Pain Surgeon?

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MitchLevi said:
His former boss constantly pumped a 24 month pain fellowship plan, and if you sat down at a table with him (Sean Mackey) he’d utterly destroy you in that debate.
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Funniest part is this specialty has turned into a *****. Anyone can basically practice pain without a fellowship or non accredited one. (Eg family practice, PM&R, and radiology). I should start a fellowship lol.

PA/NPs are doing procedures. CRNAs have an online fellowship doing 90% or what we do.

Yet they wanna do a 24 month accredited fellowship? What does it get us? Better TFESIs? Better RFAs? GTFO

I know they’re gonna say this field is becoming a surgical subspecialty. 80% of what we do surgically are SCS/ITP and a year is plenty if you go to a decent program. Vertiflex. Easy. SI fusion. Easy. Even minuteman are pretty easy.

The next rebuttal, you can’t fix you own complications. In 7 years I haven’t needed to “fix my own complication”. I am able to remove any ISPs (besides MM). But if i ever need help I have a dozen people to call.

Is a 24 month fellowship going to show us how to perform a spinal decompression for epidural hematoma?

I can’t handle how much of a waste of time most medical training is. I spent 17 years post high school in higher education .

Let’s just call it what it is. They want to extend the GME slavery.
 
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It is truly insane how low yield most of the hours are in medical training before and after the first 2-3 years of medical school.

It’s also frustrating how much time you have to spend in residency doing things you don’t care about, just to get to the fellowship.

I know multiple cardiologists that would have vastly preferred to skip the last two years of their IM residency to just go straight to their cards fellowship.

Integrated 3+3 plastics is much preferred option over the original 5 yr GS residency + 2 yr plastics fellowship.

Personally, I feel my time would have been better spent skipping residency and going straight to fellowship, even if that meant a 2 year fellowship/“residency”

If there had been option for an “integrated” pain residency, such a two year Pain training program after the intern year, (so 3 post grad years total), I would have definitely taken it over 1 yr internship, 3 yr residency, + 1 year pain fellowship.
 
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PMR should be outpt MSK and spine only.

MasterPain. I hear you, but you’re gonna taste your own flatus if you tried to debate that guy. He’s a human supercomputer and I had probably 3-4 debates with him about things I thought I knew a lot about, only to be calmly, thoroughly and completely decimated by a guy who dismantled me in a very nice manner. You think you’ve thought some things through bro?

Well, you really haven’t. You have an opinion, he’s an MD/PhD with autism who is obsessed with pain driving a 170 IQ.

I listed to a podcast with Anna Lemke one day about opiates. I told him I heard it and liked it. He asked me to highlight every single thought I had about it, and then changed my mind completely in less than 10 minutes.

At a dinner he hosted at his apartment complex, a cofellow went to his room to use the bathroom. I tried to get her to steal a pair of his underwear. I really wanted them.
 
MitchLevi said:
PMR should be outpt MSK and spine only.

MasterPain. I hear you, but you’re gonna taste your own flatus if you tried to debate that guy. He’s a human supercomputer and I had probably 3-4 debates with him about things I thought I knew a lot about, only to be calmly, thoroughly and completely decimated by a guy who dismantled me in a very nice manner. You think you’ve thought some things through bro?

Well, you really haven’t. You have an opinion, he’s an MD/PhD with autism who is obsessed with pain driving a 170 IQ.

I listed to a podcast with Anna Lemke one day about opiates. I told him I heard it and liked it. He asked me to highlight every single thought I had about it, and then changed my mind completely in less than 10 minutes.

At a dinner he hosted at his apartment complex, a cofellow went to his room to use the bathroom. I tried to get her to steal a pair of his underwear. I really wanted them.
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That’s the problem with most academics. They are “debaters”. Problem is their perspectives are completely flawed and not transferable to the real world. I’ll retire 25 years before him. Who’s smarter? He’s probably a flaming liberal who would flog me with Kamala Harris talking points too.

I don’t give a rip what he has to say. So long as a CRNA with an online fellowship can do exactly what I do for the most part no way a 24 months makes sense.

Most people don’t think a 12 month ACGME accredited fellowship make sense anymore 🤣
 
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bedrock said:
It is truly insane how low yield most of the hours are in medical training before and after the first 2-3 years of medical school.

It’s also frustrating how much time you have to spend in residency doing things you don’t care about, just to get to the fellowship.

I know multiple cardiologists that would have vastly preferred to skip the last two years of their IM residency to just go straight to their cards fellowship.

Integrated 3+3 plastics is much preferred option over the original 5 yr GS residency + 2 yr plastics fellowship.

