Pain Fellowship Reviews

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Any opinions between these two programs? From what I've gathered, sounds like BID does more flouro, less script writing, has more formal lectures, but does not get quite the number of pumps (few, if any) and stims as Brigham. Anything else to consider?

Thanks
 
As a former fellow I am biased toward BWH.

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

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

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

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

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

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

Feel free to PM me with more questions.
 
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Buckeye Anes said:
Sorry I guess that was kinda vague. I just meant they did not seem to do a whole lot of kypho/vertebroplasty or discs and they did not seem to do a lot of stims or pumps. Again this was just my impression and I did feel that this was a Very good program.
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Granted the number of kyphoplasty/vertebroplasty procedures certainly isn't going to impress anyone, between the three attendings, we'll perform anywhere from two to five SCS trials per week, implanting two to four permanent systems. We also do a fair number of intrathecal pump implants, between our refractory failed back/cancer population and our research trials. We also do quite a few discograms, both lumbar and cervical. I'm sorry that wasn't communicated to you during your interview.🙁
 
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packfan said:
Any opinions between these two programs? From what I've gathered, sounds like BID does more flouro, less script writing, has more formal lectures, but does not get quite the number of pumps (few, if any) and stims as Brigham. Anything else to consider?

Thanks
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The head of the BID anesthesia fellowship (Dr. Peeters-Asdourian) is openly hostile to PM&R participation in pain fellowships.
 
Is this UTSW at Dallas or Forth worth?? Thanks for clarifying.
Lizard1 said:
UT Southwestern

Procedure Day
Arrive 7am (earlier if need to do lots of H&Ps & consents)
OR start 7:30am
Lunch 12-12:45pm
Finish Procedures btw 2-3pm
Go down to clinic and finish up/help out - done by 3:30
spend 15-30min responding to phone calls from the day
Home by 4pm

Clinic Day
Arrive 7:30 to round on any inpatients
Clinic starts 8am
Grab lunch as you work
Work till end of clinic ~3:30pm and then see above

do about 10-15 discograms (3 levels each time)
do about 10 IDETS and 10 decompressions
do about 10 SCS's
do about 5-10 pumps
do about 5 vertebroplasties
just finished doing a high dose ketamine infusion over 4days for RSD - marginal results
all call from home - done a week at a time
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It shut down for atleast 2 years according to a letter I got after applying. Rumor has it that the fellowship director assaulted one of the fellows. Don't know if it is true, but that is what I heard on the interview trail.
 
medicineman1 said:
Anyone interview at University of Washington and Oregon Health Sciences? compare and contrast? Thanks
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U. of Washington is a very famous program. Bonica was a prior chair (author of Bonica's Management of Pain, gold standard for pain texts). The IASP was founded there and the very first pain clinic in the country was est. at U. Washington under the direction of Bonica. John D. Loeser (primary editor of Bonica's Management of Pain) is still faculty. The program recently gained a new energetic director and will also be gaining two interventional pain faculty in a few months. They are building a new pain center that will be fully functional by July of 2009. Very multidisciplinary program along with exposure to a large number or interventional procedures. I would put this program in the top 5 in the US.

OHSU is a smaller program only 3 fellows compared to U. Wash 4-5 fellows. Very multidisciplinary as well, and the Director (Dr. Sibell) is well known in the realm of interventional spine. The program is strong, but lacks the history of U. Washington.

Both are excellent programs and produce top notch fellows!!!👍👍👍
 
UW is a top 5 pain program, really? I know they have a great history, but I am surprised to see someone argue that they are one of the best of the best. I haven't seen a whole lot coming from UW, at meetings, journals etc, maybe I haven't been looking hard enough. Just 2 years ago when I was interviewing for residency there, several residents, including a chief, told me that they were in the process of rebuilding and that the pain program was not a strength. I don't doubt that they are much improved and have a bright future, but "top 5"? It is funny how there are like 25 or so programs that claim this.

panetrain said:
U. of Washington is a very famous program. Bonica was a prior chair (author of Bonica's Management of Pain, gold standard for pain texts). The IASP was founded there and the very first pain clinic in the country was est. at U. Washington under the direction of Bonica. John D. Loeser (primary editor of Bonica's Management of Pain) is still faculty. The program recently gained a new energetic director and will also be gaining two interventional pain faculty in a few months. They are building a new pain center that will be fully functional by July of 2009. Very multidisciplinary program along with exposure to a large number or interventional procedures. I would put this program in the top 5 in the US.

