Pain Fellowship Reviews

[pmrpain]

I'm currently a fellow at Loma Linda for Pain so my review is biased ....

They take both PM&R and anesthesia. 4 positions available for 1 year fellowship. They are taking applications for fellows starting in July, 2006, but deadline is soon so apply now - last I checked, they have less applications this year than normal so you will have better chances. ACGME accredited. Rotations: 6 months at the university, 3 months at the VA, and 3 months at a private pain doctor's office.

Strength: strong emphasis on interventional pain. learn how to run a pain clinic and be very productive - lot of education on medications as well. procedures include all the standard fluoro stuff, ESI, stellates/symp blocks, med branch, facet, SI, nerve blocks, etc. interventional stuff includes RF ablation, discography, spinal cord stim trials and placements, peripheral nerve stimulators, intrathecal pump trials and placements --- at the university the fellows do the trials, but the surgeons place the pumps/stims, at the private clinic the pain attending/fellows do the trials and place the pumps/stims, the VA is in the process of starting a SCS program. Reasonable work and call hours - home call, etc.

Weakness: not as many discographies as I would like. no vertebroplasties/kyphoplasties, nucleoplasties, or IDETs etc. research is encouraged - (can be a plus if you like research.) pay is so-so almost 50k/year. anesthesia fellows have an easier time moon-lighting. As a PMR fellow, it's more difficult to moonlight.

Lots more to say, but I'm tired of typing now, so priv msg me if you have questions and are seriously interested.

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[blupofol]

i actually troll these sites b/c i know a few people here and there and get curious how they like their program.

we've actually filled at hopkins for 2006-2007 so i'm not sure if this would even be useful. (btw, looks like some hot-shots coming in if i might add..)

for those of you applying for the following year here's the word...

OR: my best guess is the each of the four of us will get about 50-75 operative procedures (lumbar/cervical/occipital stims, pumps,etc). it's actually hard to calculate b/c i'm using our current rate and i'm told we're going to get busier once our surgical skills can handle the volume (i.e. 3 cases in one day) from day one the blade is yours.

less frequent fluoro: haven't done IDET yet, but they're lining up. nucleoplasty/discograms here and there.

other fluoro: coming out your ears

faculty: strongest point. well-known, well-published, book writers... hopkins. but also, i'd call each a friend. play tennis, racquetball, ect. enjoyable to work with. the OR guys are VERY patient with my rusty OR technique.

hours: lets just say, the bags under my eyes from residency have finally gone you can write me if you have specific Q's.

application: they take 3 fellows (we have 4 this year b/c military is funding one). looked like a stellar applicant pool, but historically the attendings haven't shown favoritism towards anesthesia, hopkins app's, etc. do yourself a favor and apply next year. it's lived up to all i hoped it would be and more. btw, it's pretty telling when CA-3's from a program have such a desire to stay for fellowship(keep that in mind wherever you interview at).

sure there are loads of fine programs. HTH

 

[Devi]

Hi,

I was just wondering if you could tell me more about the Columbia program.

I would agree with most of the above. The following list is based on my interviews and info from others on the interview trail.

Best Programs (in no particular order):
B&W, BID, MGH, UCLA (both Anesth and PM&R), UCSF, Texas Tech, Mayo Jacksonville, Cleveland Clinic, MD Anderson, Wake Forrest, Columbia, Cornell.

Very Good Programs (in no particular order):
Emory (Anesth), UT Southwestern, UT Houston, Einstein, UC Davis, West Virginia.

These are just my opinions. I'm sure I've left out some excellant programs so feel free to add to the list.

 

[bbbmd]

I want to know about the Combined Harvard program, UT San Antonio and MD Anderson for those of you who have interviewed there. Any comments?

By the way, UT-Houston has closed their program.

Thanks

 

[ckaypekian]

I'm currently a fellow at Loma Linda for Pain so my review is biased ....

They take both PM&R and anesthesia. 4 positions available for 1 year fellowship. They are taking applications for fellows starting in July, 2006, but deadline is soon so apply now - last I checked, they have less applications this year than normal so you will have better chances. ACGME accredited. Rotations: 6 months at the university, 3 months at the VA, and 3 months at a private pain doctor's office.

