellowship out there. The culture in the clinic is great too. The NPs, nurses, and
techs make the work there a lot of fun. Tons of smiling and teamwork, but serious
education and treatment during times of patient care.
4. Rotations: the majority of the fellowship is spent at the Temple Clinic. However, we
do rotate at both the Waco and Killeen pain clinics for one month each. They each run
differently with their own pain attendings which is a great learning opportunity. They are
all run like a private practice. Very efficient and things move pretty quickly. On average
close to 100 patients will move through the clinic in a day.

5. Faculty are incredible. The Temple pain clinic is staffed by Dr. Chris Burnett, the PD,
and Dr. Rodney Lange. They are great to work with and very happy to teach. They are
very down to earth and caring attendings who strive for excellent patient care. There are
no malignant staff within the program or peripheral clinics.

I would say one weaknesses of the program are there is not a ton of research
opportunities. However, if you want to do research, the staff is more than happy to
support you and give you the time to do it. A prior pain fellow was able to get a paper
published in the international journal Neuromodulation. The other weakness would be a
decrease in variety of surgical procedures. For instance, they do not do SI fusions or
endoscopic decompression. However, with the amount of surgical volume you do with
other procedures helps you feel significantly more comfortable learning new techniques.
My co-fellow and I have already started doing other surgical procedures that we did not
do in fellowship without any issues.

Overall, this is a top-notch program with excellent procedural experience and superb
work-life balance. There are other programs known for their procedural volume but the
work-life balance does not compare to BSW. I would go there again for training without
a doubt. I feel that I learned in 12 months here what it would take 2-5 years of fellowship
elsewhere. 4 months out, I feel very comfortable evaluating patients and performing all
types of procedures.

Here is a list of the prior Anesthesiology residencies from which the two fellows came
from. No preference is given to internal applicants. Fellows are chosen based upon their
application, merit, and desire to become the best pain physician possible.
2012-2013 Both from Baylor Scott & White
2013-2014 Both from Baylor Scott & White
2014-2015 University of Texas Medical Branch (Galveston), Baylor Scott & White
2015-2016 University of Oklahoma, Baylor Scott & White
2016-2017 University of Alabama at Birmingham, Baylor Scott & White
2017-2018 University of Alabama at Birmingham, Baylor Scott & White
2018-2019 University of Kentucky, Baylor Scott & White
2019-2020 University of Alabama at Birmingham, Baylor Scott & White
2020-2021 University of Florida, University of Mississippi
2021-2022 University of Oklahoma, Baylor Scott & White
2022-2023 Baylor College of Medicine, Mount Sinai Icahn School of Medicine
 
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I remember hearing that the Baylor Scott and White pain fellowship is no more. Is that not the case? I interviewed there and had a favorable impression of the program, as well. I know one of the previous Fellows and they only had great things to say.
 
Gnarvin said:
I remember hearing that the Baylor Scott and White pain fellowship is no more. Is that not the case? I interviewed there and had a favorable impression of the program, as well. I know one of the previous Fellows and they only had great things to say.
Click to expand...
The program has been running and fully accredited since it started in 2012. Still only takes 2 fellows per year, so lots of procedural experience.
 
GandalfTheWhite said:
does anyone have updated reviews/impressions on the following programs:
Columbia
Mt Sinai
Cedars Sinai
Cleveland Clinic
Kansas
NYU
Montefiore
Click to expand...

Montefiore Medical Center (2020-2021 graduated fellow)

