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anyone willing on chiming in on University of Michigan, UCSD, and Mayo Arizona?
Pain Fellowship Reviews
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I'm at UCSD. I think it's a very strong program, I actually did an anesthesia residency here just to improve my odds of landing this fellowship.
Things are pretty busy but the training is excellent. Procedural volume is very high and every day of the week there are at least 2 and sometimes 3 locations where we are doing procedures every 20 minutes from 8 until 5, divided between 4 fellows. Lots of bread and butter injections and ultrasound-guided procedures. Busy clinic also, with a good referral base that is heavy on patients who are good candidates for interventional procedures, a moderate amount of cancer pain, and not too many patients sent to us on unreasonable amounts of opioids. We limit new Medicaid consultations to 2 per day and at least 1 will typically no-show.
Call is in week-long blocks, q5weeks, covering inpatient chronic pain consultations but not acute pain. Calls at night are rare.
Over the year you should do at least 10 stim implants, a corresponding number of stim trials, perhaps 4-6 pumps. I've also done 6-8 MILD procedures and a couple of laser disc decompressions. Our main kypho/vertebroplasty guy is semi-retired but he will still teach you if you seek out that opportunity.
Lots of research time and support is available if that is your thing. We also do week-long off-site rotations in addiction psychiatry, neuroradiology, PM&R, palliative care, and pediatric pain (mostly acute and cancer pain).
It's hard to compare our training with that of other fellows, but based on what I've seen at the stim workshops, we're better prepared than most in that area.
Our chair has a very multidsciplinary vision, and although the majority of fellows come from anesthesia historically, we have taken from PM&R, interventional radiology, and one internist with fellowship training in hospice. One of my co-fellows is a psychiatrist who is also boarded in child psych and addiction medicine.
Our attendings are universally nice to work with and it is a very pleasant learning environment.
Overall, I have a lot of confidence in my skills and will be opening my own practice in August. Several fellows over the past few years have been very successful going out on their own.
Things are pretty busy but the training is excellent. Procedural volume is very high and every day of the week there are at least 2 and sometimes 3 locations where we are doing procedures every 20 minutes from 8 until 5, divided between 4 fellows. Lots of bread and butter injections and ultrasound-guided procedures. Busy clinic also, with a good referral base that is heavy on patients who are good candidates for interventional procedures, a moderate amount of cancer pain, and not too many patients sent to us on unreasonable amounts of opioids. We limit new Medicaid consultations to 2 per day and at least 1 will typically no-show.
Call is in week-long blocks, q5weeks, covering inpatient chronic pain consultations but not acute pain. Calls at night are rare.
Over the year you should do at least 10 stim implants, a corresponding number of stim trials, perhaps 4-6 pumps. I've also done 6-8 MILD procedures and a couple of laser disc decompressions. Our main kypho/vertebroplasty guy is semi-retired but he will still teach you if you seek out that opportunity.
Lots of research time and support is available if that is your thing. We also do week-long off-site rotations in addiction psychiatry, neuroradiology, PM&R, palliative care, and pediatric pain (mostly acute and cancer pain).
It's hard to compare our training with that of other fellows, but based on what I've seen at the stim workshops, we're better prepared than most in that area.
Our chair has a very multidsciplinary vision, and although the majority of fellows come from anesthesia historically, we have taken from PM&R, interventional radiology, and one internist with fellowship training in hospice. One of my co-fellows is a psychiatrist who is also boarded in child psych and addiction medicine.
Our attendings are universally nice to work with and it is a very pleasant learning environment.
Overall, I have a lot of confidence in my skills and will be opening my own practice in August. Several fellows over the past few years have been very successful going out on their own.
Those are all good programs; don't take this the wrong way since I know nothing about you but these positions are highly competitive especially over the last five years since we now have several more specialties competing for (about) same number of spots. Find at least ten that are where you want to end up practicing and apply there. Any spot in an ACGME accredited pain fellowship is considered desireable now.
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mayo arizona:
typically take residents from within mayo system but last fellow was anes from hopkins ( i was the only one not from mayo on my IV day). solid program. one fellow so there's minimal didactics/teaching but you get to pick which procedures you want to do. 2 fluoro rooms. mostly bread and butter procedures. attendings also do anesthesia and spend maybe 1 day per week in pain clinic. some rotations you have to go to rochester including anatomy course. elective can be done in rochester or jacksonville campus. nice hospital decent clinic. everyone was really nice and laid back. lacks the name of mayo rochester if you want to do academics but definitely good if you want to consider practicing in the phoenix area. pretty much no call. I think fellows take call one week a month and there are no weekend calls. not quite a multidisciplanary fellowship if thats what you are looking for. hope that helps!
typically take residents from within mayo system but last fellow was anes from hopkins ( i was the only one not from mayo on my IV day). solid program. one fellow so there's minimal didactics/teaching but you get to pick which procedures you want to do. 2 fluoro rooms. mostly bread and butter procedures. attendings also do anesthesia and spend maybe 1 day per week in pain clinic. some rotations you have to go to rochester including anatomy course. elective can be done in rochester or jacksonville campus. nice hospital decent clinic. everyone was really nice and laid back. lacks the name of mayo rochester if you want to do academics but definitely good if you want to consider practicing in the phoenix area. pretty much no call. I think fellows take call one week a month and there are no weekend calls. not quite a multidisciplanary fellowship if thats what you are looking for. hope that helps!
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Could you comment on the pain fellowship experience at vandy. Number of stims/pumps. Thanks.
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Hi! Anyone heard of University of Washington Seattle? what is their reputation, procedures, competitiveness? Any specifics for this program for anyone who has trained there?
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interesting to see such bipolar reviews.
FWIW, i spoke with some friends who interviewed here and they impressed by the program. Neither of them ended up going there though...
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I'm currently interviewing for fellowship positions. New to this site. Curious of any reviews/thoughts on OHSU vs CU-Denver vs Wake Forest vs Texas programs? Thanks.
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Everyone I talked to who went to Wake Forest was very impressed. I know it has had a reputation as being one of the best programs for many years. Fellows come out very well-prepared to run a pp or do academics, either way.
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Hi! I heard BID is not PMR friendly. Is that true? Anyone knows if they are IMG friendly ?
Thanks!
Thanks!
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Friendly to neither.
Harvard pain programs will consider IMG only if total rock star. Multiple 1st author papers, top of your class, MD/PhD, etc.
Every US grad wants to go there so they have their pick. If IMG, you need to be a total rock star or don't bother. If PMR IMG, they won't even look at you.
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Any recent updates?
would love to hear about wake forest, UCI, UCD, and UCSD!
thanks!
would love to hear about wake forest, UCI, UCD, and UCSD!
thanks!
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BID has a fellow that is PMR trained and another who is an IMG this year.
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Hi everyone. Wow I've been MIA for a few days/year(s).
CA-2 in anesthesia, applying for pain fellowships currently. Anyone (fellows/recent grads/attendings) have ANY recent info on the following programs? There's hardly any new info being posted and I haven't found many good resources except from attendings of how certain programs "used to be 10 years ago". A lot can change. Feel free to PM me.
UCSF
Stanford
UC-Irvine
UCLA
UCSD
Virginia-Mason
MD Anderson
UTSW
Univ of Chicago
Northwestern
Rush
UIC
Cleveland Clinic
Vanderbilt
BWH
BID
MGH
St. Luke's Roosevelt
Wake Forrest
UNC
Duke
Emory
Mayo-Jax
Thanks!!!
CA-2 in anesthesia, applying for pain fellowships currently. Anyone (fellows/recent grads/attendings) have ANY recent info on the following programs? There's hardly any new info being posted and I haven't found many good resources except from attendings of how certain programs "used to be 10 years ago". A lot can change. Feel free to PM me.
UCSF
Stanford
UC-Irvine
UCLA
UCSD
Virginia-Mason
MD Anderson
UTSW
Univ of Chicago
Northwestern
Rush
UIC
Cleveland Clinic
Vanderbilt
BWH
BID
MGH
St. Luke's Roosevelt
Wake Forrest
UNC
Duke
Emory
Mayo-Jax
Thanks!!!
On the Cleveland Clinic website, it looks like a majority of pain attendings are foreign grads. The rest of them seem to be from middle of the road residencies, and many of them are inbred CC fellowship grads. Reading through a lot of these reviews, it seems like the faculty play a big factor in how a program is viewed. Is this type of attending background similar at the other supposed top programs? And is this something to be concerned about?
Great list. I would be very interested in hearing any recent updates on many of these programs as well.
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I'm a current fellow there....happy to answer any Q's.. no problems that I'm aware of.
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Anesthesia resident who went through the process last year and interviewed at a number of the programs below, though I was geographically restricted to CA and the East Coast. Happy to answer any questions if you PM me. Matched at Stanford for next year, which was my first choice.
