Brigham, BID , MGH Pain Fellowship, Cornell

[SleepIsGood]

Also any Pros/Cons on these programs?

Updated info would be great aside from what's on the Fellowships thread.

Thanks

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[Tenesma]

in order of excellence
1) brigham and BID are tied 2) MGH slowly losing to Cornell...

 

[morpheus md]

in order of excellence
1) brigham and BID are tied 2) MGH slowly losing to Cornell...

Really? Shed some light on this for me, I thought that things were peachy with Rathmell at MGH, and that BID has few implant and high end procedures? Maybe my info is dated...

 

[mid|ine]

I would say things are very "peachy" at MGH. We are not the busiest with OR cases, but get plenty. There is plenty of bread & butter of course. Depends on what people want. We only do pumps in CA pts at MGH. I'm actually very happy to be doing minimal pumps. We also have quite a few research protocols ongoing at MGH, so you are exposed to future therapies. Having Rathmell is fantastic as well. I think 4 of the attendings have OR privileges and there is block time.

BWH program has the most surgical interventions. They also Rx the most opioids and have the most pump pts. The fellows also cover all the PCA's in the hospital, so call is brutal.

I don't know how many surgical cases are done at the BI. When I interviewed the impression I got was not many. I have heard that numbers have picked up.

 

[nvrsumr]

As a former fellow I am biased toward BWH.

If you cant choose between them there are a couple combined spots where you do a three month rotation at the other hospital plus a peds month.

The fellows I know who rotated at BI liked their experience alot. Solid number of bread and butter spine procedures with a by the book ISIS technique.

I have heard that MGH is no longer doing implants and BI hasnt for several years so BWH implant numbers should go even higher. BWH fellows are already doing around 50 each(stims and pumps). You will develop solid surgical skills on very complicated cases.

Other good things about BWH: in office US guided procedures, kyphoplasties(limited number), EMG guided botox with a pain and EMG boarded neurologist on staff, psychopharmacology training with a pain boarded psychiatrist who also does implants, 2 pain psychologists, lots of research, clinics at the Dana Farber, rounding with pain and palliative care, lots of spine procedures, lots of non spine pain procedures, varied methods of performing the same procedure by the 8-10 different attendings, lots of opportunity to moonlight, at least one nonanesthesiologist fellow, tons of lectures, lots of good dinners!

As a physiatrist they even let me have friday afternoons to do EDX studies at the clinic and bought me a new EMG machine.

Possible cons-you will become comfortable prescribing narcotics, with the high number of implants the home call is busy, they take alot of their own as fellows and staff.

Feel free to PM me with more questions.

Above is what I wrote in the fellowship thread. Sounds like my info on MGH regarding implants is incorrect.

 

[mid|ine]

FALSE I have heard that MGH is no longer doing implants and BI hasnt for several years so BWH implant numbers should go even higher. FALSE

I don't know why people continue to spread this FALSE rumor. We (MGH) have 6 OR cases scheduled for next week.

 

[nvrsumr]

I mentioned in my post that my info was incorrect. Ill have to defer to you since you are presently a fellow. As to why.... maybe you can answer that? My understanding was that not doing implants wasnt by choice. Im glad it has been worked out in the program's favor.

 

[mid|ine]

My understanding is that there was a threat from the OR that they were loosing money and wanted to cut the service. Something to do with 2 different budgets, 1 was paid for the service and made money, 1 paid for the leads and lost money. The budget that was loosing money wanted to cut the service. We are only implanting St Jude stims now, so I don't know if other reps are saying we aren't implanting...

 

[drpainfree]

cornell program is weak. u have celebrity patient who demands no one touch them except the best ATTENDING. u have minimum number of stims or pumps, but you'll see a lot of cancer patients, and demanding patients. the director of program covers acute pain putting in preop thoracic epidural. it gives you an idea how "busy" they are in chronic interventional pain.

 

[Jeff05]

the cornell program is now the tri-institute fellowship.

sloan-kettering - 3-4 months here. acute is managed by attending with NPs. fellows may place some thoracic epidurals to help out a rotating ca3. few procedures here.

however 3-4 months at cornell and 3-4 months at hss give you enough b and b procedures. here patients are consumers of healthcare, are well educated and so are demanding. this is not your big city hospital where no one speaks english and you can do whatever you want.

i think qualifying the program as weak is an overstatement. it is an average program (with a stellar name) which is improving. significantly better than other programs in the area (columbia, sinai, etc). st. luke's roosevelt gets more procedures, but without the name recognition (by patients).

cornell program is weak. u have celebrity patient who demands no one touch them except the best ATTENDING. u have minimum number of stims or pumps, but you'll see a lot of cancer patients, and demanding patients. the director of program covers acute pain putting in preop thoracic epidural. it gives you an idea how "busy" they are in chronic interventional pain.