Personally, I feel my time would have been better spent skipping residency and going straight to fellowship, even if that meant a 2 year fellowship/“residency”

If there had been option for an “integrated” pain residency, such a two year Pain training program after the intern year, (so 3 post grad years total), I would have definitely taken it over 1 yr internship, 3 yr residency, + 1 year pain fellowship.
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I talk about it all the time. The US medical training is the most ridiculous waste of time in human history.

I have a 4 year undergrad degree that’s a complete waste of time and money

I’d say 60% of first 2 years of med school waste
Of time. Anyone remember the Krebs cycle? Someone please recite me the coagulation cascade.

I’d say at least a year could have been shaved off of anesthesia residency. Intern year was mostly a waste of time.

And to be honest I learned everything I needed to know in 6 months of electives in pain during residency for PP. I was doing implants without a fellowship with zero issues/complications in PP.

Thus, fellowship (yes an ACGME one) was a waste of my time.

Need I even discuss the months to years spent studying for board exams…
 
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i knew a lot of people who thought the same way masterpain does. i know everything, this is not worth it, im better than this, i dont need to waste my time doing this.

well, part of medical training is the education. another part of medical training is to make sure the cocky know it alls who refuse to complete the process and to study and try to understand concepts of medicine dont get to become doctors, because that same cockiness and lack of understanding of the basics in the hands of those people will harm someone some day.


if you think you learned everything you needed to know about pain in the 6 months of electives, then you really have ignored the vast majority of pain medicine. yes, you can learn alot about shots, but that is only a small part of pain medicine. i am 100% sure you did not learn all of Benzon or Bonica in 6 months of electives, unless you are more brilliant than Sean Mackey.
 
Ducttape said:
i knew a lot of people who thought the same way masterpain does. i know everything, this is not worth it, im better than this, i dont need to waste my time doing this.

well, part of medical training is the education. another part of medical training is to make sure the cocky know it alls who refuse to complete the process and to study and try to understand concepts of medicine dont get to become doctors, because that same cockiness and lack of understanding of the basics in the hands of those people will harm someone some day.


if you think you learned everything you needed to know about pain in the 6 months of electives, then you really have ignored the vast majority of pain medicine. yes, you can learn alot about shots, but that is only a small part of pain medicine. i am 100% sure you did not learn all of Benzon or Bonica in 6 months of electives, unless you are more brilliant than Sean Mackey.
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Hey I’m not saying we shouldn’t pay our dues. We have an important job. And I do agree there’s a level of individual who needs to be selected to do the job. Survival of the fittest if you will.

However, I think the pendulum has swung too far and as an example I’m illustrating how ridiculous an. extra year of fellowship would be.

Believe it or not I think AI is going to change a lot of what I’m discussing. Is it beneficial for us to memorize a million things only to forget them a few days after the exam? I think the future of medicine says otherwise…
 
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My uncle is a still practicing physiatrist. Graduated 1978. 3 year fast track med school at Ohio state and 3 year residency. Was doing Fluoro guided facet injections etc in the 80s. Wrote some Emg chapters with Ernie.

Smarter than me and did in 6 years what took me 9. Med Ed could be streamlined, increase class sizes and put mlps back in the box.
 
nvrsumr said:
My uncle is a still practicing physiatrist. Graduated 1978. 3 year fast track med school at Ohio state and 3 year residency. Was doing Fluoro guided facet injections etc in the 80s. Wrote some Emg chapters with Ernie.

Smarter than me and did in 6 years what took me 9. Med Ed could be streamlined, increase class sizes and put mlps back in the box.
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Or they just cut the fat and focused on the important stuff then got to work.

There didn’t use to be fellowships and people still got great care
 
And maybe if we/the ABA lifted a finger to protect our turf I’d be more interested in listening to more training.
 
bedrock said:
plenty of people who are extremely book smart, unfortunately lack street smarts and interpersonal skills.
I'd want both but prioritize more of the latter if I had to compromise.
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He is one of those autism spectrum ppl who changes his personality depending on his settings. On stage is different than one on one is different than group setting, etc.

It’s okay to admit there are ppl out there with bigger brains than you.
 
MitchLevi said:
He is one of those autism spectrum ppl who changes his personality depending on his settings. On stage is different than one on one is different than group setting, etc.

It’s okay to admit there are ppl out there with bigger brains than you.
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Fine line between genius and insanity as they say
 
MitchLevi said:
He is one of those autism spectrum ppl who changes his personality depending on his settings. On stage is different than one on one is different than group setting, etc.

It’s okay to admit there are ppl out there with bigger brains than you.
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I'm not criticizing him personally, and yes I freely admit there are people smarter than me.