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University of Cincinnati Pain Medicine Fellowship:
Overall, a great program that provides vast exposure to all types of chronic pain. For the most part, the fellows rotate in the outpatient setting in both a pseudo-private practice setting as well as inner city pain office.
This fellowship is made up of 3 core fellows and 1 combined adult/pediatric pain fellow (for 2014-2015 there will be 2 fellows).
They rotate weekly at home call that requires them to round on the acute in-patients on the weekends.
Procedures are evenly distributed throughout the week amongst fellows. Typically averages out to about 60-70 interventional procedures a month for each fellow that includes easy bread and butter procedures to more advance procedures such as SCS trials, sympathetic blocks, trigeminal RFAs and etc.
Implants are evenly distributed in monthly intervals in which they have free range on all implants on that given month. Mostly involves SCS implants, SCS revisions, peripheral nerve stimulator trials (i.e. trigeminal) and intrathecal pump implants.
They don’t do vertebral augmentation (i.e. kyphoplasty, vertebroplasty) but some fellows have scrubbed in with the orthopedic surgeons and experienced it firsthand.
One of the assets of the program is the monthly cadaver lab in which the fellows are exposed to multiple different products and procedures (i.e. Dfine, Stryker, Kyphon, TRUfuse, Medtronic, ST Jude, and Boston Scientific).
The attendings (Drs. Sachdeva, Bruns, and Fortman) are easy going and great to work with. There are monthly journal clubs in different restaurants throughout the city that provide a great time to unwind and hangout with coworkers.
Cincinnati Children’s Hospital Medical Center Fellowship:
Overall, provides a vast exposure to all types of chronic pain in both children and adults.
The adult pain rotation is about 6 months in duration and is essentially as described above.
The pediatric pain rotation is about 6 months in duration and is described below.
The 4-week acute pain service rotation is very intense and involves providing peripheral nerve blocks/catheters, epidural catheters and managing PCAs for acute surgical patients. The amount of procedures and cases that are experienced in this rotation is impressive given that CCHMC is the busiest pediatric OR in the US.
The 2-week palliative care rotation allows for a unique experience given the complexity of the patients and the variety of pathologies that they present. Their pain management is complex and provides excellent learning experiences.
Throughout the 6 month rotation, the fellow spends time working in the outpatient pain clinic about 2 days per week. The fellow gets exposure to complex pain patients from around the country. These complexities include EB, CRPS, EDS, migraines, functional abdominal pain, cancer-related pain and etc. Drs. Goldschneider, Rose and Szabova are excellent teachers and have a breadth of knowledge handling these complex cases. The fellow also gets exposed to pain psychologist and physical therapist that are experts in treating these pain conditions.
Interventional experience for chronic pain in the pediatric rotation is limited but procedures include sympathetic blocks, Bier blocks, LESI, MBB, and SI joint injections.
There are also opportunities for a 2-week elective that may be done at outside institutions (i.e. cancer centers) to further enrich the learning experience.
The rest of the time at pediatric rotation is spent rotating in the medical pain service, headache clinic, connective tissue disorder clinic, EB clinic, eczema clinic, rheumatology clinic as well as participating in implants in the adult hospital. The experience that is gained in the clinic allows the fellow to become a well-rounded pain physician.
This coming year (2014-2015), the fellowship will be taking 2 fellows per year.
These descriptors of the fellowship were provided by one of the fellows participating in this fellowship currently.
Overall, a great program that provides vast exposure to all types of chronic pain. For the most part, the fellows rotate in the outpatient setting in both a pseudo-private practice setting as well as inner city pain office.
This fellowship is made up of 3 core fellows and 1 combined adult/pediatric pain fellow (for 2014-2015 there will be 2 fellows).
They rotate weekly at home call that requires them to round on the acute in-patients on the weekends.
Procedures are evenly distributed throughout the week amongst fellows. Typically averages out to about 60-70 interventional procedures a month for each fellow that includes easy bread and butter procedures to more advance procedures such as SCS trials, sympathetic blocks, trigeminal RFAs and etc.
Implants are evenly distributed in monthly intervals in which they have free range on all implants on that given month. Mostly involves SCS implants, SCS revisions, peripheral nerve stimulator trials (i.e. trigeminal) and intrathecal pump implants.
They don’t do vertebral augmentation (i.e. kyphoplasty, vertebroplasty) but some fellows have scrubbed in with the orthopedic surgeons and experienced it firsthand.
One of the assets of the program is the monthly cadaver lab in which the fellows are exposed to multiple different products and procedures (i.e. Dfine, Stryker, Kyphon, TRUfuse, Medtronic, ST Jude, and Boston Scientific).
The attendings (Drs. Sachdeva, Bruns, and Fortman) are easy going and great to work with. There are monthly journal clubs in different restaurants throughout the city that provide a great time to unwind and hangout with coworkers.
Cincinnati Children’s Hospital Medical Center Fellowship:
Overall, provides a vast exposure to all types of chronic pain in both children and adults.
The adult pain rotation is about 6 months in duration and is essentially as described above.
The pediatric pain rotation is about 6 months in duration and is described below.
The 4-week acute pain service rotation is very intense and involves providing peripheral nerve blocks/catheters, epidural catheters and managing PCAs for acute surgical patients. The amount of procedures and cases that are experienced in this rotation is impressive given that CCHMC is the busiest pediatric OR in the US.
The 2-week palliative care rotation allows for a unique experience given the complexity of the patients and the variety of pathologies that they present. Their pain management is complex and provides excellent learning experiences.
Throughout the 6 month rotation, the fellow spends time working in the outpatient pain clinic about 2 days per week. The fellow gets exposure to complex pain patients from around the country. These complexities include EB, CRPS, EDS, migraines, functional abdominal pain, cancer-related pain and etc. Drs. Goldschneider, Rose and Szabova are excellent teachers and have a breadth of knowledge handling these complex cases. The fellow also gets exposed to pain psychologist and physical therapist that are experts in treating these pain conditions.
Interventional experience for chronic pain in the pediatric rotation is limited but procedures include sympathetic blocks, Bier blocks, LESI, MBB, and SI joint injections.
There are also opportunities for a 2-week elective that may be done at outside institutions (i.e. cancer centers) to further enrich the learning experience.
The rest of the time at pediatric rotation is spent rotating in the medical pain service, headache clinic, connective tissue disorder clinic, EB clinic, eczema clinic, rheumatology clinic as well as participating in implants in the adult hospital. The experience that is gained in the clinic allows the fellow to become a well-rounded pain physician.
This coming year (2014-2015), the fellowship will be taking 2 fellows per year.
These descriptors of the fellowship were provided by one of the fellows participating in this fellowship currently.
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V
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A few reviews... may be errors, feel free to correct.
Rush : this is the only place that gave out little faux-leather notebooks (nice touch), so I actually took notes.
Highly interventional, and for that reason one of the more sought after spots in Chicago I think. Historically and anecdotally not PM&R-friendly, but they interviewed me so ostensibly they are open to a PM&R candidate. I was however the only PM&R candidate on my day (with 19 anesthesia candidates). One of the fellows said it would be nice to have a PM&R guy in the mix, because the anesthesia guys all know the same things already. 4 fellows. Rotate through 4 services 1 week at a time (or however the fellows choose to set it up):
1) Oak Park- clinic/procedures, a little mellower rotation (relatively speaking)
2) OR/Procedures- busy, tons of procedures, full range of procedures.
3) Clinic/Call- very busy, take call/consults for acute/chronic pain, round on inpatient pain service (they admit to their own service), work in busy clinic, take call/consults 24/7 for the week. They said you frequently get multiple calls through the night. Overnight call is from home, can manage a lot over the phone but occasionally have to come in. Have an anes resident in house as well. Round sat/sun.
4) Float- outside rotations such as PM&R, psych, neuro, neurosurg or float to clinic/backup for on-call fellow. Call the on-call fellow ~6:30a to see if he needs help. Mellowest.
General start time for rotations ~6:30am, earlier for the call fellow, who may start rounding with residents as early as 5:30 or 6, depending on the census.
Interview was interesting. Panel interview. 5 attendings. Hot seat style. Not threatening or malignant, but not your typical friendly “get to know you” type of interview either. People didn’t seem to like it but I don’t think it was too bad.
These guys work hard. One fellow: “I haven’t worked like this since internship.” Another fellow: “Would I do it again? I don’t have to.” But they’re doing tons of high-end procedures, operating kind of like a surgical service. I asked if they placed permanent pumps, the fellow replied: “I did 3 on Friday.” They do permanent stims too. High procedure volume and complexity. Fellows said they are ready for anything when they’re done and place well for jobs.
For some this may be the Holy Grail of fellowships. For others it may be a nightmare. To each their own.
Rush : this is the only place that gave out little faux-leather notebooks (nice touch), so I actually took notes.