OHSU is a smaller program only 3 fellows compared to U. Wash 4-5 fellows. Very multidisciplinary as well, and the Director (Dr. Sibell) is well known in the realm of interventional spine. The program is strong, but lacks the history of U. Washington.

Both are excellent programs and produce top notch fellows!!!👍👍👍
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morpheus md said:
UW is a top 5 pain program, really? I know they have a great history, but I am surprised to see someone argue that they are one of the best of the best. I haven't seen a whole lot coming from UW, at meetings, journals etc, maybe I haven't been looking hard enough. Just 2 years ago when I was interviewing for residency there, several residents, including a chief, told me that they were in the process of rebuilding and that the pain program was not a strength. I don't doubt that they are much improved and have a bright future, but "top 5"? It is funny how there are like 25 or so programs that claim this.
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morpheus, Your info is dated, they just recently hired two interventional pain physicians including Andrea M. Trescot, MD, the former ASIPP president. UW does just about everything in large number but V-plasty. However, with the new hires it is likely that these procedures will be integrated.:diebanana:
 
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panetrain said:
morpheus, Your info is dated, they just recently hired two interventional pain physicians including Andrea M. Trescot, MD, the former ASIPP president. UW does just about everything in large number but V-plasty. However, with the new hires it is likely that these procedures will be integrated.:diebanana:
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Again, a good program, sure but none of what you are telling me puts UW in the class of programs, such as MGH, MD Anderson, Hopkins, UCLA, Stanford, etc, etc, etc, that have been strong for years, and have graduated fellows that have gone on to be leaders in the field.
 
mgh is as interventional as you want it to be... unfortunately the onus falls onto you to initiate certain treatment modalities 🙁

if you are gung-ho, then you can spend a month doing vertebro/kypho with Josh Hirsch (a vertebro superstar)
if you are gung-ho, you can collect procedures on the inpatient patients - or you can be lazy and just up their meds...
if you are gung-ho, then you can pressure your staff to pursue more options (PDD, nucleoplasty, etc)...

however there was a lot of staff turnover there in the last few years, so i don't know what it is like now.
 
There is plenty of intervention at MGH - I'm a fellow there now. Looks like I will be doing 6-10 OR cases this month. We do plenty of all of the B&B. We do some discos, IDET and neucleoplasty, but not tons. As stated you can do a full month with Hirsch doing plenty of vertebro/kypho. And of course you get to work with Rathmell and tons of other great staff.

And to clarify some of the misinformation posted in this thread - WE DO DO PLENTY OF IMPLANTS - PUMPS AND STIMS!
 
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I'm a 4th year anesthesia resident and spent the last 4 months applying and interviewing at a number of programs (all of Texas, NYC programs, Pacific NW, etc...)

As many of you know, there are a lot of great programs out there. In fact, I think it is kind of hard to find a bad program, more likely, it is an issue of "fit" or whether the program that you are looking at matches your expectations of your ideal pain fellowship.

Three negative things that seemed to come up again and again were:
1) Lack of interventional procedures (Iowa)
2) Level of scut work involved or bad hours, call &/or weekend coverage structure (Cornell)
3) Bad location (yeah, I know its only 1 year, but a year in NYC, Seattle, or Portland sure beats a year in Lubbock, Houston, or Iowa City.)

One of the most impressive programs was certainly the Univ. of Washington. Washington had a real sense of history/legacy along with a robust number of interventional procedures, little to no scut for fellows, renowned and talented names for faculty (and this list is still growing,) a brand new pain center opening, and tons of political and financial backing from the UofW and NIH (if i'm correct, their dept of Anes&Pain was #2 in NIH funding only behind JHopkins.) All of that combined with the fact that it is in one of the coolest cities in America made it an easy sell.

As far as top 5, who knows? Those rankings are very debatable and it ends up like an argument over who was the greatest basketball player ever (Chamberlain? Bill Russell? Jordan?) There are many great programs and you can make an argument for any of them being better or worse than another.