Strength: strong emphasis on interventional pain. learn how to run a pain clinic and be very productive - lot of education on medications as well. procedures include all the standard fluoro stuff, ESI, stellates/symp blocks, med branch, facet, SI, nerve blocks, etc. interventional stuff includes RF ablation, discography, spinal cord stim trials and placements, peripheral nerve stimulators, intrathecal pump trials and placements --- at the university the fellows do the trials, but the surgeons place the pumps/stims, at the private clinic the pain attending/fellows do the trials and place the pumps/stims, the VA is in the process of starting a SCS program. Reasonable work and call hours - home call, etc.

Weakness: not as many discographies as I would like. no vertebroplasties/kyphoplasties, nucleoplasties, or IDETs etc. research is encouraged - (can be a plus if you like research.) pay is so-so almost 50k/year. anesthesia fellows have an easier time moon-lighting. As a PMR fellow, it's more difficult to moonlight.

Lots more to say, but I'm tired of typing now, so priv msg me if you have questions and are seriously interested.

I'M CURRENTLY APPLYING TO LLUMC. ANY ADVICE?

 

[md2k]

Hi,

I was just wondering if you could tell me more about the Columbia program.

Stinks unless youre into psych. Very high emphasis on the psychatric component of pain. Dont do many procedures, maybe 3 to 4 on clinic days. Overall, weak program with good name.

Texas tech is a great program with Racz and now boswell.

 

[saltnpepper]

Hi,

I was just wondering if you could tell me more about the Columbia program.

Columbia has two programs, the main campus (Presbyterian) one does not do much interventional procedures. They have a new attending trained at Hopkins who might make the program a little more interventional. But currently, he is stuck in the OR most of the time and doing minimum pain. There are two fellows in the program, alternating doing in-pt pain and clinics. So basically, you are spending half of your time (6 months) doing in-pts. However, at Columbia, you don’t do much scud work. You go to work at 8am, and don’t need to put in thoracic epidurals early in the morning. You have residents doing the initial work for consults most of the time. For out pt clinics, it is very medically oriented. Agree with md2K, it is a weak interventional program.
The other Columbia program is St Luke’s Roosevelt. It is well known for its regional program. However, they have a well established pain center. Multiple people have told me this is the best interventional pain fellowship in NYC. They have four fellows, rotating every week. Basically, each month, you do two weeks of fluoro rooms, one week follow up clinics, and one week chronic pain consultation. PCAs are taken care of by a nurse. Minimum scud. No thoracic epidurals in the am either. The day starts at 8am with daily lectures. Dr. Hertz is regarded as the best teacher by fellows there. They all seem very happy. I know people have chosen St Luke’s over BID and many fellows there claimed that it was their first choice when they applied. Actually, the set up at St Luke’s is very similar to the BI. If you like the BI, look into St Luke’s also. Both are among the best providing training in bread and butter fluoro procedures.
Cornell has a great name in terms of the medical center. The fact that fellows rotate through HSS and MSK seems very attractive. However, there are a lot of undesirable things in the set up. Fellows there spend 3-4 months at the NY hospital, during which you are essentially on call everyday, taking care of all PCA and epidural pts (30-40pts). You go in at 6:30am to place them and would be on beeper call all day and all weekend. Fellows work until 8pm most of the time. I think they still do fluoro procedures in the OR (I could be wrong on this though). HSS is where you get most of your fluoro procedures. You spent 3 months there. There are a lot of volume there. However, those are all private patients. The message some attendings send out is that: “these are my pts, and I can handle them myself. I don’t need you to be here. If you are here, you’d better not mess up with them.” Some fellows complained that they had to watch procedures sometimes at HSS. MSK is mainly medical management for cancer pain, which is great. However, you may not want to spend 3-4 months out of your 1 year long fellowship just to do that. You also need to do epidurals in the morning and be on call a lot. Overall, Cornell has a great name, but it is not a very strong interventional program with significant amount of intern level scud work. I know people have quite mid way there due to lack of hands on procedures.