  • Sites:
    • Montefiore Hutchinson Campus (Pain Clinic and Spine Center) for 10 months (5 blocks). I believe the facilities were built around 2016. Ample clinic space and 3 fluoro suites, although we are currently using 2 due to the pandemic.
    • Jacobi/North Central Bronx Hospitals for 2 months (1 block)
    • Moses Hospital (~8 days total for Palliative Care clinic, 2 weeks for addiction/psych consults)
    • Headache Clinic at the Hutchinson Campus (1 week)
  • Rotations: Split into 6 two-month blocks
    • Dr. Wahezi (3 days clinic with one day at the Spine center, 2 fluoro procedure days)
    • Dr. Vydyanathan (3 days clinic with one day at the Spine center, 2 procedure days)
    • Anesthesia Faculty (On average, 3 days clinic, 2 procedure days)
    • PM&R Faculty (On average, 3 days clinic, 2 procedure days)
    • Jacobi/NCB Block
      • Typically 2.5 days of inpatient acute pain consults at Jacobi, primarily medication/PCA management as well and epidurals/blocks. This is when you learn a lot more about opioid management as we do not prescribe opioids in clinic.
      • 2.5 days at Jacobi and NCB hospitals doing PM&R clinic (Mix of pain and sports medicine and procedures). There are some fluoro days but the volume is significantly less.
  • Clinic Schedule: Most clinics usually run from 8am-4/5pm. Clinic volume varies, between 25-35 patients which are shared between you and the attending.
  • Procedures:
    • Ultrasound: Typically done in clinic - shoulders, knees, TAP blocks, etc.
    • Fluoroscopy: Fair mix of bread and butter procedures including interlaminar/transforaminal ESI's, medial branch blocks/RFA's, sympathetic blocks, genicular nerve blocks, hips, SI's,etc. - Not as many cervical procedures as I wanted but still felt comfortable out of fellowship
    • SCS trial numbers vary depending on the rotation, some fellows get more than others depending on the luck of the draw. Ranging from 10-15 trials in a COVID year. I honestly feel it's not about the volume but the way you learn how to troubleshoot a procedure. The last couple of stims I performed independently so I felt comfortable doing them. Implants are performed by neurosurgery/IR.
    • Good amount of tenotomy (TENEX) procedures during your Wahezi block, less so throughout the year
    • Kyphoplasty numbers are not as high, probably single digits
    • Botox for chronic migraines done at the headache clinic
    • We do not do pumps (which I was pretty happy about, makes our calls a lot lighter)
  • Call: Very light! You're on call for one full week every 5 weeks, responsibilities include after-hours outpatient issues. On average I would get 2-5 calls when on call the entire week. There were some weeks I did not get any calls. There are NO consults or pump management.
  • EMR: Epic at all sites
  • Benefits/Vacation:
    • 4 weeks of vacation, 5 personal/sick days, you have the opportunity to attend conferences with educational days
    • Subsidized housing (Need to apply)
    • Educational stipend
  • Research: Mandatory QI project which took me a couple of hours to make. There are several opportunities to be involved with research studies ongoing at Montefiore or book chapters.
  • Location: Most fellows live in either Manhattan (~45min-1hr commute) or the subsidized housing in the Riverdale area or near the Moses Hospital. A car would be very convenient but not mandatory.
  • Overall:
    • I truly enjoyed my time at Montefiore. The faculty, fellows and staff are very supportive and it felt like a family. In my humble opinion I think we're Top 2 in the NYC area if you're hoping to work in an outpatient clinic doing a mix of bread and butter procedures and stims.
    • Most of the faculty are anesthesia trained, the program is under PM&R. Not really sure why this matters.
    • Excellent work-life balance, and Manhattan next door to enjoy
    • The main clinic is virtually opioid-free, and the Acute pain rotation at Jacobi gives you the right amount of experience to feel comfortable prescribing opioids if needed.
  • Cons:
    • If you want to do pumps, inpatient consults/acute pain and manage epidural catheters this is probably not the best program for you
    • The Jacobi rotation can be a little slow at times and the procedural volume is low.
    • Cancer pain/Palliative rotation is primarily medication management. We do some cancer pain procedures (i.e. superior hypogastric plexus blocks) but they're not as common.
 
Hello everyone, I am a current fellow posting a review about my program. This website has been helpful during my application process about 2 years ago. Time to post a review in return

Just my 2 cents: fellowship is only a year, maximize your learning opportunities and resources, make the most of it. Anywhere you go, the amount of knowledge obtain will be dependent on your efforts.

University of Louisville (UofL):
2 fellows (current fellow – 2 anesthesia, last year – PMR and anesthesia) anesthesia-based program

Rotation: 6 months University of Louisville Pain Clinic, 6 months Louisville Veterans Affairs (VA); along with mandatory ACGME rotations
PD: Alexander Bautista (trained at CCF for Pain)

University – mixed schedule: Monday to Friday starts 7 - 7:30ish, will round on inpatient/see consults, usually cancer pain; rounding list is about 2 to 5 patients; consults are quick and relatively simple, the hospital is attached to the pain clinic
Monday usually full clinic day; Tuesday to Friday: mix of Clinic and Procedures;

UofL Procedures – mixture of bread and butter (joints, facets, epidurals, ONB, synvisc, geniculars, etc) along with sympathetic blocks (stellate, celiac, LSB, superior hypogastric, ganglion impar) RFA, peripheral nerve blocks (TAP, brachial plexus, etc).

UofL OR days (2-4 days per month) – SCS trials & implants, ITP opioid/baclofen implants, 1-2/kypho per year

Bonus: second half of the year – rotate with private practice pain doc on Fridays for OR cases

VA: 6 months per year: 8am to 4pm mainly do procedures: currently with 2 pain docs, will do approximately 9 to 14 BnB (facets, joints, epidurals, RFA, etc) procedures per day

Calls: UofL share pager/evoice call with resident; so about 2-3 weeks/per month on your UofL month, usually home phone calls, rarely have to come in on weekends (I haven't come in yet this year).

Pros: Dr. Bautista is a great PD; very focused on improving the program and maximizing education opportunities; my co-fellow and I have been able to attend NANs cadaver courses, along with 2 main company cadaver courses

Didactics - (lecture or JC) approximately once a week with him, and utilizes ASRA APPD/hot topics

Up and coming: also planning to rotate with another private practice pain doc about 2-3x per month during UofL rotation for his OR day to learn more advance procedures such as DRG, spacers, MILD, etc (will keep you guys posted how this has been going as the year progresses); also trying to add PNS in UofL.
-Planning to switch from Cerner to Epic at UofL clinic;
-UofL is also actively expanding their pain services/clinics and hired another pain physician planning to work in the satellite clinics; also actively hiring another pain physician
 
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anyone heard anything about interviews this year? been awfully quiet
 
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people have not posted much reviews on the sheets but on the discord there is discussion
 
RWJ - University Hospital Pain fellowship. Anyone familiar?
 
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