Highly interventional, and for that reason one of the more sought after spots in Chicago I think. Historically and anecdotally not PM&R-friendly, but they interviewed me so ostensibly they are open to a PM&R candidate. I was however the only PM&R candidate on my day (with 19 anesthesia candidates). One of the fellows said it would be nice to have a PM&R guy in the mix, because the anesthesia guys all know the same things already. 4 fellows. Rotate through 4 services 1 week at a time (or however the fellows choose to set it up):
1) Oak Park- clinic/procedures, a little mellower rotation (relatively speaking)
2) OR/Procedures- busy, tons of procedures, full range of procedures.
3) Clinic/Call- very busy, take call/consults for acute/chronic pain, round on inpatient pain service (they admit to their own service), work in busy clinic, take call/consults 24/7 for the week. They said you frequently get multiple calls through the night. Overnight call is from home, can manage a lot over the phone but occasionally have to come in. Have an anes resident in house as well. Round sat/sun.
4) Float- outside rotations such as PM&R, psych, neuro, neurosurg or float to clinic/backup for on-call fellow. Call the on-call fellow ~6:30a to see if he needs help. Mellowest.
General start time for rotations ~6:30am, earlier for the call fellow, who may start rounding with residents as early as 5:30 or 6, depending on the census.
Interview was interesting. Panel interview. 5 attendings. Hot seat style. Not threatening or malignant, but not your typical friendly “get to know you” type of interview either. People didn’t seem to like it but I don’t think it was too bad.
These guys work hard. One fellow: “I haven’t worked like this since internship.” Another fellow: “Would I do it again? I don’t have to.” But they’re doing tons of high-end procedures, operating kind of like a surgical service. I asked if they placed permanent pumps, the fellow replied: “I did 3 on Friday.” They do permanent stims too. High procedure volume and complexity. Fellows said they are ready for anything when they’re done and place well for jobs.
For some this may be the Holy Grail of fellowships. For others it may be a nightmare. To each their own.
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The rest of these I didn't take any notes on, so not as detailed, sorry.
UCLA/WLAVA (PM&R): 4 x three month rotations. 6 months total at the VA. 3 months at UCLA w/ Dr Fish. 3 months with a private guy who does infusions and stims among other stuff for high-end clientele. Work closely with PM&R faculty at the VA. Weekly didactics at the VA. Busy MSK/pain clinic. Reasonable procedure volume. Doesn’t sound like tons of high end procedures but enough to get started, and more US than other places, as well as prolotherapy in injection clinic. Really nice and friendly program director. Happy fellows. There is subsidized housing. Home call once per month 1 week at a time, sounded pretty low key. Very rarely if ever have to come in. No rounding sat/sun. Couple hours work from home on the call weekends. The most MSK-friendly of all the acgme pain fellowships I interviewed at. LA = weather always good / traffic always bad. I had this ranked #1 before I withdrew from the match (for OOM spine offer).
UCLA/WLAVA (PM&R): 4 x three month rotations. 6 months total at the VA. 3 months at UCLA w/ Dr Fish. 3 months with a private guy who does infusions and stims among other stuff for high-end clientele. Work closely with PM&R faculty at the VA. Weekly didactics at the VA. Busy MSK/pain clinic. Reasonable procedure volume. Doesn’t sound like tons of high end procedures but enough to get started, and more US than other places, as well as prolotherapy in injection clinic. Really nice and friendly program director. Happy fellows. There is subsidized housing. Home call once per month 1 week at a time, sounded pretty low key. Very rarely if ever have to come in. No rounding sat/sun. Couple hours work from home on the call weekends. The most MSK-friendly of all the acgme pain fellowships I interviewed at. LA = weather always good / traffic always bad. I had this ranked #1 before I withdrew from the match (for OOM spine offer).
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UMich : ~45 hrs/week. Serious about chronic pain management. Not super procedure heavy but enough, and heavy on the stim trial experience (PD does a lot). Put stims anywhere you can put em. Interestingly, there is an interventional spine program through PM&R dept right next door and you rotate with them as well for a month. I applied there (late) but did not receive an interview. VA has a trillion dollar 3-D C-arm imager which looked kinda cool. They set aside 2-3 spots for PM&R, which has separate interview days from the anesthesia guys and a separate nrmp match code.
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UWash: Faculty in flux but some new guys coming in. Really nice facilities at the main clinic site. They have one of those fancy 3D C-arms too. Fellows seemed pretty mellow/happy. Supposedly there was some malignant guy there a few years ago but he’s gone. I got a good vibe on interview day. All the faculty I met were very collegial. Seattle = weather usually bad but traffic usually good. And Seattle in the summertime is awesome. Some things in flux but seems the program will remain strong/actually probably improve.
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EVMS: PM&R-based prog. Only 1 spot. Small faculty base, but overall seemed nice. Seems like they tend to take in-house candidates but PD disputed that. Procedure suite kind of cramped at EVMS but otherwise facilities OK. They rotate at the pain service at the Naval Hospital as well, which is anesthesia-based and busy w/ procedures. Current fellow is former PM&R resident, seemed pretty happy w/ training.
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Beth Israel NYC (Mt Sinai): Recently taken over by Mt Sinai, which has a separate pain fellowship at their campus on the upper east side. Disorganized interview day. Told to arrive at 6:45am even though your interviews may not start until 9:30 or 10. Mediocre/old facilities. Great neighborhood though (Union Square). One of the interviewers told me right away “Oh I like you I’m going to make sure you’re at the top of the list.” Discussed this later with another candidate who was told the exact same thing. Maybe she really liked us both? I kinda doubt it was sincere. Fellows look unhappy, indicate the place is disorganized and the workload heavy with lots of scut, lots of med mgmt, high-dose opioid rx’ing for drug seeking pts, but plenty of procedural experience, and ultimately the means to an end. Home call 1 week at a time, round on pain service on the weekends. Busy call. Faculty in flux after recent takeover by Mt Sinai. Now fellows will spend some time rotating up at Mt Sinai, but won’t get procedures there (reserved for the Mt Sinai fellows). Will the fellowship survive? Unknown, but they said it will remain up and running for now. Who knows... maybe it will even improve. Speaking with other candidates, this is a place they would rank last, or consider not even ranking. I was on the fence.
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Northwestern (RIC): 1 PM&R spot, 5-6 anesthesia spots match separately through anesthesia. Sounds like time is pretty evenly split btwn RIC pain rehab and NW anesthesia group. No procedures at RIC, as it is a rehab-model, day-treatment, multidisc type of program w/ PT/OT/psych/biofeedback, etc. Med mgmt and team leadership. Incredible facilities, as is typical of RIC and NW. On the anesthesia side, busy clinic with same day procedures. The anesthesia guys get more time there (and less at RIC), but it sounds like the PM&R fellow gets plenty of exposure to bread/butter stuff and some exposure to more advanced procedures. The recent fellow seemed very happy with her training. Recently long-time PD left, but new PD is solid, very affable guy. Other RIC faculty also very collegial.
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VCU: PM&R dept but PD is anesthesiologist. Sounds like they potentially take all specialties. Interestingly they are out-of-match, with no intention to join as PD sees no net benefit to participation (personally I agree). Informed of this on the interview day. Interviews 3-4 weekends in August, then they make offers. 6 months at VA w/ busy service. 3 months with PD (lotta stims, including perms). 3 months with another guy who does acupuncture and complementary zen stuff in addition to reg pain practice. Home call one week at a time, sounded pretty mellow. No rounding on weekends. One of the fellows at the Sat interview was carrying the pager, didn't hear it go off once. PD kind of intense but appears collegial and obviously cares about the program and is dedicated to the fellows’ training.
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UWisc-Madison: Unaccredited pain/msk program in major university medical center PM&R dept. This program has all the trappings of acgme accreditation, it is set up to be accredited, but apparently the university (not the dept) is dragging its feet. Politics, perhaps. Anyway, once it is accredited, I predict it will become a highly competitive place, maybe one of the top PM&R-based programs. Nice facilities, nice stable faculty, reasonable procedure exposure, decent MSK experience, nice college town w/ reasonable COL. Currently the fellow is signed up as a faculty appointment and actually serves as an attending (minus the pay) in the PM&R dept, taking call a few times a year with the PM&R residents (+ weekend rounds on the rehab inpatients). Presumably this would all change if/when accredited. They have one interview day and take everyone out to a very nice dinner the night before. 1 position, out of match. They make an offer the week after the interview.
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I got an (out of match) offer from an interventional spine and sports fellowship (OSS/Furman) which I ultimately felt was a better fit than most of the places reviewed above (I would say tied with UCLA/WLAVA), so I pulled out of the match to accept that position, but I think would have been happy with training at 6/8 of the above places. For anyone who’s interested, I will post my spine/sports reviews over in the PM&R forum.