 

[tigerbalm]

Completely agree with Saltnpepper. I interviewed at all programs in NYC. St Luke's is the best interventional program in the city. Fellows there are very happy. However, the secretary there can be a little disorganized and you may have to keep calling her to schedule an interview spot. They interview in late Oct and Nov, later than other NYC programs. But it is well worth of your effort to go take a look.
When you look at a pain fellowship program, you want to make sure you have enough hands on training. One year is short. You want to do exactly what you need to learn instead of doing intern work (haven't you had enough of that already?). Many attendings and fellows have told me that a better training program is far more important than the name of the medical center.

 

[paz5559]

Completely agree with Saltnpepper. I interviewed at all programs in NYC. St Luke's is the best interventional program in the city. Fellows there are very happy. However, the secretary there can be a little disorganized and you may have to keep calling her to schedule an interview spot. They interview in late Oct and Nov, later than other NYC programs. But it is well worth of your effort to go take a look.
When you look at a pain fellowship program, you want to make sure you have enough hands on training. One year is short. You want to do exactly what you need to learn instead of doing intern work (haven't you had enough of that already?). Many attendings and fellows have told me that a better training program is far more important than the name of the medical center.

I was also advised by the program chair that Memorial Sloan Kettering would not consider aplications from non-anesthsia trained applicants.

 

[drshy44]

How would these programs compare in terms of didactic,clinical and intereventional procedures? Which would be a better choice to learn procedures?
Any input is appreciated.

Completely agree with Saltnpepper. I interviewed at all programs in NYC. St Luke's is the best interventional program in the city. Fellows there are very happy. However, the secretary there can be a little disorganized and you may have to keep calling her to schedule an interview spot. They interview in late Oct and Nov, later than other NYC programs. But it is well worth of your effort to go take a look.
When you look at a pain fellowship program, you want to make sure you have enough hands on training. One year is short. You want to do exactly what you need to learn instead of doing intern work (haven't you had enough of that already?). Many attendings and fellows have told me that a better training program is far more important than the name of the medical center.

 

[thepainguy]

Just take some weekend courses! No need for a long fellowship.lol.

 

[md2k]

Just take some weekend courses! No need for a long fellowship.lol.

That's Crap. There is more to pain medicine than just a weekend course in how to do some blocks.. You havt to know a bit more than just how to do a facet or caudal or whatever you think you can learn in a weekend. It's people like that that give pain medicine a bad rap.

 

[PainDr]

Lighten up! I think he was just kidding.

 

[trezur]

Does anyone know anything regarding the Pain Fellowship program at The Mayo Clinic Scottsdale? Any insights would be appreciated

 

[MACMD]

Can anyone give any info. on the NYU pain program and how it compares to other NYC programs including Columbia, Cornell and st. Luke. Thanks

 

[md2k]

Can anyone give any info. on the NYU pain program and how it compares to other NYC programs including Columbia, Cornell and st. Luke. Thanks

Interviewed at all of them.. Only Lukes is worth going to.

 

[paz5559]

Interviewed at all of them.. Only Lukes is worth going to.

Just remember the above is one person's opinion, and that people have agendas other than what is necessarily in your best interest (ie talking badly about a program in order to decrease their competition).

 

[md2k]

Just remember the above is one person's opinion, and that people have agendas other than what is necessarily in your best interest (ie talking badly about a program in order to decrease their competition).

I agree with Paz. It is only one persons opinion. However, I am not out to bag these programs and I dont have an agenda. I turned them down and went to a program in texas. If you ask other people who have interviewed at these progrmas they will most likely tell you the same things. With that being said, I interviewd at these programs back in sept 2004. Maybe things have changed and the programs have improved?????

 

[Idiopathic]

Okay, this question has been asked often, but with so-so answers. What exactly helps one in getting a pain fellowship? Do your Step scores matter or is it all subjective criteria (strength of residency, letters of rec, interview skills). Are there objective criteria that are used to evaluate applicants? Thanks.

 

[drusso]

I think pain-relevant research experience helps.

 

[poeyfarre]

I am looking for information regarding the pain fellowship in MD Anderson, Emory and Jackson Memorial, Miami. When should I start applying?
Thanks

 

[ParaVert]

I will be starting my pain fellowship at MDACC in July. One of my good friends is currently finishing his fellowship there as well. As far as application timeline, the best advice is, "the earlier, the better," i.e.: NOW. One of the rate-limiting steps in the application process is getting recommendation letters (I waited 9 weeks for my Chair letter). Try to have everything in by the beginning of August.

