neurology

Discussion in 'Pain Medicine' started by neurosign, Aug 13, 2006.

  1. neurosign

    neurosign Member
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    Hey everyone, can you please provide some information about pain medicine fellowship programs that are known to accept neurology-trained candidates? I have heard pain medicine is becoming a more multi-disciplinary department at the major programs but not sure how actively they are trying to recruit non-anesthesia trained residents. Any insight on level of competetion for neurologists applying to pain med?

    Thanks.
     
  2. PainDr

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    There are no fellowships that are "known to accept" neurologists. It's a difficult situation. Although all ACGME programs are being forced to become more multidisciplinary, many are making the changes very grudgingly. Also as pain becomes more popular, the competition becomes more intense. I was able to get a top fellowship (my first choice), but had a long standing committment to the specialty (pain rotations starting in med school and continuing throughout residency, research, mentors, etc.).

    On the other hand, I have a good friend who was unable to secure a spot, even though she is genuinely interested in the field. She chose to prove her committment by accepting a palliative pain management fellowship, with plans to reapply to interventional programs next year.

    I guess the best advice is to be prepared for criticizm. You'll have to explain why you chose neuro over anesthesia or PM&R. You should apply widely and if you want a top spot, you'll have to be a strong candidate, with hands on experience, good inservice scores, research and mentors willing to provide good LORs. Good luck!
     
  3. lobelsteve

    lobelsteve SDN Lifetime Donor
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    Here are the 4 Neuro -Pain programs listed by Freida:

    Pain Medicine (N)

    Georgia


    Medical College of Georgia Program
    Augusta, Georgia 181-12-21-001


    Louisiana


    Louisiana State University Program
    New Orleans, Louisiana 181-21-12-005


    New York


    Memorial Sloan-Kettering Cancer Center Program
    New York, New York 181-35-31-004


    Ohio


    Cleveland Clinic Foundation Program
    Cleveland, Ohio 181-38-12-003
     
  4. PainDr

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    As of two years ago, of the programs listed above, the only one that was interventional was the Georgia program and they only took one fellow. The other "neuro" programs, if they are interventional, are in their infancy. Maybe things have changed, but I would still recommend applying to anesthesia and PM&R programs.
     
  5. drusso

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    I know a neurologist who recently finished a pain fellowship. Apparently he did very well. Of note, he did a neuromuscular medicine fellowship the year before his pain fellowship. I think that neurology is sort of a "Johnny Come Lately" to the field (in part because I think that the "old guard" neurologists looked down at Pain Medicine as "unscientific"), but I don't see any reason why a qualified neurology applicant with interest, enthusiasm, and experience would not be competitive. It makes perfect sense to me that neurologists should be interested in pain. And, if they aren't putting people in training programs now, neurology may not have a place at the table 20 years from now.

    As for programs changing grudgingly versus enthusiastically, I think programs that have been "slow to evolve" are now having to play catch-up lest they lose their accreditation, and more importantly, miss out on attracting top applicants to their program regardless of specialty of origin.
     
  6. drrinoo

    drrinoo Rinoo Shah, MD
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    The LSUHSC program is an excellent one and it just got accreditation last year.

    The director, singlehandedly, with the assistance of one of the former fellows was able to get accreditation. This is a testament to his commitment. He has made efforts to ensure that his fellows get a well rounded experience, including interventional pain.

    Additionally, LSUHSC has some excellent resources, such as the departments of anesthesiology, pm+r, neurosurgery/neurology, and orthopedics....all of which are world class.
     
  7. drrinoo

    drrinoo Rinoo Shah, MD
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    one other interview tip....with the move towards having a multidisciplinary faculty, (either in the department or as a formalized interdepartmental relationship) as a future requirement for ACGME...you could use this as carrot to secure a spot....as a neurologist, you would be a highly desired candidate if you expressed a committment to stay on as a faculty member....

    throw around.....'I believe interventional pain specialists should treat more headache patients....', 'anesthesiologists should learn about EMGs...with their expertise in the use of neuromuscular blockers and the use of peripheral nerve stimulators...', and 'all pain specialists should be able to do a comprehensive neurological exam', you get the picture
     
  8. bbbmd

    bbbmd Pain Doctor/Physiatrist
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    MD Anderson just got a great neurologist trained in interventions to join the staff. One of the current fellows is a neurologist and is top notched and one of the fellows last year was a neurologist. The program has representation from Anesthesia, PM&R and Neurology and has a pain psychologist on staff. It is such a wonderful learning environment because we share aspects of our different expertise with each other. I think all of the specialties have equally important contributions to pain management. Multidisciplinary training is definitely the way to go!!!
     
  9. paz5559

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    The Cleveland Clinic Neurology Program is a multidiciplinary program that includes rotations with ortho and, rheum, as well as neuro and Santosh Thomas, and interventionist who trained at the Florida Spine Institute in Clearwater. It should be noted this is different from the anesthesia-based CCF program headed up by Nagy Mikhail

    LSU, on the other hand, has three different pain programs, albeit at 2 locations. The only anesthesia pain program is in Shreeveport, not at the mothership in New Orleans. The neurology program is headed up by Harry Gould. There is clearly an interventional component to this program, as a recent graduate now works exclusivily as an interventionist. She works with the MD they farm there interventional component out to, Alan Parr, whose has a palatial office across the lake from New Orleans. Dr. Parr is a board member of ASIPP, but has a reputation for being excessively aggressive procedurally in the New Orleans academic community. LSU's PM&R-based pain program is nominally headed by Dr. Phalen. Prior to Katrina, the fellows worked 1.5d/wk with Dr. Charles Aprill, an extraordinary teacher and a founding member of ISIS, during the 6-8mo they were assigned to Charity Hospital. They also spent 4-6 mo at the VA, where they were nearly autonomous. However, post-Katrina, my information may be ancient history, so I would urge anyone considering any of the three LSU programs to check with the folks in NOLA.
     
  10. drrinoo

    drrinoo Rinoo Shah, MD
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    PAZ,

    Your thoughts on the impetus for having two, instead of just one pain program at LSUHSC and why the PM+R pain program did not get accreditation?

    Also, a correction...SantHosh
     
  11. paz5559

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    LSU PM&R program most certainly IS ACGME accredited

    www.acgme.org
    Program #3412131013

    As for why two LSU programs? Why does Harvard have BID, BWI, MGH, Children's and Spauding? I imagine the answer is politics.

    Thank you for correcting the spelling of Dr. Thomas' first name, btw. I have only met him on one or two occasions at meetings, but he has alwyas struck me as a really good guy.
     

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