Bottom line was that I loved what Washington had to offer and their program really "fit" what I was looking for in a pain fellowship. I put it at the top of my list above several other "big name" programs, recieved multiple offers, and was glad to accept a position at Washington for 2009-2010.
 
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AggieAlum said:
I'm a 4th year anesthesia resident and spent the last 4 months applying and interviewing at a number of programs (all of Texas, NYC programs, Pacific NW, etc...)

As many of you know, there are a lot of great programs out there. In fact, I think it is kind of hard to find a bad program, more likely, it is an issue of "fit" or whether the program that you are looking at matches your expectations of your ideal pain fellowship.

Three negative things that seemed to come up again and again were:
1) Lack of interventional procedures (Iowa)
2) Level of scut work involved or bad hours, call &/or weekend coverage structure (Cornell)
3) Bad location (yeah, I know its only 1 year, but a year in NYC, Seattle, or Portland sure beats a year in Lubbock, Houston, or Iowa City.)

One of the most impressive programs was certainly the Univ. of Washington. Washington had a real sense of history/legacy along with a robust number of interventional procedures, little to no scut for fellows, renowned and talented names for faculty (and this list is still growing,) a brand new pain center opening, and tons of political and financial backing from the UofW and NIH (if i'm correct, their dept of Anes&Pain was #2 in NIH funding only behind JHopkins.) All of that combined with the fact that it is in one of the coolest cities in America made it an easy sell.

As far as top 5, who knows? Those rankings are very debatable and it ends up like an argument over who was the greatest basketball player ever (Chamberlain? Bill Russell? Jordan?) There are many great programs and you can make an argument for any of them being better or worse than another.

Bottom line was that I loved what Washington had to offer and their program really "fit" what I was looking for in a pain fellowship. I put it at the top of my list above several other "big name" programs, recieved multiple offers, and was glad to accept a position at Washington for 2009-2010.
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UW for the past years has been really weak. However, in the past year or so they've been adding promising new faculty including Alex Cahana from Switzerland as Pain Director and I think there is some exciting things in store for UW in the upcoming couple years. They've been VERY weak on procedures recently but hopefully that will turn around soon. Best of luck!
 
chinochulo said:
🙄 not sure what you're talking about, as they've had PM&R guys in the past....

The implant numbers at BID hovered around 3-4 per week when I was there...
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Dr. Peeters-Asdourian has expressed to multiple Spaulding residents, as well as BID fellows and staff, that she does not believe PM&R physicians have appropriate skills to perform pain procedures. If PM&R docs rotate on her service, she is openly hostile to them, and derides their abilities to her colleagues.
 
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Does anyone know anything about this fellowship program? I got an offer from them, but am unsure of the reputation of the program. Would it make more sense to take the offer (if they are a good program) or simply do a year of research and reapply next year (if they are a weak program). Please let me know. I need to decide quickly. Thank you.
 
I went to UPMC for interview and it's amazing that the PD started asking question about applicant's Religoin😱 Unbelievable 👎thumbdown
I dont know what else i can say but totally disappointed.
any recommendation?
 
ampaphb said:
Dr. Peeters-Asdourian has expressed to multiple Spaulding residents, as well as and BID fellows and staff that she does not believe PM&R physicians have appropriate skills to perform pain procedures. If PM&R docs rotate on ehr service, she is openly hostile to them, and derides their abilities to her colleagues. That's what I'm talking about.
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She should be punished.
 
BI allows Spaulding PMR residents to rotate with them and took a well qualified Spaulding resident for next years fellowship class.

The Dartmouth pain fellowship does a pretty good number of implants from what Ive heard. I did an implant cadaver course as a fellow that their PD proctored-very nice guy. They hired a PMR doc who did a fellowship at BWH a couple years ago. I definitely wouldnt hold off a year to do research.
 
nvrsumr said:
BI allows Spaulding PMR residents to rotate with them and took a well qualified Spaulding resident for next years fellowship class.

The Dartmouth pain fellowship does a pretty good number of implants from what Ive heard. I did an implant cadaver course as a fellow that their PD proctored-very nice guy. They hired a PMR doc who did a fellowship at BWH a couple years ago. I definitely wouldnt hold off a year to do research.
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The BWH fellow you are referring to left very unhappy from her position at Dartmouth within 6 months of starting work there. She was so unhappy that she left without another job lined up, and ultimately went to work at the Fresno VA, rather than continuing at Dartmouth.

