"Private Practice" Pain Fellowship

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V-SWAG

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Budding CA-2 here, interested in doing a pain fellowship after graduating. I am planning on going into private practice after graduation and was wondering if anyone knew of any pain fellowships which were structured more like private practice; heavy emphasis on interventional/surgical procedures and not so much on research or psych/rehab or inpatient pain. I know most pain programs will provide a good amount of procedures but I'm less interested in "big name programs" and would like to go somewhere where I would feel confident moving into private practice right after I graduate. I know the match was just a few weeks ago, anyone get this sense out on the interview trail with any particular programs? Any info would be greatly appreciated, thanks.

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I'm a current fellow at Northwestern and can attest to the fact that you will be well prepared for any private practice environment if you train here. The division chief emphasizes efficiency and streamlining the clinic to make it very productive; he previously worked in private practice so he knows how to train you to succeed. There's also ample support staff: 2 MAs, 2 XR techs, a clinic manager, a program coordinator, a research RN who answers patient calls and a PA for med management appointments. Some programs don't even have one XR tech, which blows my mind! There is no waiting around for an hour to present to your attending like at some programs - you're paired with an attending for the day and you see (almost) all the patients and do all the procedures. I'll actually be taking an academic position in California so there are definitely opportunities for research (I mean - Benzon sees patients in clinic two days a week so clearly you have a good contact) but research is not required. The total number of procedures has to be near the top 5%ile in the nation but we're still out of there by 4:30 every day. We do lotssss of WCRF of SI, C/T/L spine and knee (this would be a huge money maker in private practice), conventional RF, lots of ultrasound based procedures (hip, TGN and stellate ganglion blocks - U/S bills exceptionally well for those of you concerned about RVUs) many stims and a fair but not exhausting number of pumps. We even do discos because despite the controversy they have diagnostic value and certain surgeons need them to make a plan for spine intervention in clinically challenging patients.

The majority of your year is in the clinic doing interventions but we have 3 total weeks of rehab throughout the year and you fine tune physical exam skills during those weeks, then 2 week rotations in psych and palliative. You also do some time at Children's clinic but the only acute pain you do is on call (every sixth weekend) unless you're aggressive and try to do more electively. Oh AND the fellowship director is pretty much the best thing about the program - she's approachable, has get togethers at her home downtown and will definitely go to bat for you to get your ideal position. Ok enough gushing about NMH - on my interview trail it seemed another good private practice location was BID: not a strong emphasis on research and a very efficient process for seeing patients - but then you don't get to live in downtown Chicago :) I have also heard that Vandy has great training for private practice but I didn't interview there so that's just the rumor. Rush in Chicago also does a fair number of procedures but again I didn't interview there. Good luck!!
 
I'm a current fellow at Northwestern and can attest to the fact that you will be well prepared for any private practice environment if you train here. The division chief emphasizes efficiency and streamlining the clinic to make it very productive; he previously worked in private practice so he knows how to train you to succeed. There's also ample support staff: 2 MAs, 2 XR techs, a clinic manager, a program coordinator, a research RN who answers patient calls and a PA for med management appointments. Some programs don't even have one XR tech, which blows my mind! There is no waiting around for an hour to present to your attending like at some programs - you're paired with an attending for the day and you see (almost) all the patients and do all the procedures. I'll actually be taking an academic position in California so there are definitely opportunities for research (I mean - Benzon sees patients in clinic two days a week so clearly you have a good contact) but research is not required. The total number of procedures has to be near the top 5%ile in the nation but we're still out of there by 4:30 every day. We do lotssss of WCRF of SI, C/T/L spine and knee (this would be a huge money maker in private practice), conventional RF, lots of ultrasound based procedures (hip, TGN and stellate ganglion blocks - U/S bills exceptionally well for those of you concerned about RVUs) many stims and a fair but not exhausting number of pumps. We even do discos because despite the controversy they have diagnostic value and certain surgeons need them to make a plan for spine intervention in clinically challenging patients.

The majority of your year is in the clinic doing interventions but we have 3 total weeks of rehab throughout the year and you fine tune physical exam skills during those weeks, then 2 week rotations in psych and palliative. You also do some time at Children's clinic but the only acute pain you do is on call (every sixth weekend) unless you're aggressive and try to do more electively. Oh AND the fellowship director is pretty much the best thing about the program - she's approachable, has get togethers at her home downtown and will definitely go to bat for you to get your ideal position. Ok enough gushing about NMH - on my interview trail it seemed another good private practice location was BID: not a strong emphasis on research and a very efficient process for seeing patients - but then you don't get to live in downtown Chicago :) I have also heard that Vandy has great training for private practice but I didn't interview there so that's just the rumor. Rush in Chicago also does a fair number of procedures but again I didn't interview there. Good luck!!



I think there is value in not having an x ray tech. Where I did residency we had a rotation in an asc without an x ray tech. The resident would turn the c arm for the fellow and vice versa. You learn an extra skill. When you go out in private practice you might have an ma turning the scope and you better know how the thing operates.
 
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I will be a fellow next year - I DONT want the X-ray tech doing too much bc I want to learn the flouro.....

Rush is good if you want to be a leader in implantable devices. For that, you are expected to work >80hrs a week during fellowship. It is a surgical fellowship...
 
I think there is value in not having an x ray tech. Where I did residency we had a rotation in an asc without an x ray tech. The resident would turn the c arm for the fellow and vice versa. You learn an extra skill. When you go out in private practice you might have an ma turning the scope and you better know how the thing operates.


I totally agree! I do the fluoro when it's break time for our techs or they have a vacation day... or when i feel like it! Our PD encourages it too. It's a reasonably quick skill to pick up when you have such outstanding XR techs present to teach you the skills as well. We are just so busy I can't imagine not having a tech and having to do it myself every. single. procedure..
 
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