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I thought they had already applied for ACGME accreditation in the past? Someone mentioned it in one of the threads a while ago. Madison is a great town, I've always been surprised they don't have an accredited pain fellowship.
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- 21
I think they're ready to apply but never got approval from their own GME to move forward.
Big update compiled from interview experiences of three applicants (all PM&R) from this past interview season. The details slowly decrease with each program which was probably indicative of how tired we got towards the end of interview season, but we all matched and are very pleased with our programs so well worth it!
UC Irvine
Details
Solid program
Lot of ultrasound peripheral blocks
2 days/week of procedures
Inpatient acute pain with no calls during the week (blind thoracic epidurals)
2 fellows only, 1 PM&R and 1 anesthesia currently, next year 2 anesthesia
Interview ~50 for 2 spots
Interview Day/Questions
Tell me about a difficult case
Tell me about yourself (every attending)
Tell me something about yourself that's NOT on your CV
What would you tell patient about fibro
RN: how do you feel being told what to do from an RN
What do you feel is a weakness of pain medicine?
Where do you see yourself doing in the future?
Where do see pain going in the future?
Talk about leadership experience (what you gained)
Tell me the last peripheral block you did
What kind of practice you want
UT San Antonio Details
6 fellows, 3 anesthesia and 3 PM&R currently
Interview ~25-30 for 6 spots
Solid laid back program
Procedure logs: 1000+
Fluoro day 1 per week. Getting DSA soon. ~7-10 blocks per day
Ultrasound day 1.5 per week. Great exposure. Everything is image guided including trigger points. Pump refills.
2 months at the VA, 9 months at pain clinic. 10 clinic patients a day about, use epic; Rotate with addiction, palliative, psychiatry/psychology, PM&R, anesthesia, Neuro (headache clinic)
Setting up new rotation at army base in very near future
Didactics every morning, spine conference once per month with neurosurgery and radiology, grand rounds Thursday
Typical day starts at 7:30 ends by 3-4
No call essentially. No inpatient acute pain coverage
Majority Medicaid patients - blah. decent pain seeking population per fellows. Good variety of referral source.
Interventional clinic. Not really opioid heavy prescribing tendencies.
Low to nill vertebral augmentation (unless seek it out with Ortho spine/radiology)
Cancer pain is growing with new relationship but very low to no pumps.
Not research heavy but can involve yourself if you want
Good ancillary staff. Chill clinic atmosphere. 1 fluoro room. 1 u/s room
$1500 educational fund
Encourage conference attendance. No day off if work till noon!!
Fellows were happy
15-20 stims per year per fellow. Scrub the case with neurosurgery to learn how to do perms
Interview Day/Questions
Why pain
No CV pimping questions
Very get to know you type interview, tell me about yourself
Why pain and not spine or sports, difficult pain patient, experience about pain, difficult dealing with staff member, leadership role experience
UC Davis
Details
6 fellows – good mix of PM&R/Anesthesia – 5 August spots, 1 January spot (outside match)
They do not necessarily favor their own…fellows said they will take the best from wherever (2 fellows trained in the same residency even)
Did not tell how many the interview, even after asking in a few different ways
Kind of an intense morning compared to other places
Extremely academic environment, big name attendings (Fishman, Mahajan, etc)
Very involved in the AAPM organization
3 fluoro suites running, ~30 procedures a day total
Clinic has 8 patients a day per attending, 4 in the AM, 4 in the PM. attending run clinic…aka they do not NEED the fellows. PM&R and anesthesia residents rotate
They do NOT Rx opioids. They are consultants who only provide recommendations.
EPIC EMR/dragon dictation software, good templates, home access
Minimal pump exposure (0-3)
SCS (~10) including trials and implantations total… also heard the program does ~2/month
Sounds like a good number of bread and butter, but hard to get an exact number
No acute pain rotations. No epidural catheter management!!!!
Call schedule is very chill. Q6 weeks. Home call. Very rarely will get called in.
Scholarly activity is required, but sounds like even a case report would work, option to write book chapters with staff
Intense lecture schedule: daily noon lectures, daily morning journal clubs
August: Pain “boot camp” lecture series daily
Typical day: 7:45am – 4:30pm
Didactics are probably the best overall, very comprehensive, fellows seemed to be annoyed a bit but happy at the end of the day
Addiction medicine rotation, no electives
Curriculum designed to make you a leader in the field of pain medicine for sure
People were nice and it’s a solid program
Interview Day/Questions
Interviewed with 5-6 other applicants
Morning starts off sitting in on a journal club w/ continental breakfast
3 formal 1 on 1 interviews x 15 min each – structured hypothetical situation questions: how to deal with a difficult patient, how to deal with a difficult co-worker, tell me a time when you demonstrated leadership, etc.
20-30 minute group session with 2 staff where you discuss a case
The afternoon is “optional” where you can spend time in clinic and in the fluoro suite – good time to interact with different attending. Low stress feel.
Be sure to set aside some time for this interview day… flying in and out of Sacramento is a PITA
University of Utah
Details
- 4 fellows; all current ones are Anes but they said they matched someone from PM&R who will be starting in July. Not sure how many they’re interviewing but they only had 3 options for interview dates, 5 ppl on my day seemed to be high. They seem to take a few of their own so may not need to interview many.
- Super friendly, everyone calls each other by first name
- Fellows feel good about bread & butter (ESI, MBB, facets, RFA, SI), said only thing lacking was SCS. In follow up email with a recently graduated fellow, he said that he still didn’t feel comfortable with more complicated cases and usually asked one of his practice’s senior partners to help him out. Kinda worry about procedural volume.
- Excellent exposure to cancer pain, close association with Huntsman cancer center, lots of intrathecal pump placement and management. PD (Dr Brogan) is big with this!
- Acute pain service manages all PCAs, regional, etc
- Call is chill, lifestyle friendly program for sure
Interview Day/Questions
- Chill interview (asked about a couple things on CV, what I’m looking for in a Pain program, type of practice I see myself in in the future, more get to know you)
University of Toledo
Details
- 2 fellows: 1 Anes, 1 PM&R (internal) this year, 2 Anes next year
- 60 interviewees for 2 spots
- Tons of procedures; both fellows at > 1100 in June. Tons of SCS (20+ implants and trials/fellow), some pumps
- For 6 months, spend Wednesdays at University of Michigan. May start half days at St. Luke’s (local in Toledo). 9 months Pain clinic. 1 month each of non-primary specialty.
- Didactics 6:45AM daily on M/Tues/Thurs – videos; 7AM on FRI MCQ’s, Wed 7AM fellow presents 1x/month
- Journal club monthly, 4-5 per fellow
- Cadaver workshop twice a year
- Continuity clinic ½ day per week, 5-7 patients
- Inpatient service: 12-15 patients, only see educational cases, NP Coverage
- St. Lukes: new hospital; ½ days x 2 (may replace UMich eventually)
- Clinic numbers: patients 400/month, 120 new consults, 300 follow ups, 80 pump refills and post op implants
Interview Day/Questions
- Do you have any questions (a thousand times so have questions, no matter how irrelevant, ready to roll), Why Pain? What are your weaknesses? What’s a weakness in our program? Tell me about yourself
- Interview day kinda disorganized. Two PM&R faculty members do group interviews but don’t really interview… they just asked if we had any questions and told us stuff about the program we already knew. PD interview is in the afternoon and I get the sense he’s the guy you have to win over/impress.
University of Iowa
Details
- Previously had 4 fellows but going down to 3 (lost one due to funding); interviewing about 30-40 applicants
- In the process of hiring a new PD (?big wig)
- 2 internal anesthesia this year, however they like PM&R applicants.
- No internal anesthesia applying for 2015
- Previously involved a decent amount of Acute/Regional exposure but Chronic Pain and Acute/Regional Pain has been separated. Spend about 2-4 weeks on Acute/Regional service to meet ACGME requirement (~50 patients)
- Manage CHRONIC pain consults on inpatient but not ACUTE pain; super chill, low census
- Spend 2 weeks with Palliative Care, some other time with Neurosurgery to work on neuro exam (not really necessary for us PM&R folks) and reading imaging. Non-Anes fellows will spend maybe a month learning Anes skills, may be built into Acute/Regional experience
- Elective time, PMR for EMGs and MSK clinic
- Large majority of fellowship spent in Chronic Pain clinic; seeing patients and doing procedures mixed into work day. Rarely leave later than 5pm.
- Didactics on Monday afternoons after clinic
- Wednesday journal clubs few times a month
- Full time pain pharmacist, who manages clinic patients for opioids, etc.
- Lots of bread and butter
- 20 stim trials per one fellow, neurosurgery does implants (don't typically scrub in with them)
- Fellows feel really comfortable with all procedures. Some wish they got more exposure to pumps and kypho but otherwise felt training, exposure, and volume were great
- Call will be q3 weeks. Home call. Rarely will need to come in.