I think that the MDACC fellowship is undoubtedly one of the best-kept secrets in the pain world. First off, they do TONS of interventions. You get more pumps and vertebroplasties PER FELLOW than virtually anywhere else in the country. Sure, Cleveland Clinic does an unbelievable volume of implantables, but they also have 10 fellows competing for procedures. At MDACC, there's half that many. Percutaneous Disc Decompression, RFA of EVERYTHING you can think of, SCS, peripheral nerve stimulation, they do it all, and plenty of it.

At MDACC, the pain fellows have no acute pain duties (no epidurals or PCA mgmt) unless consulted by the acute pain svc. (usu. established chronic pain pts in-house for surgery). In addition, the palliative svc. is also separate, which takes a tremendous burden of narcotic patients off the chronic fellows.

MDACC has several fantastic faculty members. First, the chair of the department is David L. Brown, world-renowned regional-anes guy. The head of acute interventional pain, Krishna Boddu, was faculty at Virginia Mason. Allen Burton is the Chief of Cancer Pain. Not only has he been a frequent lecturer at the ASA for neurostimulation, vertebroplasty, and intrathecal pumps, he is also one of the nicest guys I know. This guy is reason alone to beg for a fellowship.

MDACC realizes that most of their fellows will pursue private practice. To accommodate that, we get three months of totally private practice experience. One month is with Kenneth Alo, one of the busiest and best-known private guys in the country (look on the Stryker Dekompressor website to see his work). These rotations not only give you excellent experience with "real world" pain, they make you FAST. In addition, you get hands-on exposure to practice management.

The dept. has prided itself on multidisciplinary training. In my class next year, there will be two ANES (including myself), one PM&R, one Neuro. All VERY strong residents, all good people.

I would say that the only major weaknesses of the program are that there is minimal pediatric pain (virtually no pedi-interventional), and that they typically take known entities. I'm pretty sure that everyone in my class did a rotation at MDACC prior to interviewing.

All in all, I think that MDACC is the best program in the South, and the interventional experience (both cancer and non) is second to none.

I also interviewed at UVA, Hopkins, Brigham, Beth Israel, Cleveland Clinic, Texas Tech - Lubbock, and was offered fellowships at several of these.

 

[chinochulo]

you will be a good person to refer my pump patients to, because after 10 months of putting in nothing but pumps you should be pretty good at it.

 

[bbbmd]

you will be a good person to refer my pump patients to, because after 10 months of putting in nothing but pumps you should be pretty good at it.

Ill be at MDACC as well!!! Yup, we'll be pretty good at puttin' in those pumps! Actually, we'll have 12 months of it and doing a whole lot of other procedures too.

I agree with ParaVert's review of the program. I couldn't be happier with my decision! What sold the program to me? The faculty; the breadth of procedures we learn; the training/mentorship; the great working environment; research opportunities; location (of course this is an individual thing); and how happy the current fellows are with their training. I echo ParaVert's statement "MDACC fellowship is undoubtedly one of the best-kept secrets in the pain world"

I heard that the incoming class is "VERY strong" from a few sources also (maybe Paravert and the other 2, but certainly not me... Im just a hardworking PM&R guy). Looking forward to meeting them for happy hour next week! Man, we havent even started yet and already a happy hour!!!

B

 

[gecko]

I was accepted at 3 programs: MD Anderson, UCLA's PMR, and Harvard's Combined program, and ultimately chose to go to UCLA, primarily because of my PMR background, and what I want to be doing after fellowship. I can't say enough about MD Anderson's program (I believe it's the best program if you want to do more pumps/stims/vertebroplasties because of the cancer population)...however, I don't believe that's what I'll ultimately be doing in the future. Don't get me wrong, UCLA's VA program will also give you a ton of experience with those procedures (comparable, if not more than BIDMC, MGH, or even BWH). The thing that sold me on UCLA's program was that it was extremely well-rounded. It'll prepare me better for the bread and butter private practice pain management, yet still give me plenty of the more invasive interventional procedures...and it has the most balanced multidisciplinary pain clinic I've seen/heard of...plus, I'll keep up with my EMGs. Attendings are really easy-going, and you can't beat the West LA location!