Beasley and Fanciullo are old school (last I heard, they still weren't using contrast, and they certainly don't plce stims. Prior to Devi taking the position, they had another very well trained staff member (Dan Graubert) who also left after a very brief tenure. Caveat emptor.
 
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ampaphb said:
The BWH fellow you are referring to left very unhappy from her position at Dartmouth within 6 months of starting work there. She was so unhappy that she left without another job lined up, and ultimately went to work at the Fresno VA, rather than continuing at Dartmouth.

Beasley and Fanciullo are old school (last I heard, they still weren't using contrast, and they certainly don't plce stims. Prior to Devi taking the position, they had another very well trained staff member (Dan Graubert) who also left after a very brief tenure. Caveat emptor.
Click to expand...

I interviewed with Dr. Graubert when I visited there. Nice guy...
 
Kmeachem said:
Does anyone know anything about this fellowship program? I got an offer from them, but am unsure of the reputation of the program. Would it make more sense to take the offer (if they are a good program) or simply do a year of research and reapply next year (if they are a weak program). Please let me know. I need to decide quickly. Thank you.
Click to expand...

I have heard good things about Dartmouth from a very well known and respected pain attending at my program. His info is about 2 years old, but in terms of procedures, didactics and research they sounded solid. I agree that it would probably not be a wise move to sit out and reapply.
 
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Any of you have an opinion on canadian pain fellowships or the ones in australia? Dr Swarm, director of the pain service At Washington University in St Louis did his fellowship at university of Sydney. What about Mcgill or University of Toronto?

Are these programs good? Are they well recognized in the states?
 
NorthernDoc said:
Any of you have an opinion on canadian pain fellowships or the ones in australia? Dr Swarm, director of the pain service At Washington University in St Louis did his fellowship at university of Sydney. What about Mcgill or University of Toronto?

Are these programs good? Are they well recognized in the states?
Click to expand...


I'm sure you might get a great pain education at McGill. I've heard of Dr. Swarm and his affiliations. However, these programs are NOT well recognized in the states. Therefore, they will not provide the pedigree which is necessary to fast-track to the top positions in our field. If you have a choice, secure a fellowship in a well-respected program in the United States if you want to practice here.
 
In regards to this great discussion, what do people think of other California Pain programs not yet mentioned, such as USC or Loma Linda?
 
cornell is a part of the tri-institute program (includes sloan-kettering and hospital for special surgery). you only spend 3 months there. the call is NOT bad, at all, and the level of scut is also not that bad - most of it is taken care of by anes residents.

for the balance of name, education, and procedural training it is top 2 in NYC.


AggieAlum said:
I'm a 4th year anesthesia resident and spent the last 4 months applying and interviewing at a number of programs (all of Texas, NYC programs, Pacific NW, etc...)

As many of you know, there are a lot of great programs out there. In fact, I think it is kind of hard to find a bad program, more likely, it is an issue of "fit" or whether the program that you are looking at matches your expectations of your ideal pain fellowship.

Three negative things that seemed to come up again and again were:
1) Lack of interventional procedures (Iowa)
2) Level of scut work involved or bad hours, call &/or weekend coverage structure (Cornell)
3) Bad location (yeah, I know its only 1 year, but a year in NYC, Seattle, or Portland sure beats a year in Lubbock, Houston, or Iowa City.)

One of the most impressive programs was certainly the Univ. of Washington. Washington had a real sense of history/legacy along with a robust number of interventional procedures, little to no scut for fellows, renowned and talented names for faculty (and this list is still growing,) a brand new pain center opening, and tons of political and financial backing from the UofW and NIH (if i'm correct, their dept of Anes&Pain was #2 in NIH funding only behind JHopkins.) All of that combined with the fact that it is in one of the coolest cities in America made it an easy sell.

As far as top 5, who knows? Those rankings are very debatable and it ends up like an argument over who was the greatest basketball player ever (Chamberlain? Bill Russell? Jordan?) There are many great programs and you can make an argument for any of them being better or worse than another.

Bottom line was that I loved what Washington had to offer and their program really "fit" what I was looking for in a pain fellowship. I put it at the top of my list above several other "big name" programs, recieved multiple offers, and was glad to accept a position at Washington for 2009-2010.
Click to expand...
 