- Use EPIC in clinic, can dictate via Dragon if you want
- 2 fluoro suites, however moving to a new clinic in Jan 2015
- Free-for-all in clinic, in terms of patient assignment, unless seen by the same fellow in the past
- Attendings seem all very laid back and friendly
- Average start time 8AM. Home by 4ish. See about 6-7 clinic patients per day.
- Clinic is mixed in with procedures. No separate procedure day. Iowa care which is the Medicaid requires no prior auth so they do a lot of injections on the initial evaluation. All read their own films.
- Good food in the 3 cafeterias
- Low cost of living
Interview Day/Questions
- Super chill interview day. Questions: What are you looking for in a program? Tell me about yourself. What are your future practice plans? Tell me about a difficult patient.
University of Chicago
- 2 anesthesia fellows, both from U Chicago starting in 2014
- Fellows do all procedures (not residents); 5 anesthesia residents in clinic at all times
- Overall very happy fellows
- Only call is 1 weekend per month, rounding on acute pain patients, 8-12
- 1500 procedures per fellow; good bread and butter; ~10 stims, ~10 pumps, ~10 kyphos
- “Chief fellow” duties 6 months of out the year. Run clinic, do schedules, etc.
- Seems to be an attending-centric run clinic. They don't NEED the fellows.
- Decent cancer pain referrals. Ketamine infusions in clinic.
- Anesthesia fellows can moonlight in-house in the OR for $50/hour
- Busy day, didactics every morning at 7AM, get done typically between 3-5pm.
- Staff patients with residents, no scut! No notes
- Not the best didactics, have to study independently
- Take pain in-service exam
- Interview ~ 30 total
Vanderbilt
Details
- Young attendings, all really nice! Jackson (PD) is, per fellows, very holistic in approach. Patil (assistant PD) is graduate of Vandy. Dittrich was awesome and trained at BIDMC; supposedly does a bunch of injections that no one else does. Recruited Huntoon from Mayo… HUGE name is Pain world!
- Beautiful facilities, nice staff and faculty, fellows really nice and chill
- No specifics on numbers for procedures but I got the impression the recently graduated fellows felt pretty comfortable with most everything. Faculty members said there’s probably enough volume to have 6 fellows but don’t have the funding to support that many.
- Most of the year is spent at main Pain Medicine clinic with short periods spent on other services thrown in throughout the year (palliative, PM&R, neurology, neurosurgery). Able to spend elective time at PP clinic, integrative health center, etc
- If you want research, you can get on board with existing projects or have the resources you need to start up your own
- Interviewed ~12-15 for 3 spots
Interview Day/Questions
Why Pain? Why Vandy? Tell me about yourself/hobbies. Tell me about this research. What type of practice do you see yourself in after fellowship? What type of research projects would you like to get involved in in the future?
University of Michigan
Details
5 anesthesia + 3 PM&R spots (2 different matches)
PD is a straight shooter… no nonsense type of guy
Large faculty, non-malignant learning environment, good relationship between PM&R and anesthesia
Fellowship is not high volume, but good variety and plenty of B&B apparently
2-3 stims/year, neurosurgery does implants, good relationship with them to scrub in, etc.
EMG rotation built in along with PM&R MSK clinic for joints
Neurosurgery, Addiction, Acute pain service 6 weeks total, VA for 3 months
High salary + $5000 bonus in Oct for all residents/fellows + $3000 educational fund (have to pay for parking)
Mandatory scholarly activity required
½ day week continuity clinic
Didactics at 6:45AM three days a week, home usually by 5-6pm
Each fellow is assigned an attending mentor x 6 months à have to answer patient calls ~3/day
Interview Day/Questions
Laid back interview, standard questions, why pain, what study would you create if you had unlimited funding, tell me about yourself, weaknesses
UPMC
Details
- New awesome young PD and new big dawg chairman (from B&W)
- About 20-25 applicants on my interview day so guessing they’ll interview about 70ish applicants for the 9 spots?
- Wednesday morning didactics, lots of great topics, attendings run
- Cheap cost of living ($900 for 2 bedroom in Shadyside, cool part of city where all residents and fellows live), pay for PGY-5 next year about $62K
- All the resources you need for research, lots of opportunities for research if you want it
- Fellows seemed cool. Spread out among 6 sites.
- Call pretty reasonable, very little acute pain but you have to cover 3 hospitals and see consults if called up to 4pm. Staff on phone with the attending.
- No moonlighting allowed
- Difficult to gauge how much volume the fellows are doing; you basically work 2 months with a different attending, all have different styles. Per email follow up with one of the fellows in November, he had upwards of 400-500 procedures already
- Lots of driving to different sites in the burbs, max commute 30 minutes
- 1-3 stims/year, no kypho, no pumps
Interview Day/Questions
- Split applicants into morning and afternoon sessions; half do 7 interviews while the other half go on a tour of the city and a few of the clinics then switch
- 7 interviewers
- Why Pain? Tell me about your research. What practice setting in the future? Hobbies? How do you like to manage pain medicine patients? How would you manage difficult patient on high dose opioids? Thoughts on role of opioids in pain. What do you think PM&R brings to the field of Pain Medicine?
Medical College of Wisconsin
3 spots in match, 1 pain+ anesthesia peds outside the match
Main clinic is new. Mon/tues ~30-35 patients between 2 residents and 2 fellows, Wed/Thurs ~10-20 patients
5 months of clinic at MCW, 5 months of VA, 2 months of other requirements
Usually 2 fellows at the main MCW clinic, 1 fellow at the VA
Didactics every Thursday morning at 7
Typical day is 8-4
Home call during the week, anesthesia resident is the first one to call
Solid B&B, numbers are unknown
Work next to a very busy private practice with high volume
All attendings seemed very nice including PD.
New chair is being hired from UF (Dr. Hurley ?) supposedly big dawg
1 internal anesthesia applicant
Montefiore
- Interviewing 15-20 for 3 spots; at least 2 internal applicants
- Excellent procedural volume, very little inpatient consults/management, use of MSK US and time for occasional EMG included
- Rotate with 3-4 main faculty members throughout the year, all very personable
- Strong push for research
- Two of the fellows I met lived on Upper East Side and had about a 45 minute subway ride to Bronx
- Excellent didactic curriculum, spine conference
- Not a big name yet but struck me as excellent training!
Mayo Clinic Jacksonville
Details
- Most of the time spent in the Pain clinic with other rotations including Palliative, Behavioral/ Addiction Medicine, Neurorads (both reading imaging and lots of kypho/vertebroplasty opportunities), PM&R, EMG, Anes (for non-Anes applicants), Pain Rehab Center, inpatient consults (didn’t seem like too many and mainly managed by PAs)
- Awesome numbers, only thing low was pumps but as PM&R I couldn’t care less about pumps. But ya, really great numbers overall!
- Recent addition of PM&R-trained pain faculty member from Mayo Rochester location bringing in way more MSK US which is really cool
- Well-organized program, good didactics but not overwhelming, great research opportunities, if presenting at conferences you get up to $1700 each time, just really nice and pleasant people to train with
- Overall, probably one of the best programs I’ve seen. Only drawback is Jacksonville didn’t seem like that cool of a city but could certainly do it for a year and the winter would be awesome
Interview Day/Questions
- Meet with PD, go over program, etc then tour with fellow, lunch, then interviews with 5 faculty. Chair (Anes) just kept asking me about being a DO and then talked about how much of a benefit the Mayo name was. PD (PM&R) was very laid back, why Pain, weaknesses, tell me about yourself; super friendly. Faculty member (Neuro-trained) didn’t really ask any questions, bizarre painful conversation. Another PM&R-trained faculty member that recently made the move from the Rochester location was awesome; super laid back, talked about some research, asked some questions regarding stuff in my personal statement. Last one was with Pain Psychologist, very nice, asked about future plans.
MD Anderson
Details
- Interviewing 25 for 5 spots
- Rotate services each week: inpatient, clinic, clinic procedures, OR procedures
- Good education, resources, opportunity to get involved in research, beautiful and massive medical center
- Inpatient consists of consults, a little bit of epidural management, take home call during that week. Clinic is seeing patients. Outpatient procedures, 8-12ish/day, B&B stuff. OR is more advanced procedures (stim, pumps, kyphos). PD (former fellow at MDA) said he did like a 100 kyphos during his year.
- There’s also a crazy busy month at a private practice. PD said when he was a fellow, he knocked out something close to 350 TFESIs that month alone.
- Have good mix of anesthesia and PM&R faculty. Dr Abdi (big name in Pain) joined on as chairman a couple years ago.