Good luck to everyone on their hunt for a fellowship spot...it's getting tougher, especially for PMR residents...but if you prepare early, you should find a spot!

 

[Dryacku]

Any info on any of the florida programs?

 

[C Fiber]

I heard MD Anderson does not put in too many stims though. And the inpatient consults are plenty busy to keep the fellows working until 6-7PM.

 

[anesthesiology]

HI,
I am new to this forum. Can anyone tell me about the pain fellowship program at Univ of Florida, Gainsville ?
thanks

 

[md2k]

Any info on any of the florida programs?

They are all weak. Not sure about mayo?? USF not bad, however probably closing d/t recent info that anesthesia program is closing. Miami and Gainseville not very good.

 

[paz5559]

They are all weak. Not sure about mayo?? USF not bad, however probably closing d/t recent info that anesthesia program is closing. Miami and Gainseville not very good.

Curious if you are speaking of the anesthesia or PM&R programs when you categorically damn all programs in the state?

 

[md2k]

Curious if you are speaking of the anesthesia or PM&R programs when you categorically damn all programs in the state?

I'm strictly speaking about anesthesia. I dont know anything about the PM&R programs in florida.

Can you still get me that book???

 

[ParaVert]

As you know, I will be starting at MD Anderson in 6 weeks. I just spoke with the secretary for the pain department, Trish Rendon. She told me that they did 28 stimulator trials and 17 implants during the month of April. They've also started doing kyphoplasty in addition to vertebroplasty. I think they're averaging 5/month, but is increasing.

I do admit that the hours are longer at MDA than some other places. The fellows average about 60hrs/wk. Usu come in b/t 7-8am, usu stay b/t 5-7pm. Avg. 1 weekend/month inpatient rounding (w/o attending, come in whenever you want) Sat. and Sun., with Monday off at noon.

At least with Anderson, long hours translates into tons of procedures, not just tons of consults (although there seem to be plenty of them, too.)

 

[docnyc]

Hi all,

Great forum! I am new to this forum so i apologize if someone has already written about these programs, but can anyone give me an idea of how these programs are? Specifically in regards to how interventional they are (injections and implantables), call duties, outpatient/inpatient exposure, good overall experience vs bad? I am anesthesia trained.

Duke
Emory
UVA
Mayo Jacksonville

Thanks!!!

 

[anesthesiology]

They are all weak. Not sure about mayo?? USF not bad, however probably closing d/t recent info that anesthesia program is closing. Miami and Gainseville not very good.

thanks for the reply.

 

[anesthesiology]

As you know, I will be starting at MD Anderson in 6 weeks. I just spoke with the secretary for the pain department, Trish Rendon. She told me that they did 28 stimulator trials and 17 implants during the month of April. They've also started doing kyphoplasty in addition to vertebroplasty. I think they're averaging 5/month, but is increasing.

I do admit that the hours are longer at MDA than some other places. The fellows average about 60hrs/wk. Usu come in b/t 7-8am, usu stay b/t 5-7pm. Avg. 1 weekend/month inpatient rounding (w/o attending, come in whenever you want) Sat. and Sun., with Monday off at noon.

At least with Anderson, long hours translates into tons of procedures, not just tons of consults (although there seem to be plenty of them, too.)

Glad to know that U are joining good fellowship program. Is MD anderson a purely cancer oriented/interventional program or it also has mixture of pain training as regular pain fellowship programs offers. Because if the program is purely cancer oriented then one will be good in putting pumps and other stuff and has to be associated with the big pain centers rather than starting your own clinic. I may be wrong in my assesment and will appreciate if u can give some input.
thanks

 

[paz5559]

Glad to know that U are joining good fellowship program. Is MD anderson a purely cancer oriented/interventional program or it also has mixture of pain training as regular pain fellowship programs offers. Because if the program is purely cancer oriented then one will be good in putting pumps and other stuff and has to be associated with the big pain centers rather than starting your own clinic. I may be wrong in my assesment and will appreciate if u can give some input.
thanks