However, I'm not convinced they are any happier. There is more to life than just raw intelligence.
 
bedrock said:
I'm not criticizing him personally, and yes I freely admit there are people smarter than me.

However, I'm not convinced they are any happier. There is more to life than just raw intelligence.
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It’s best to have a solid mix of book smarts and street smarts
 
He is for sure locked away in an ivory tower, but he did say fellows always complain they don’t do enough procedures, when in reality what they’re not getting enough of is how to manage pain.

That’s a wise statement.
 
MitchLevi said:
He is for sure locked away in an ivory tower, but he did say fellows always complain they don’t do enough procedures, when in reality what they’re not getting enough of is how to manage pain.

That’s a wise statement.
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Agreed. How many LMBBs/ESIs/SIJ injections does one have to do to be considered proficient?

One thing I think is massively undervalued in training is radiological evaluation and spine pathology. We work so closely with spine surgeons. I think it’s important to know a lot about spine surgery, the types, and why which surgeries are done. When you do, you then know which surgeon to refer to. Not all are created equal. I value a solid MIS surgeon.
 
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nvrsumr said:
My uncle is a still practicing physiatrist. Graduated 1978. 3 year fast track med school at Ohio state and 3 year residency. Was doing Fluoro guided facet injections etc in the 80s. Wrote some Emg chapters with Ernie.

Smarter than me and did in 6 years what took me 9. Med Ed could be streamlined, increase class sizes and put mlps back in the box.
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Sounds like my dad. Was in the fast track that same time. Did 3 yr college, 3 yr med school then 3 yr IM. Just retired at 72. The guy’s a walking Harrison’s
 
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what can be shortened is the time spent in college.

there are 22 combined undergrad-medical school program that can cut those 8+ years to 6 or 7. but people would have to decide during high school that they wanted to go to med school, and a drop out rate is inevitable. if any of your kids are interested in med school, definitely look in to these programs.
 
Ducttape said:
what can be shortened is the time spent in college.

there are 22 combined undergrad-medical school program that can cut those 8+ years to 6 or 7. but people would have to decide during high school that they wanted to go to med school, and a drop out rate is inevitable. if any of your kids are interested in med school, definitely look in to these programs.
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I did it, 3 year college 4 year med school, 7 year “fast tracked” program from high school. I had no college experience and wouldn’t do it again. You never get those years of spending your parents money and doing nothing back again
 
Ducttape said:
what can be shortened is the time spent in college.

there are 22 combined undergrad-medical school program that can cut those 8+ years to 6 or 7. but people would have to decide during high school that they wanted to go to med school, and a drop out rate is inevitable. if any of your kids are interested in med school, definitely look in to these programs.
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This is easy. Look at Europe and other countries. They skip undergrad and get them straight into medical focused training
 
well my experience was vastly different. 6 years. 2 years purely undergrad. 2 years where med school courses counted as credit for undergrad.

double major biomedical sciences and sociology.



went to every football home game, a lot of basketball and hockey games. didnt miss anything and in fact, much to you all's chagrin, if i hadnt done the program i might be a sociologist at some academic center.

masterPain said:
This is easy. Look at Europe and other countries. They skip undergrad and get them straight into medical focused training
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not quite the same. did a lot of growing up those first 2 college years. and had a lot of fun.
 
Ducttape said:
well my experience was vastly different. 6 years. 2 years purely undergrad. 2 years where med school courses counted as credit for undergrad.

double major biomedical sciences and sociology.



went to every football home game, a lot of basketball and hockey games. didnt miss anything and in fact, much to you all's chagrin, if i hadnt done the program i might be a sociologist at some academic center.


not quite the same. did a lot of growing up those first 2 college years. and had a lot of fun.
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I have two bachelors and a minor. Had WAY too much fun in the 7 years 🙈😵‍💫🤐
 
masterPain said:
I have two bachelors and a minor. Had WAY too much fun in the 7 years 🙈😵‍💫🤐
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Guess it depends where you went for it. I was at a commuter school. Never went to a college football game, no campus life, etc. Also way too many science credits in a concentrated time. Would have appreciated some diversification as a break
 
The hubris in this thread is insane.

The attitudes here are the same that some of these cocky mid-levels have. And the "pain surgeons" maiming unsuspecting grandmas, claiming to be subject matter experts after doing a hungover "course" on a melting cadaver at an airport hotel for 4 hours.
 
Darkside_ said:
The hubris in this thread is insane.

The attitudes here are the same that some of these cocky mid-levels have. And the "pain surgeons" maiming unsuspecting grandmas, claiming to be subject matter experts after doing a hungover "course" on a melting cadaver at an airport hotel for 4 hours.
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Can you elaborate?
 
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