Interview Day/Questions
- 4-5 interview in the morning, lunch at nice restaurant right on campus with fellow(s). No crazy questions. Toughest questions for me: What was your greatest personal victory and failure? Otherwise it was stuff about CV, research, tell me about yourself, etc
GLA VA/UCLA
Details
- Interviewing 30 for 4 spots, 1 internal applicant
- 6 months at VA: Monday procedures with Anes Pain, Friday with PM&R Pain. Wednesday afternoon injection clnic (joints, TPI, etc with US guidance typically). Half day for admin/research. Lots of B&B as well as some stuff that can only be done in VA (pulsed RF, etc). Inpatient management of PCAs and consults is actually much lighter than I originally thought… very reasonable
- 3 months at UCLA Spine Center: B&B, stims, Mondays are for EMGs, half day for admin/research
- 3 months with private practice Anes Pain Doc: anesthesia pain, cancer pain, CRPS, pumps, neuromodulation, ketamine infusions. Not as much hands on because it’s a cash practice and the patients want the attending to do procedures.
- Nice, approachable, and overall young faculty. Time allotted during week for research/admin. Procedure heavy, exposure to MSK US, EMG.
Interview Day/Questions
- Interview day was disorganized; applicants had to transport themselves back and forth from VA to UCLA site and back again. Barely got any time with one interviewer between his procedures during a procedure day. Interviews were very laid back and friendly, more get-to-know you feel.
Stroger Hospital of Cook County
Details
- Monthly rotation schedule: 1 week procedures, 1 week inpatient consults and a bunch of PCA management, 2 weeks clinic
- Gave impression they weren’t super accepting of PM&R given the amount of inpatient requirement
- Solid B&B exposure probably
Interview Day/Questions
- Disorganized interview day, straightforward questions
Cornell Tri-Institute
Details
- 3 months HSS, 3 months NYP, 3 months MSKCC, other time spent at new NYP West Side location, Palliative Care, Anes/PM&R
- 6 spots I think, approximately a 10:1 interviewee to spot ratio
- Good didactics, big names, strong exposure to all aspects of Pain
- NYP requires pre-op blocks/catheter placement most mornings before clinic
- West Side rotation helping increase procedural volume, especially B&B stuff
- Was disappointed to hear there’s not much hands on at HSS, though the fellows stated the teaching was excellent. It’s a busy private practice feel, sometimes cash-based/VIPs, don’t want fellow to do procedure. Moonlighting opportunities at HSS.
- Unsure of exact numbers but sounded like solid procedural volume overall. Bigger kypho volume (~50) than I expected!
- Beautiful facilities, good resources, great NYC location
Interview Day/Questions
- Overview to start the day then split into two groups; half interview, other half goes on tour of MSKCC then switch
- Typical interview questions, no curveballs
- As PM&R applicant, one HSS Anes attending seemed very concerned about me not getting exposed to pre-op procedures… meh!
Beth Israel Deaconess Medical Center
Details
- 7 fellows/year; current class is all Anes, next year’s will have at least two PM&R
- Great name, city, training, resources. Attendings are smart, friendly, laid back!
- Most of year spent at Pain clinic and Spine Center; other rotations include Anes, Palliative, Neuro/Psych
- Inpatient consults/call 1 of every 7 weeks split among fellows
- Daily didactics at 7am; monthly spine conference with spine surgeons and radiology; journal club. Overall, get the sense the education is excellent!
Interview Day/Questions
- Very organized interview day; program coordinator is on top of it!
- Big group of applicants; half interview while the other half is on tour then switch
- Typical questions, no curveballs; laid back, pleasant interviews
Hope this helps some of the future applicants!
UC Irvine
Details
Solid program
Lot of ultrasound peripheral blocks
2 days/week of procedures
Inpatient acute pain with no calls during the week (blind thoracic epidurals)
2 fellows only, 1 PM&R and 1 anesthesia currently, next year 2 anesthesia
Interview ~50 for 2 spots
Interview Day/Questions
Tell me about a difficult case
Tell me about yourself (every attending)
Tell me something about yourself that's NOT on your CV
What would you tell patient about fibro
RN: how do you feel being told what to do from an RN
What do you feel is a weakness of pain medicine?
Where do you see yourself doing in the future?
Where do see pain going in the future?
Talk about leadership experience (what you gained)
Tell me the last peripheral block you did
What kind of practice you want
UT San Antonio Details
6 fellows, 3 anesthesia and 3 PM&R currently
Interview ~25-30 for 6 spots
Solid laid back program
Procedure logs: 1000+
Fluoro day 1 per week. Getting DSA soon. ~7-10 blocks per day
Ultrasound day 1.5 per week. Great exposure. Everything is image guided including trigger points. Pump refills.
2 months at the VA, 9 months at pain clinic. 10 clinic patients a day about, use epic; Rotate with addiction, palliative, psychiatry/psychology, PM&R, anesthesia, Neuro (headache clinic)
Setting up new rotation at army base in very near future
Didactics every morning, spine conference once per month with neurosurgery and radiology, grand rounds Thursday
Typical day starts at 7:30 ends by 3-4
No call essentially. No inpatient acute pain coverage
Majority Medicaid patients - blah. decent pain seeking population per fellows. Good variety of referral source.
Interventional clinic. Not really opioid heavy prescribing tendencies.
Low to nill vertebral augmentation (unless seek it out with Ortho spine/radiology)
Cancer pain is growing with new relationship but very low to no pumps.
Not research heavy but can involve yourself if you want
Good ancillary staff. Chill clinic atmosphere. 1 fluoro room. 1 u/s room
$1500 educational fund
Encourage conference attendance. No day off if work till noon!!
Fellows were happy
15-20 stims per year per fellow. Scrub the case with neurosurgery to learn how to do perms
Interview Day/Questions
Why pain
No CV pimping questions
Very get to know you type interview, tell me about yourself
Why pain and not spine or sports, difficult pain patient, experience about pain, difficult dealing with staff member, leadership role experience
UC Davis
Details
6 fellows – good mix of PM&R/Anesthesia – 5 August spots, 1 January spot (outside match)
They do not necessarily favor their own…fellows said they will take the best from wherever (2 fellows trained in the same residency even)
Did not tell how many the interview, even after asking in a few different ways
Kind of an intense morning compared to other places
Extremely academic environment, big name attendings (Fishman, Mahajan, etc)
Very involved in the AAPM organization
3 fluoro suites running, ~30 procedures a day total
Clinic has 8 patients a day per attending, 4 in the AM, 4 in the PM. attending run clinic…aka they do not NEED the fellows. PM&R and anesthesia residents rotate
They do NOT Rx opioids. They are consultants who only provide recommendations.
EPIC EMR/dragon dictation software, good templates, home access
Minimal pump exposure (0-3)
SCS (~10) including trials and implantations total… also heard the program does ~2/month
Sounds like a good number of bread and butter, but hard to get an exact number
No acute pain rotations. No epidural catheter management!!!!
Call schedule is very chill. Q6 weeks. Home call. Very rarely will get called in.
Scholarly activity is required, but sounds like even a case report would work, option to write book chapters with staff
Intense lecture schedule: daily noon lectures, daily morning journal clubs
August: Pain “boot camp” lecture series daily
Typical day: 7:45am – 4:30pm
Didactics are probably the best overall, very comprehensive, fellows seemed to be annoyed a bit but happy at the end of the day
Addiction medicine rotation, no electives
Curriculum designed to make you a leader in the field of pain medicine for sure
People were nice and it’s a solid program
Interview Day/Questions
Interviewed with 5-6 other applicants
Morning starts off sitting in on a journal club w/ continental breakfast
3 formal 1 on 1 interviews x 15 min each – structured hypothetical situation questions: how to deal with a difficult patient, how to deal with a difficult co-worker, tell me a time when you demonstrated leadership, etc.
20-30 minute group session with 2 staff where you discuss a case
The afternoon is “optional” where you can spend time in clinic and in the fluoro suite – good time to interact with different attending. Low stress feel.
Be sure to set aside some time for this interview day… flying in and out of Sacramento is a PITA
University of Utah
Details
- 4 fellows; all current ones are Anes but they said they matched someone from PM&R who will be starting in July. Not sure how many they’re interviewing but they only had 3 options for interview dates, 5 ppl on my day seemed to be high. They seem to take a few of their own so may not need to interview many.
- Super friendly, everyone calls each other by first name
- Fellows feel good about bread & butter (ESI, MBB, facets, RFA, SI), said only thing lacking was SCS. In follow up email with a recently graduated fellow, he said that he still didn’t feel comfortable with more complicated cases and usually asked one of his practice’s senior partners to help him out. Kinda worry about procedural volume.
- Excellent exposure to cancer pain, close association with Huntsman cancer center, lots of intrathecal pump placement and management. PD (Dr Brogan) is big with this!