Just a suggestion, but perhaps you might consider reading the thread before posting a question that has already been directly addressed (ie. post #76 in this very thread)

 

[anesthesiology]

Just a suggestion, but perhaps you might consider reading the thread before posting a question that has already been directly addressed (ie. post #76 in this very thread)

Thanks for your suggestion, I did read his very nice post before posting.It is a forum where new people like me like to ask some questions though sometime silly it may appear. U may be very experianced , I don't know.I was just trying to differentiate between the the regular pain programs and purely cancer management programs. I was told by one of the colleague that pure cancer pain programs are not involved with the usual program where they teach lots of bread and butter pain management and purely cancer programs teach only pain associated with the cancer and they don;t have too many other chronic patients. That was the reason of my questioning .

 

[C Fiber]

I heard that they do their bread and butter chronic pain procedures with the private guys for 3 months out of 12 months. I think you do a few ESIs at the main hospital but mostly you do the vertebroplasties and pumps and inpatient consults on the other 9 months, but this was as of 1 year ago. Seems like that they have increased their numbers in SCS since then. I wonder if they are doing any disc procedures like Dekompressor, Nucleoplasties?

 

[ParaVert]

One month of the outside rotations is with Ken Alo, one of the most well known pain docs using Dekompressor in the US. Check out the Stryker website for his cohort trial and follow-up data. In addition, both Dr.'s Burton and Pham (Anderson faculty) do nucleoplasty and/or Dekompressor, including cervical disc decompression. Truthfully, it is hard finding any fellowship that does a ton of intradiscal procedures, but the MDA fellows get their fair share. If you're interested in hard-core disc experience, check out Cleveland Clinic.

As far as the bread-and-butter, that stuff pretty much sorts itself out. Nobody does a Pedi-Anes fellowship to do a year of tubes and tonsils. Honestly, after doing 3 months of pain and 1 month of regional in residency, I feel confident in lumbar MBB's, transforaminals, even straightforward cervical ESI's. Frankly, it doesn't take that long to learn to do a good LBP workup and perform basic diagnostic injections. Remember, most pain guys out there doing "bread and butter" never did a fellowship.

 

[ParaVert]

I heard Duke requires manditory research and is not very interventional. Emory has historically been good, but is in transition. A friend of mine went there for residency but is going elsewhere for fellowship. UVA is very good, but bread-and-butter. You'll get a great education, both Rowlingson and Hamill-Ruth are great. Minimally interventional. You'll be lucky to get 10 pumps, no intradiscal stuff beyond discograms, no vertebro/kypho. Dunno about Mayo.

Hi all,

Great forum! I am new to this forum so i apologize if someone has already written about these programs, but can anyone give me an idea of how these programs are? Specifically in regards to how interventional they are (injections and implantables), call duties, outpatient/inpatient exposure, good overall experience vs bad? I am anesthesia trained.

Duke
Emory
UVA
Mayo Jacksonville

Thanks!!!

 

[anesthesiology]

One month of the outside rotations is with Ken Alo, one of the most well known pain docs using Dekompressor in the US. Check out the Stryker website for his cohort trial and follow-up data. In addition, both Dr.'s Burton and Pham (Anderson faculty) do nucleoplasty and/or Dekompressor, including cervical disc decompression. Truthfully, it is hard finding any fellowship that does a ton of intradiscal procedures, but the MDA fellows get their fair share. If you're interested in hard-core disc experience, check out Cleveland Clinic.

As far as the bread-and-butter, that stuff pretty much sorts itself out. Nobody does a Pedi-Anes fellowship to do a year of tubes and tonsils. Honestly, after doing 3 months of pain and 1 month of regional in residency, I feel confident in lumbar MBB's, transforaminals, even straightforward cervical ESI's. Frankly, it doesn't take that long to learn to do a good LBP workup and perform basic diagnostic injections. Remember, most pain guys out there doing "bread and butter" never did a fellowship.

Thank your very much for your nice explanation.I am sure u have done good amount of work in this field. Do u know about mt sinai and Michigan programs? I am out of residency for 3 years so I am kind of ignorant about the programs. I will appreciate your answer.