 

[Tenesma]

i agree with name recognition re: cornell --- and those that have graduated from their combined program are well balanced pain docs.... and best of the NYC programs in general...

i don't know about MGH in the last few years --- i know what it used to be like (prior to the change in staff/administration) when i thought it was pretty great...

i also agree with the point re: pumps --- putting in a pump is a joke - once you have done 3 or 4 you can do hundreds of them especially if you do a bunch of scs and are efficient with pockets and tunneling...

the ONLY problem with low pump volume is that you are not going to necessarily get the exposure to pump management with the different devices (ie: codman vs medtronic) nor will you gain much exposure with pump interrogation and trouble shooting (ie: is it motor failure vs catheter tear vs kink, etc....)

then again, if pumps are used primarily for cancer patients they usually die before you start running into mechanical issues...

 

[Rhizo]

I was at MGH for the transition. There was a bit of a shake-up, but much of it was moving in the right direction. I really wish we had been able to participate in more clinical trials when I was a fellow. It might have changed my direction. I thought Jim was an excellent teacher, and I wish I had gotten more opportunity to work with him.

It's funny, at the time I thought staying at MGH might have been a mistake compared to Brigham or BI. Now I think the major difference is the pump volume at BWH, and since I don't do them, I don't care. I'm doing plenty of bread and butter procedures, I have respect for the literature and the evidence, I implant my own stims and do vertebroplasty. I was nervous at first but in the end I feel like I was well prepared.

 

[Number 13]

Long time lurker first time poster. I can't begin to tell you how helpful everyone's input has been on other thread. I have been following the posts for almost 2 years and I am finally at the point of applying and waiting for interviews.

I recently sent off all of my applications and just received my first interview offer at Cornell. 😀 This is definately in my top choices and there were a few others I was hoping to hear from as well (BID, BWH, MGH, MD Anderson, CC, and Hopkins). Just as an impression or basis of comparison, if one receives an interview at Cornell, is it too far off base to think that they might be on par to get an interview offer from the any of the above listed places ...or are those places in such a different league that it's comparing apples and oranges 😳. Just getting early application jitters and looking for a little insight on what to expect.

Thanks again everyone for your input and keep up the advice!!!

 

[TheAssMan]

Long time lurker first time poster. I can't begin to tell you how helpful everyone's input has been on other thread. I have been following the posts for almost 2 years and I am finally at the point of applying and waiting for interviews.

I recently sent off all of my applications and just received my first interview offer at Cornell. 😀 This is definately in my top choices and there were a few others I was hoping to hear from as well (BID, BWH, MGH, MD Anderson, CC, and Hopkins). Just as an impression or basis of comparison, if one receives an interview at Cornell, is it too far off base to think that they might be on par to get an interview offer from the any of the above listed places ...or are those places in such a different league that it's comparing apples and oranges 😳. Just getting early application jitters and looking for a little insight on what to expect.

Thanks again everyone for your input and keep up the advice!!!

As the man who granted you the interview (and no I do not know who you are, nor is it my concern to find out-life is short), I am unsure. I do know that what we look for is likelihood that you will be accepted before offering interviews. We know you guys spend money and time to come here and we do not wish for you to waste those things. The initial batch was over 120 apps, of which 40 interview offers were sent (we have at best 60 interviews). Will go through more this week.

But, given that you were selected, you had to be strong. Each program looks for different things so we can not be prognostic of another, nor they of us. In many cases, multiple individuals from a single strong program applied to us, but only 1 might be given an interview (or all). What we look for: 1) reasons to choose pain (beside some family member having been in pain), 2) why us 3) what you want to do in the future, 4) level of collegiality.

In short, we want to pick people who will thrive and want to work with us. Our biggest nightmare is a disgruntled fellow. Come to the interview day-it is informative, we are bluntly honest and we will elucidate you as to the misconceptions you have of our (now much changed) program as well as our weaknesses. Take fellow's email addresses, we'll even give you ALL the fellows emails for the last 3 years if you wish to ask questions.

And for those wondering, we do not judge you based on these posts (I mean what kind of program are we creating if we did). We judge you on what people who know you say about you, what you write, how we click, etc. I look at these boards just to get an idea of what people are saying about us and am freely admitting I am one of the Attendings at Sloan (VTM)-I'll be giving you the tour.