- Acute pain service manages all PCAs, regional, etc
- Call is chill, lifestyle friendly program for sure
Interview Day/Questions
- Chill interview (asked about a couple things on CV, what I’m looking for in a Pain program, type of practice I see myself in in the future, more get to know you)
University of Toledo
Details
- 2 fellows: 1 Anes, 1 PM&R (internal) this year, 2 Anes next year
- 60 interviewees for 2 spots
- Tons of procedures; both fellows at > 1100 in June. Tons of SCS (20+ implants and trials/fellow), some pumps
- For 6 months, spend Wednesdays at University of Michigan. May start half days at St. Luke’s (local in Toledo). 9 months Pain clinic. 1 month each of non-primary specialty.
- Didactics 6:45AM daily on M/Tues/Thurs – videos; 7AM on FRI MCQ’s, Wed 7AM fellow presents 1x/month
- Journal club monthly, 4-5 per fellow
- Cadaver workshop twice a year
- Continuity clinic ½ day per week, 5-7 patients
- Inpatient service: 12-15 patients, only see educational cases, NP Coverage
- St. Lukes: new hospital; ½ days x 2 (may replace UMich eventually)
- Clinic numbers: patients 400/month, 120 new consults, 300 follow ups, 80 pump refills and post op implants
Interview Day/Questions
- Do you have any questions (a thousand times so have questions, no matter how irrelevant, ready to roll), Why Pain? What are your weaknesses? What’s a weakness in our program? Tell me about yourself
- Interview day kinda disorganized. Two PM&R faculty members do group interviews but don’t really interview… they just asked if we had any questions and told us stuff about the program we already knew. PD interview is in the afternoon and I get the sense he’s the guy you have to win over/impress.
University of Iowa
Details
- Previously had 4 fellows but going down to 3 (lost one due to funding); interviewing about 30-40 applicants
- In the process of hiring a new PD (?big wig)
- 2 internal anesthesia this year, however they like PM&R applicants.
- No internal anesthesia applying for 2015
- Previously involved a decent amount of Acute/Regional exposure but Chronic Pain and Acute/Regional Pain has been separated. Spend about 2-4 weeks on Acute/Regional service to meet ACGME requirement (~50 patients)
- Manage CHRONIC pain consults on inpatient but not ACUTE pain; super chill, low census
- Spend 2 weeks with Palliative Care, some other time with Neurosurgery to work on neuro exam (not really necessary for us PM&R folks) and reading imaging. Non-Anes fellows will spend maybe a month learning Anes skills, may be built into Acute/Regional experience
- Elective time, PMR for EMGs and MSK clinic
- Large majority of fellowship spent in Chronic Pain clinic; seeing patients and doing procedures mixed into work day. Rarely leave later than 5pm.
- Didactics on Monday afternoons after clinic
- Wednesday journal clubs few times a month
- Full time pain pharmacist, who manages clinic patients for opioids, etc.
- Lots of bread and butter
- 20 stim trials per one fellow, neurosurgery does implants (don't typically scrub in with them)
- Fellows feel really comfortable with all procedures. Some wish they got more exposure to pumps and kypho but otherwise felt training, exposure, and volume were great
- Call will be q3 weeks. Home call. Rarely will need to come in.
- Use EPIC in clinic, can dictate via Dragon if you want
- 2 fluoro suites, however moving to a new clinic in Jan 2015
- Free-for-all in clinic, in terms of patient assignment, unless seen by the same fellow in the past
- Attendings seem all very laid back and friendly
- Average start time 8AM. Home by 4ish. See about 6-7 clinic patients per day.
- Clinic is mixed in with procedures. No separate procedure day. Iowa care which is the Medicaid requires no prior auth so they do a lot of injections on the initial evaluation. All read their own films.
- Good food in the 3 cafeterias
- Low cost of living
Interview Day/Questions
- Super chill interview day. Questions: What are you looking for in a program? Tell me about yourself. What are your future practice plans? Tell me about a difficult patient.
University of Chicago
- 2 anesthesia fellows, both from U Chicago starting in 2014
- Fellows do all procedures (not residents); 5 anesthesia residents in clinic at all times
- Overall very happy fellows
- Only call is 1 weekend per month, rounding on acute pain patients, 8-12
- 1500 procedures per fellow; good bread and butter; ~10 stims, ~10 pumps, ~10 kyphos
- “Chief fellow” duties 6 months of out the year. Run clinic, do schedules, etc.
- Seems to be an attending-centric run clinic. They don't NEED the fellows.
- Decent cancer pain referrals. Ketamine infusions in clinic.
- Anesthesia fellows can moonlight in-house in the OR for $50/hour
- Busy day, didactics every morning at 7AM, get done typically between 3-5pm.
- Staff patients with residents, no scut! No notes
- Not the best didactics, have to study independently
- Take pain in-service exam
- Interview ~ 30 total
Vanderbilt
Details
- Young attendings, all really nice! Jackson (PD) is, per fellows, very holistic in approach. Patil (assistant PD) is graduate of Vandy. Dittrich was awesome and trained at BIDMC; supposedly does a bunch of injections that no one else does. Recruited Huntoon from Mayo… HUGE name is Pain world!
- Beautiful facilities, nice staff and faculty, fellows really nice and chill
- No specifics on numbers for procedures but I got the impression the recently graduated fellows felt pretty comfortable with most everything. Faculty members said there’s probably enough volume to have 6 fellows but don’t have the funding to support that many.
- Most of the year is spent at main Pain Medicine clinic with short periods spent on other services thrown in throughout the year (palliative, PM&R, neurology, neurosurgery). Able to spend elective time at PP clinic, integrative health center, etc
- If you want research, you can get on board with existing projects or have the resources you need to start up your own
- Interviewed ~12-15 for 3 spots
Interview Day/Questions
Why Pain? Why Vandy? Tell me about yourself/hobbies. Tell me about this research. What type of practice do you see yourself in after fellowship? What type of research projects would you like to get involved in in the future?
University of Michigan
Details
5 anesthesia + 3 PM&R spots (2 different matches)
PD is a straight shooter… no nonsense type of guy
Large faculty, non-malignant learning environment, good relationship between PM&R and anesthesia
Fellowship is not high volume, but good variety and plenty of B&B apparently
2-3 stims/year, neurosurgery does implants, good relationship with them to scrub in, etc.
EMG rotation built in along with PM&R MSK clinic for joints
Neurosurgery, Addiction, Acute pain service 6 weeks total, VA for 3 months
High salary + $5000 bonus in Oct for all residents/fellows + $3000 educational fund (have to pay for parking)
Mandatory scholarly activity required
½ day week continuity clinic
Didactics at 6:45AM three days a week, home usually by 5-6pm
Each fellow is assigned an attending mentor x 6 months à have to answer patient calls ~3/day
Interview Day/Questions
Laid back interview, standard questions, why pain, what study would you create if you had unlimited funding, tell me about yourself, weaknesses
UPMC
Details
- New awesome young PD and new big dawg chairman (from B&W)
- About 20-25 applicants on my interview day so guessing they’ll interview about 70ish applicants for the 9 spots?
- Wednesday morning didactics, lots of great topics, attendings run
- Cheap cost of living ($900 for 2 bedroom in Shadyside, cool part of city where all residents and fellows live), pay for PGY-5 next year about $62K
- All the resources you need for research, lots of opportunities for research if you want it
- Fellows seemed cool. Spread out among 6 sites.
- Call pretty reasonable, very little acute pain but you have to cover 3 hospitals and see consults if called up to 4pm. Staff on phone with the attending.
- No moonlighting allowed
- Difficult to gauge how much volume the fellows are doing; you basically work 2 months with a different attending, all have different styles. Per email follow up with one of the fellows in November, he had upwards of 400-500 procedures already
- Lots of driving to different sites in the burbs, max commute 30 minutes
- 1-3 stims/year, no kypho, no pumps
Interview Day/Questions
- Split applicants into morning and afternoon sessions; half do 7 interviews while the other half go on a tour of the city and a few of the clinics then switch
- 7 interviewers
- Why Pain? Tell me about your research. What practice setting in the future? Hobbies? How do you like to manage pain medicine patients? How would you manage difficult patient on high dose opioids? Thoughts on role of opioids in pain. What do you think PM&R brings to the field of Pain Medicine?
Medical College of Wisconsin
3 spots in match, 1 pain+ anesthesia peds outside the match
Main clinic is new. Mon/tues ~30-35 patients between 2 residents and 2 fellows, Wed/Thurs ~10-20 patients
5 months of clinic at MCW, 5 months of VA, 2 months of other requirements
Usually 2 fellows at the main MCW clinic, 1 fellow at the VA
Didactics every Thursday morning at 7
Typical day is 8-4
Home call during the week, anesthesia resident is the first one to call
Solid B&B, numbers are unknown
Work next to a very busy private practice with high volume
All attendings seemed very nice including PD.