 

[docnyc]

I heard Duke requires manditory research and is not very interventional. Emory has historically been good, but is in transition. A friend of mine went there for residency but is going elsewhere for fellowship. UVA is very good, but bread-and-butter. You'll get a great education, both Rowlingson and Hamill-Ruth are great. Minimally interventional. You'll be lucky to get 10 pumps, no intradiscal stuff beyond discograms, no vertebro/kypho. Dunno about Mayo.

Thanks for the info!!!!! Its very difficult to found out what program does what just by reading their information packets posted on the web.

 

[lobelsteve]

Emory has two programs.
Anesthesia and PMR.

The PMR program is 100% outpatient, procedure based.
For the last few months there have been 15-25 stims per month divided among the fellows. PAZ could comment more on the current numbers. When I trained there I did so many ESI, MBB, RF, SIJ that I would giv eup my procedures for others and just clean house by seeing as many OV's as possible. I waited my turn for pumps, stims, and disc procedures- did not break 100 for any of these, but well over that for the others.

 

[md2k]

I heard Duke requires manditory research and is not very interventional. Emory has historically been good, but is in transition. A friend of mine went there for residency but is going elsewhere for fellowship. UVA is very good, but bread-and-butter. You'll get a great education, both Rowlingson and Hamill-Ruth are great. Minimally interventional. You'll be lucky to get 10 pumps, no intradiscal stuff beyond discograms, no vertebro/kypho. Dunno about Mayo.

I interviewed there in 2004 and was not impressed with the program.
They encourage research but dont require it. They had problems with staff sticking around, there was no chairmain for the pain department.
They dont perform many procedures, maybe 3-4/day for two fellows.
Thay had only 1 day per month slot in the OR for Stim or pump implants. In the VA, they perform blind procedures b/c thay cant afford a flouro machine.

However, I must say there hours and call are very good. Start at 8am and done by 3pm, and no calls. Well, maybe not that good as it is at the expense of your education or lack thereof. Worst of all they think their sh-t dont stink b/c its Duke. THere are some positives. If you want to do regional they are really good. You will graduate from a pain fellowsh-t with great regional skills.

 

[wes2308]

Anybody have any more information about the UVA program in Charlottesville or the program in Richmond, VA

Thanks

 

[PainDevil]

I'm a current Duke Pain fellow, and here are my two cents:

Fellowship consists of 6 months at Duke Pain clinic, 3 months at VA, 2 months of electives and 1 months of Acute pain

Duke Pain clinic: Fluoro-guided procedures, 12-15 a day on average. RFs, discograms as they come, etc, bread and butter stuff of course are done here. Fellows don't cross paths so you do them everyday (if you so desire-- you could delegate them to residents if you wish, you're in charge of the schedule). You will also learn medical management as well. Busy rotation, nice free-standing facility

VA: There is a (new) fluoro machine. 2 NPs to help see patients, which is a definite plus.

Acute pain: One month as a block, but no nights, no weekends!! Four NPs carry the acute pain pager. The fellow does consults, and round on pts in the morning.

OR: Guaranteed 3 days a month in ASC, in reality often 4 days a month (sometimes more) due to add-ons (cancer pts, revisions, etc). OR days usually full with permanent implants, trials, or pumps... yes we do all these at the ASC, so no scheduling hassles, turnover delays, etc. You'll be doing them pretty much on your own by the third month, under supervision of course.

Didactics: Monday morning pain conference with breakfast, Thursday morning journal clubs

Faculty: All seven faculty are fun to work and chill with. Frequent activities outside of work. Director is Dr. Winston Parris, who's helped promote the field since the seventies. Pain fellowship program director genuinely cares about his fellows!

Other: Duke name helps with job search. Prospective employers were impressed with my training. The fellowship has a strong preference for anesthesia-trained applicants, and is competitive. North Carolina weather is mild, plenty of stuff to do for young guys like myself.

Cons: No vertebroplasty; would have liked more disc procedures.

 

[Doctodd]

VA: There is a (new) fluoro machine, which of course you can use, but personally my preference is not to use it since I'm comfortable doing my procedures blindly (I'm anesthesia-trained).

Monetarily and liability-wise, i suggest you rethink what you said above.