Which fellowships offer internal options to moonlight in the O.R's or covering OB.
 
Anyone with info on Pain at USF/Tampa? FREIDA lists link for Neuro non-interventional program, but seperate website looks like anethesia.
 
Hey, for any residents out there looking for a fellowship program that is extremely interventional and has fantastic faculty I would highly recommend the University of Colorado program.

The fellows there end up with about 100 stim trials/placements per year. They are well trained in all spinal interventions from cervical on down. This past year they have begun doing percutaneous facet stabilizations which is another option in the treatment of lumbar spondylosis.

The program has two tracks, the Anethesia based track and the PM&R based track. The Anesthesia based track is almost completely interventional and is where the above procedural numbers are generated. However, there are elective months which allow the fellows to "cross train" and spend time with PM&R or Anesthesia depending on what their base track is.

The attendings in this program are fantastic and are excellent physicians. They constantly go out of their way to teach fellows and are extremely easy to get along with. The learning environment is very ideal.

Overall, I would very much encourage anyone interested in being trained to be 100% comfortable with all interventions, and who would like to spend a year living beside the Rocky Mountains to check out this program.
 
I thought all the fellows spent equal amount of time in both tracks regardless of their prior training. Are you saying that the PM&R fellows spend most of their time in the PM&R base track and vice versa for anesthesia fellows? If so how many elective months do you get to cross train?
 
Currently either track will take candidates from either background. In other words, you don't have to be anesthesia trained to get into the anesthesia based track or PM&R trained to get into the PM&R track.

As far as the cross training there are 4-6 months of electives that are available in either track. Usually the time spent with the "cross training" is about 2 months of those electives because there must be time for getting the other required electives under the ACGME requirements.

This is a very fellow friendly program and you can and will certainly learn the things you are most interested in learning. Obviously there are responsibilities that must be met, but the faculty is very willing to work with you to personalize your electives to meet your interests/needs.
 
ampaphb said:
Dr. Peeters-Asdourian has expressed to multiple Spaulding residents, as well as and BID fellows and staff that she does not believe PM&R physicians have appropriate skills to perform pain procedures. If PM&R docs rotate on ehr service, she is openly hostile to them, and derides their abilities to her colleagues. That's what I'm talking about.
Click to expand...


FWIW - I interviewed there as a PM&R resident last Fall and felt like I got a fair shake, including from the PD. I did, nevertheless, make a strong effort in every interview there to specifically describe my procedural experience and numbers knowing that some programs have concerns about PM&R residents 'hands'. I also made sure I had Anes pain, in addtion to PM&R pain letters, and that they commented on my 'hands'. I have heard great things about the BI program from recent BI anes resident (now pain fellow elsewhere for geographic concerns).

I can only comment on my experience but I found that program to be great to work with/interview and they were very timely with their offers.
 
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Does anyone know of good research-oriented pain fellowships?

I am an MD/PhD student and would ultimately like to practice 1 day/wk, and run a basic science lab the other 6.
 
Ligament said:
UW for the past years has been really weak. However, in the past year or so they've been adding promising new faculty including Alex Cahana from Switzerland as Pain Director and I think there is some exciting things in store for UW in the upcoming couple years. They've been VERY weak on procedures recently but hopefully that will turn around soon. Best of luck!
Click to expand...

I've heard that they have been on the weaker side for years. I am familiar with Dr. Andrea Trescot. I believe she was over the program at Univ of Florida, but left for Univ of Wash after UFl's pain program closed! Does anyone have any further insight into Dr. Trescot? Did she really assault one of the fellows from U Florida???
 
bubblywatr said:
Does anyone know of good research-oriented pain fellowships?

I am an MD/PhD student and would ultimately like to practice 1 day/wk, and run a basic science lab the other 6.
Click to expand...


UCLA has offered a 2 year 50% research, 50% clinical pain fellowship in the past to people serious about pain research and academic pain.
 
Calilove said:
I've heard that they have been on the weaker side for years. I am familiar with Dr. Andrea Trescot. I believe she was over the program at Univ of Florida, but left for Univ of Wash after UFl's pain program closed! Does anyone have any further insight into Dr. Trescot? Did she really assault one of the fellows from U Florida???
Click to expand...

Wow 😱
 
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