New chair is being hired from UF (Dr. Hurley ?) supposedly big dawg
1 internal anesthesia applicant
Montefiore
- Interviewing 15-20 for 3 spots; at least 2 internal applicants
- Excellent procedural volume, very little inpatient consults/management, use of MSK US and time for occasional EMG included
- Rotate with 3-4 main faculty members throughout the year, all very personable
- Strong push for research
- Two of the fellows I met lived on Upper East Side and had about a 45 minute subway ride to Bronx
- Excellent didactic curriculum, spine conference
- Not a big name yet but struck me as excellent training!
Mayo Clinic Jacksonville
Details
- Most of the time spent in the Pain clinic with other rotations including Palliative, Behavioral/ Addiction Medicine, Neurorads (both reading imaging and lots of kypho/vertebroplasty opportunities), PM&R, EMG, Anes (for non-Anes applicants), Pain Rehab Center, inpatient consults (didn’t seem like too many and mainly managed by PAs)
- Awesome numbers, only thing low was pumps but as PM&R I couldn’t care less about pumps. But ya, really great numbers overall!
- Recent addition of PM&R-trained pain faculty member from Mayo Rochester location bringing in way more MSK US which is really cool
- Well-organized program, good didactics but not overwhelming, great research opportunities, if presenting at conferences you get up to $1700 each time, just really nice and pleasant people to train with
- Overall, probably one of the best programs I’ve seen. Only drawback is Jacksonville didn’t seem like that cool of a city but could certainly do it for a year and the winter would be awesome
Interview Day/Questions
- Meet with PD, go over program, etc then tour with fellow, lunch, then interviews with 5 faculty. Chair (Anes) just kept asking me about being a DO and then talked about how much of a benefit the Mayo name was. PD (PM&R) was very laid back, why Pain, weaknesses, tell me about yourself; super friendly. Faculty member (Neuro-trained) didn’t really ask any questions, bizarre painful conversation. Another PM&R-trained faculty member that recently made the move from the Rochester location was awesome; super laid back, talked about some research, asked some questions regarding stuff in my personal statement. Last one was with Pain Psychologist, very nice, asked about future plans.
MD Anderson
Details
- Interviewing 25 for 5 spots
- Rotate services each week: inpatient, clinic, clinic procedures, OR procedures
- Good education, resources, opportunity to get involved in research, beautiful and massive medical center
- Inpatient consists of consults, a little bit of epidural management, take home call during that week. Clinic is seeing patients. Outpatient procedures, 8-12ish/day, B&B stuff. OR is more advanced procedures (stim, pumps, kyphos). PD (former fellow at MDA) said he did like a 100 kyphos during his year.
- There’s also a crazy busy month at a private practice. PD said when he was a fellow, he knocked out something close to 350 TFESIs that month alone.
- Have good mix of anesthesia and PM&R faculty. Dr Abdi (big name in Pain) joined on as chairman a couple years ago.
Interview Day/Questions
- 4-5 interview in the morning, lunch at nice restaurant right on campus with fellow(s). No crazy questions. Toughest questions for me: What was your greatest personal victory and failure? Otherwise it was stuff about CV, research, tell me about yourself, etc
GLA VA/UCLA
Details
- Interviewing 30 for 4 spots, 1 internal applicant
- 6 months at VA: Monday procedures with Anes Pain, Friday with PM&R Pain. Wednesday afternoon injection clnic (joints, TPI, etc with US guidance typically). Half day for admin/research. Lots of B&B as well as some stuff that can only be done in VA (pulsed RF, etc). Inpatient management of PCAs and consults is actually much lighter than I originally thought… very reasonable
- 3 months at UCLA Spine Center: B&B, stims, Mondays are for EMGs, half day for admin/research
- 3 months with private practice Anes Pain Doc: anesthesia pain, cancer pain, CRPS, pumps, neuromodulation, ketamine infusions. Not as much hands on because it’s a cash practice and the patients want the attending to do procedures.
- Nice, approachable, and overall young faculty. Time allotted during week for research/admin. Procedure heavy, exposure to MSK US, EMG.
Interview Day/Questions
- Interview day was disorganized; applicants had to transport themselves back and forth from VA to UCLA site and back again. Barely got any time with one interviewer between his procedures during a procedure day. Interviews were very laid back and friendly, more get-to-know you feel.
Stroger Hospital of Cook County
Details
- Monthly rotation schedule: 1 week procedures, 1 week inpatient consults and a bunch of PCA management, 2 weeks clinic
- Gave impression they weren’t super accepting of PM&R given the amount of inpatient requirement
- Solid B&B exposure probably
Interview Day/Questions
- Disorganized interview day, straightforward questions
Cornell Tri-Institute
Details
- 3 months HSS, 3 months NYP, 3 months MSKCC, other time spent at new NYP West Side location, Palliative Care, Anes/PM&R
- 6 spots I think, approximately a 10:1 interviewee to spot ratio
- Good didactics, big names, strong exposure to all aspects of Pain
- NYP requires pre-op blocks/catheter placement most mornings before clinic
- West Side rotation helping increase procedural volume, especially B&B stuff
- Was disappointed to hear there’s not much hands on at HSS, though the fellows stated the teaching was excellent. It’s a busy private practice feel, sometimes cash-based/VIPs, don’t want fellow to do procedure. Moonlighting opportunities at HSS.
- Unsure of exact numbers but sounded like solid procedural volume overall. Bigger kypho volume (~50) than I expected!
- Beautiful facilities, good resources, great NYC location
Interview Day/Questions
- Overview to start the day then split into two groups; half interview, other half goes on tour of MSKCC then switch
- Typical interview questions, no curveballs
- As PM&R applicant, one HSS Anes attending seemed very concerned about me not getting exposed to pre-op procedures… meh!
Beth Israel Deaconess Medical Center
Details
- 7 fellows/year; current class is all Anes, next year’s will have at least two PM&R
- Great name, city, training, resources. Attendings are smart, friendly, laid back!
- Most of year spent at Pain clinic and Spine Center; other rotations include Anes, Palliative, Neuro/Psych
- Inpatient consults/call 1 of every 7 weeks split among fellows
- Daily didactics at 7am; monthly spine conference with spine surgeons and radiology; journal club. Overall, get the sense the education is excellent!
Interview Day/Questions
- Very organized interview day; program coordinator is on top of it!
- Big group of applicants; half interview while the other half is on tour then switch
- Typical questions, no curveballs; laid back, pleasant interviews
Hope this helps some of the future applicants!
- Joined
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Happy new year every one. I really appreciate it if anyone could share solid feedback about the Cleveland clinic interventional spine fellowship.
- Joined
- May 30, 2005
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- 21,250
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If it is Rus DeMicco, it is good.
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Man, just looked through here for fun. Glad I stayed home. 35 stims, 12 kyphos already. More implants than trials.
- Joined
- Feb 20, 2013
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What type of applicant package do you need to be working with to be considered for top interventional pain fellowships, coming from an anesthesiology route? Scores. etc? Is doing a pain research project really critical during CA-1/CA-2 year?
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MGH: program has died, two major implanters have left, Rathmell is leaving in just 2 months, probably the lowest tier pain program in Boston now. Unfortunate. Great hospital and one of the best (if not the best!) anesthesia programs.
BWH: solid program, likely best in the country (AAPM award 3 years in a row), very interventional, 1000+ procedures per fellow, 10 fellows with usually 6-10 perm implants a week, maybe 75 perm implants per fellow. Good hours, done by 430pm usually. Very busy, get comfortable with lots of narcotic Rx. Lots of cancer pain. Good staff/faculty. Teaching is sort of weak despite daily AM conference for an hour. Would definitely do it again. Getting Rathmell in 2 months as BWH Anesthesia Chair.
BWH: solid program, likely best in the country (AAPM award 3 years in a row), very interventional, 1000+ procedures per fellow, 10 fellows with usually 6-10 perm implants a week, maybe 75 perm implants per fellow. Good hours, done by 430pm usually. Very busy, get comfortable with lots of narcotic Rx. Lots of cancer pain. Good staff/faculty. Teaching is sort of weak despite daily AM conference for an hour. Would definitely do it again. Getting Rathmell in 2 months as BWH Anesthesia Chair.
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- Mar 26, 2012
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cbest, you're correct. The American Academy of Pain Medicine (AAPM) awards the "Pain Medicine Fellowship Excellence Award" yearly. The 2015 award is shared by BIDMC and Mayo, not BWH. The American Pain Society awards the "Clinical Center of Excellence" award, which was awarded to UC Davis and BWH for 2015 in the University-based program division (note: there is also a Community-based program award). Take these awards to mean what you will. I also wanted to clear up the confusion Phyzicz may have had regarding AAPM's versus APS' awards.
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