T

 

[md2k]

Wow!!! Sounds like things have improved since last year. You guys can now use flouro at the VA.

I'm a current Duke Pain fellow, and here are my two cents:

Fellowship consists of 6 months at Duke Pain clinic, 3 months at VA, 2 months of electives and 1 months of Acute pain

Duke Pain clinic: Fluoro-guided procedures, 12-15 a day on average. RFs, discograms, etc, bread and butter stuff of course are done here. Fellows don't cross paths so you do them everyday (if you so desire-- you could delegate them to residents if you wish, you're in charge of the schedule). Busy rotation, nice free-standing facility

VA: There is a (new) fluoro machine, which of course you can use, but personally my preference is not to use it since I'm comfortable doing my procedures blindly (I'm anesthesia-trained). 2 NPs to help see patients, which is a definite plus.

Acute pain: One month as a block, but no nights, no weekends!! Four NPs carry the acute pain pager. The fellow does consults, and round on pts in the morning.

OR: Guaranteed 3 days a month in ASC, in reality 4 days a month (sometimes more) due to add-ons (cancer pts, revisions, etc). OR days full with permanent implants, trials, pumps... yes we do all these at the ASC, so no scheduling hassles, turnover delays, etc. You'll be doing them pretty much on your own by the third month, under supervision of course.

Didactics: Monday morning pain conference with breakfast, Thursday morning journal clubs

Faculty: All seven faculty are fun to work and chill with. Frequent activities outside of work. Director is Dr. Winston Parris, who's helped promote the field since the seventies. Pain fellowship program director genuinely cares about his fellows!

Other: Duke name definitely carried me far in my job search... got calls from "invitation only" places too. Prospective employers were impressed with my training, number of procedures (esp implantables). The fellowship has a strong preference for anesthesia-trained applicants, and is competitive. North Carolina weather is mild, plenty of stuff to do for young guys like myself.

Cons: No vertebroplasty, if that's a big thing for you.

 

[EchoPedos]

I am wondering if there are fellowship programs which additionally offer advanced teaching in peripheral nerve blocks. I've heard that VM offers a 1 month elective during te fellowship, do we know if there are others that might offer more than one month?
Thanks.

 

[Lizard1]

OK - here's the scoop for the Emory Pain Fellowship(anesthesia) from first hand knowledge:

Basically have three different places where you can be assigned to for a month at a time
1. Acute Pain Svc
2. Clinic
3. Procedures

The acute service places epidurals for post-op analgesia throughout the day and then rounds on pts with epidurals. The teaching is improving but mostly it's a get the work done-see ya later type of scenario. Many fellows get frustrated with this part of the fellowship as they believe there fellowship time is being wasted doing this rotation instead of being in clinic or doing procedures. The ugly is that you spend 4-6mos doing acute pain

The clinic - well once you get past the two HUGE attitudes that belong to the two RN's(?) there, the you get to focus on the pts. They have both been reprimanded but we'll see if anything changes. How interesting clinic is depends upon who the attending is. Some attendings just want to make it through the day, some teach, where some seem even annoyed that you're seeing their pts and they have to wait for you to examine & come up with a plan. Avg day is 9-5 BUT you are generally called the night before to help out with first start epidurals on the acute svc at 6am at a different hospital. Typicall 3-4mos of clinic

Procedures - Tons of bread & butter blocks under fluoro that's directly attached to the clinic. Again, the teaching depends on the attending. Some will talk you through it and teach whereas others will try and take over immediately with even the most experienced fellow - obviously annoying. 3 mos of procedures

Also, one month you can be assigned to the cancer service. There's no real set plan, it's just kinda treat a CA pt as they appear whether it's a refill script or a pump. You could have 3-4 days of just reading and then the next day get called to a different hospital for a CA consult and they 15 min later the attending will page you saying there is CA pt coming to clinic shortly(different hospital)

Now this is the nitty gritty on the program. I'm sure other programs may be like this but generally not talked about. Also, for some reason, this program seems to attract fellows that have not passed their boards - frustrating. Hopoefully this will change with this yrs class. 5 of the graduating Emory anesthesia residents went into pain this yr and 2 of us are staying here - mostly because of family issues rather than the strength of the program