Couple of things that are wrong:
-->Scut has diminished-lots.
-->Most call is covered by NPs, Residents etc at various hospitals-though there is still some.
-->MSK has many more procedures (still not as much as HSS, but more unique)-in fact Attending of the year (out of 15) for last 2 years was one of the junior MSK attendings.
-->Attendings/NPs do most all acute pain at MSK to minimize fellow exposure to non chronic pain. NPs do majority of call. Fellows have 1/2 to 1 day/wk and get Monday off no matter what.

For more info, look at our administrative website (it is however abridged-more intended to run the fellowship than for interviewees).
http://analgesia.home.att.net/timbo.html

Good luck.

 

[lobelsteve]

As the man who granted you the interview (and no I do not know who you are, nor is it my concern to find out-life is short), I am unsure. I do know that what we look for is likelihood that you will be accepted before offering interviews. We know you guys spend money and time to come here and we do not wish for you to waste those things. The initial batch was over 120 apps, of which 40 interview offers were sent (we have at best 60 interviews). Will go through more this week.

But, given that you were selected, you had to be strong. Each program looks for different things so we can not be prognostic of another, nor they of us. In many cases, multiple individuals from a single strong program applied to us, but only 1 might be given an interview (or all). What we look for: 1) reasons to choose pain (beside some family member having been in pain), 2) why us 3) what you want to do in the future, 4) level of collegiality.

In short, we want to pick people who will thrive and want to work with us. Our biggest nightmare is a disgruntled fellow. Come to the interview day-it is informative, we are bluntly honest and we will elucidate you as to the misconceptions you have of our (now much changed) program as well as our weaknesses. Take fellow's email addresses, we'll even give you ALL the fellows emails for the last 3 years if you wish to ask questions.

And for those wondering, we do not judge you based on these posts (I mean what kind of program are we creating if we did). We judge you on what people who know you say about you, what you write, how we click, etc. I look at these boards just to get an idea of what people are saying about us and am freely admitting I am one of the Attendings at Sloan (VTM)-I'll be giving you the tour.

Couple of things that are wrong:
-->Scut has diminished-lots.
-->Most call is covered by NPs, Residents etc at various hospitals-though there is still some.
-->MSK has many more procedures (still not as much as HSS, but more unique)-in fact Attending of the year (out of 15) for last 2 years was one of the junior MSK attendings.
-->Attendings/NPs do most all acute pain at MSK to minimize fellow exposure to non chronic pain. NPs do majority of call. Fellows have 1/2 to 1 day/wk and get Monday off no matter what.

For more info, look at our administrative website (it is however abridged-more intended to run the fellowship than for interviewees).
http://analgesia.home.att.net/timbo.html

Good luck.

I've recently met some of the current and former staff for BI and MGH. Both were super guys, easy to talk to, attentive listeners, and knew their stuff. Plus, the link you posted is amazing. Pain fellow admin has come a long way, and this site has good clinical info, automated procedure log, etc. Bookmarked.

 

[SleepIsGood]

Long time lurker first time poster. I can't begin to tell you how helpful everyone's input has been on other thread. I have been following the posts for almost 2 years and I am finally at the point of applying and waiting for interviews.

I recently sent off all of my applications and just received my first interview offer at Cornell. 😀 This is definately in my top choices and there were a few others I was hoping to hear from as well (BID, BWH, MGH, MD Anderson, CC, and Hopkins). Just as an impression or basis of comparison, if one receives an interview at Cornell, is it too far off base to think that they might be on par to get an interview offer from the any of the above listed places ...or are those places in such a different league that it's comparing apples and oranges 😳. Just getting early application jitters and looking for a little insight on what to expect.

Thanks again everyone for your input and keep up the advice!!!

Hey man, congrats on your interview at Cornell ! Just from reading the post from the previous poster it looks like they have something that they look at.

I can tell you that I got rejected from Cornell, but got interviews at some of the other places you mentioned. So go figure....

Congrats and good luck!

 

[Number 13]

Well I can honestly say thank you for the interview and I am VERY excited!!! Thanks for your input too...

 

[Dhanwanthari]

What's new at these great programs?

Who's doing CT guided procedures? +/- IR staffing?

How were this past year's fellows' experience in the OR?

 

[oreosandsake]

bump



I would like to contact a recent BID graduate, and would really appreciate it if you could send me a message.

thanks 🙂